Dusani Bagatiseng (L) with Modise Tuelo and Florah Marope (R)
Florah Marope, aged 40, is a leader of a support group that is changing lives the hard way: by trying to get people to talk about the risks of multiple concurrent partnerships, and encouraging them to change their behaviors. Florah, who is HIV positive, says that when she found out that she was infected, she learnt about “positive living” from a counsellor. She discovered that in order to take care of herself she would have to eat healthy, refrain from having unprotected sex and from having more than one partner. Florah changed her behaviour but did not stop there. She took initiative and became the leader of the support group, which currently has 12 members. Florah’s story is being repeated all over Botswana through dozens of community-based interventions implemented, managed and monitored by Population Services International/Botswana (PSI/B) with funding from the CDC/BOTUSA.
Multiple concurrent Partnerships have been identified as one of the factors escalating the spread of HIV infections in Botswana. In 2007, 17.5% of men and 17.4% of women aged 15-34 years reported being engaged in MCP. So great is the causal link that it has prompted the Government of Botswana through the National AIDS Coordinating Agency (NACA) to mobilise partners to formulate a national strategic response to the issue. The national campaign was launched by NACA on the 5th March 2009 with the well-known “O Icheke” campaign. PSI also implements interpersonal outreach activities at local level with its partners which it trains to carry out the interventions at grassroots level. One such partner is Humana People to People (HPP), an outreach organisation which uses field agents to carry out IPC interventions.
Between January 2009 and July 2010, HPP trained 35 IPC agents and a total of more than 51,000 people were reached in ten districts with interventions that range from large-group “MCP awareness sessions” to small group and one-on-one personal risk management sessions. Dusani Bagatiseng, aged 23, is a field agent trained by HPP to carry out interventions in Mogoditshane, and he has been passing on the knowledge he gained from HPP to the members of the Bophelo Support Group. Dusani has been able to help Florah and her team by educating her members using the MCP flipchart and other innovative interpersonal communication tools.
But bringing about change with interpersonal MCP communications campaigns are not easy. In her work, Florah quickly realised that not everyone was able to accept their status with the same ease as she did. “Some of the member of my group struggle with accepting their status and therefore resort to even riskier behaviours like MCP, drinking and refusal to take treatment,” explains Florah. Without formal training, Florah was unable to properly educate the members of her support group.
“Dusani has really helped our group which really needed someone to encourage and guide it,” says Florah. When faced with issues like MCP, Dusani was able to educate members of the group in ways Florah could not. “Dusani showed us on the flipchart how quickly HIV spreads through a network how one gets affected even by having two partners, then it becomes real as they visualize it,” explains Florah. As a result, “some of the members in my support group were eventually able to reduce their number of partners and remain with just one.”
One such member is Modise Tuelo, aged 48. Also living with HIV, Modise used to engage in MCP on a regular basis. When he first joined the group, Florah told him about the importance of changing his behavior but the message did not stick until Dusani showed him the simple yet innovative MCP flipchart developed by PSI and its field teams. Another tool used by field teams is the MCP flanellogram, an interactive tool that uses characters to demonstrate how a network is constituted and how HIV spreads through networks. As the IPC agent teaches the group he invites them to participate through pasting characters on the flanellogram and the arrows which show which way transmission will go in a network, this way people feel involved during the session. “I could actually see how I was putting myself at risk and those around me and this made me evaluate my behavior and eventually led to me only having one partner at a time,” says Modise. The support and motivation he received from Florah and Dusani convinced him to stick to one sexual partner.
One of the BOFWA Peer educators demonstrates how HIV spreads in a network using a flanellogram.
Many similar success stories are taking place all over Botswana. Through active partnership and capacity building, community-based organisations are at the forefront of combating the spread of HIV which has devastating health and economic effects.
For more information, contact Botho Tlhobogang, PSI/B Corporate Affairs Coordinator: [email protected].
For more information on PSI/Botswana online, please go to staging.psi-2017.flywheelsites.com/botswana
