Behaviour change: key to HIV and Aids management

Although Zimbabwe has witnessed a marked decline in HIV prevalence from a peak of 29 to 15 percent since the first recorded case in 1985, it still has one of the highest HIV prevalence in the world. The decline in prevalence is partially attributable to high mortality and to change in sexual  behaviour. A key driver of behaviour change has been that people associated high mortality rates to HIV. This led to reduction of high risk behaviours such as multiple concurrent partners.

A Sadc expert think tank meeting held in Maseru, Lesotho, identified the major key drivers of HIV and Aids. In Zimbabwe, the key drivers are multiple and concurrent sexual relationships, age mixing and incorrect and inconsistent use of condoms. In response to the Sadc resolution, Zimbabwe, through the coordination of the National  Aids Council (NAC) developed and launched the Zimbabwe National Behaviour Change Strategy (2006-2010) in 2006.

The strategy was adapted from the Stepping Stones Approach (A gendered approach) with emphasis placed on individual risk perception and creation of an enabling environment for behaviour change to take place. The programme aims at generating demand for HIV services and commodities and promoting safer sexual practices. The programme was extensively implemented in 26 districts with the support of the Expanded Support Programme and European Union before it was rolled out to cover the whole country with the support of the Global Fund under Round 8 and later under the New Funding Model.

The National Aids Council is coordinating the BC programme through seven implementing partners. The implementing partners, Family Care Trust (FACT), ZiCHIRe, Zimbabwe Aids Prevention Service Organisation (Zapso), Regai Dzive Shiri (RDS), Matabeleland Aids Council (MAC), World Vision and Midlands Aids Service Organisation (Maso) have a strong network of  39 BC officers and 65 BC facilitators that have a reach of  65 districts countrywide. The BC programme carries out activities such as Five week love and respect sessions, video screenings, community sensitisation and mobilisation and demand creation.

The National Behaviour Change Programme (NBCP) which is  coordinated by NAC, is implemented across all the country’s 10 provinces with support of  non-governmental organisations (NGOs) that have been capacity built to address key drivers of HIV. In Zimbabwe, NGOs play a key role in social mobilisation.

Zimbabwe is currently experiencing a mature generalised epidemic which implies that all sexually active people are at risk of contracting it. Within this context, promoting safe sexual behaviour has to be at the heart of HIV prevention in all communities of Zimbabwe. With current national HIV prevalence rate 15 percent, the overall goal of the programme is to reduce the number of newly sexually transmitted infections which is in accordance with the national focus for “Zero new infections of HIV, Zero HIV related deaths and Zero stigma and discrimination”. Prevention remains the pillar of HIV interventions as the emphasis is on closing the tap of new infections.
Given this context the behaviour change programme focuses on reducing key risk sexual behaviours, in particular multiple and concurrent sexual partners, low risk perception as well as other underlying vulnerability factors such as imbalanced gender relations, stigma and discrimination and risky cultural and religious practices.

The Behaviour Change Programme continues to be an instrumental tool in creating demand for the uptake of HIV prevention services in support of the endeavour to reach universal access to HIV prevention, treatment, care and support in the aforementioned areas. District teams continue to strengthen social mobilisation activities on condom promotion, HIV testing and counselling, elimination of mother to child transmission and voluntary male circumcision amongst other HIV prevention strategies.

The Behaviour Change (BC) programme is  driven by 3,000 behaviour change facilitators (BCFs) who are volunteers scattered around the country. These BCFs are community based volunteers who have passion for community work  in particular HIV programmes. They go through an intensive training programme and are regularly supervised to ensure that they deliver quality and factual information. It is advisable to talk to a Behaviour Change Facilitator in your community.

Behaviour change begins with you as an individual.
Stick to one faithful partner
If you have to have sex, use condoms correctly and consistently
Get tested for HIV
If you are on treatment remember to take your anti-retroviral medicine as prescribed, always.