O Icheke National Campaign Plan - CONCURRENT SEXUAL ...

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National Campaign Plan: Multiple Concurrent Partnerships32goal areas are: (1) Prevention of HIV infection through Behaviour Change Intervention Communication(BCIC) / Information, Education, Communication (IEC), Condom Distribution, Prevention of Mother to ChildTransmission (PMTCT), Treatment of sexually transmitted infections (STIs), Vaccine Trials, HIV Counsellingand Testing (HCT), and Community Mobilisation, (2) Provision of care and support through access to AntiRetroviral Therapy (ART), Community Home Based Care (CHBC), Orphan Care and Support Groups forPeople Living with HIV/AIDS (PLWHAs), (3) Strengthened management of the national response to HIV/AIDS, (4) Psychosocial support and economic impact mitigation and (5) Provision of a strengthened legal andethical environment.A Mid Term Review (MTR) was conducted in August 2007 of the NSF to measure progress and assess futureattainment of the five key goal areas. One of the major key recommendations was the need to increase preventionefforts in Botswana. In response to the MTR, NACA developed a roadmap for expanding the preventionresponse and led the development of the “National Operational Plan for Scaling Up HIV Preventionin Botswana” to support the Government of Botswana’s goal of Zero new infections by 2016. The NationalPrevention Plan called for a National Prevention Campaign, with the first outlined strategic communicationcomponent to focus on reduction of multiple concurrent partnerships.NACA and development partners (BOTUSA, ACHAP, UN & others) in recognition of the critical cornerstoneof prevention in decreasing HIV prevalence engaged in several conversations through The UN SecretaryGeneral’s Task Force on Women, Girls and HIV/AIDS Botswana Country Report (2004), the First NationalPrevention Workshop (2005), SADC Prevention Think Tank (2006), National Strategy for Behaviour Change(2006) and finally development of the National Operational Prevention Plan (2008).The National Operational Prevention Plan outlines intervention methods to achieve significant and measurableprogress towards “Zero New Infections” as described in Vision 2016. One of the key interventions outlinedwas strategic communication to prevent sexual transmission based on understanding key determinantsof sexual transmission. The National Prevention Operational Plan calls for a high-profile BCIC campaignspecifically focusing on the acknowledged drivers of the epidemic, initially targeting multiple concurrentpartnerships. The Mid Term Review of the National Strategic Framework recommended that such a campaignfocus specifically on young people and socio-cultural constructs related to gender, sex, and sexuality, usinginnovative communication channels.
National Campaign Plan: Multiple Concurrent Partnerships33Annex 2. MCP AND HIV RISKSouthern Africa is the region in the world worst-affected by HIV/AIDS: all the highest HIV prevalence countriesare in this region. Comparison of HIV prevalence with sexual behaviour indicators made it clear thatage of sexual debut, lifetime number of sexual partners and rates of condom use could not explain the globaldistribution of HIV infections. The focus shifted to the pattern of sexual partnerships, rather than the overallnumber of sexual partners as the driver of HIV transmission. The premise that the pattern of sexual relationshipsdrives sexually transmitted infections (STIs) is not a new one, and social networks in relation to STIshave been studied for over 20 years. However, it is only in recent years that it has gained widespread credibilityand acceptance as an explanation of high HIV rates in Sub-Saharan Africa.There are two key reasons why communities where MCP is common experience wider and more rapid HIVtransmission than communities where serial monogamy is the norm: the ‘network effect’ and viremia or theacute infection phase of HIV. These factors are explained in more detail below.The Network EffectA person’s sexual network includes all the people she or he is linked with over a relatively short period oftime through sexual partnerships. This includes his or her own sexual partners, their sexual partners, theirpartners’ sexual partners, and so on. The more men and women in a society have more than one partner, themore people in the network become linked to each other. Conversely, the more men and women in a societyhave only one partner at a time, the fewer people in the network are linked.Figure 2-1 Dense Sexual NetworkFigure 2-2 De-linked Sexual NetworkFigures 2-1 and 2-2 above contrast two ways in which 18 individuals might be linked by their sexual networkat a particular point in time. In Figure 2-1, although half the people have only one sexual partner, all but twoof them are linked to each other; in Figure 2-2, where each person only has one partner, they are not linkedto anybody but that partner.
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