1. Washington D.C., USA, 22-27 July 2012www.aids2012.org Presented by:Lesego Busang(ACHAP) Onkemetse C. Ntsuape(MOH) EVALUATION OF SMC SHORT TERM COMMUNICATION STRATEGY - BOTSWANA ACHAP Symposium - International AIDS Conference Washington DC, USA 23 rd July 2012

2. Washington D.C., USA, 22-27 July 2012www.aids2012.org Introduction - Overview SMC Adopted as HIV prevention add-on strategy 2009 STCS Implemented since 2009 Evaluated in September/October 2011 –Inform LTCS development –Baseline Collaboration between MOH, ACHAP and PSI

3. Washington D.C., USA, 22-27 July 2012www.aids2012.org Methodology Cross-sectional study (September/November 2011) Quantitative –2,973 males and 375 females aged 15-49 years Qualitative approaches –Focus group discussions (35 FGD’s) –Key Informant Interviews (32 KII) Basis of sampling was 2011 Census Sampling Frame ensuring: –Urban/Rural, geographical and circumcision prevalence representation Hence 7 health districts were sampled

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5. Washington D.C., USA, 22-27 July 2012www.aids2012.org SMC helps reduce the chances of HIV infection (All FGD’s)  * It reduces infection rate but doesn’t mean that you won’t get infected with the virus. (Gaborone females) SMC promotes hygiene (All FGD’s)  I take it that circumcision helps one be clean; foreskin accumulates dirt and other diseases (Kweneng females)

6. Washington D.C., USA, 22-27 July 2012www.aids2012.org Excessive bleeding – * I take it that if you cut someone’s foreskin what comes to mind would be ‘what if I lose a lot of blood and die?’ and the pain, so these things discourages them to go and circumcise. (Females FGD)

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11. Washington D.C., USA, 22-27 July 2012www.aids2012.org Recommendations Strive to achieve high levels of correct knowledge. Develop targeted messaging for identified gaps; ie for concerns on “pain/complications” and “believes” Use circumcised men to respond to perceptions on pain. Educate communities on use of local anesthesia to address pain. Explore use of non-surgical devices; ie PrePex. Increase use of interpersonal communications. Promote other SMC benefits such as cleanliness. Develop/customize messages to local context. Strategically assign mobilizers to communities. Empower leaders on SMC facts ( buy-in and cultural concerns ). Pilot materials extensively before roll out.

12. Washington D.C., USA, 22-27 July 2012www.aids2012.org Credits and Acknowledgements: Health Education Officers Districts Health Management Teams Community leaders Study Participants THANK YOU

13. Washington D.C., USA, 22-27 July 2012www.aids2012.org Evaluation Objectives Establish the extent to which the objectives of the STCS were met; ie establish if –the general public is informed about the Government of Botswana/Ministry of Health/ position on SMC as an HIV prevention strategy. –men currently seeking SMC services at health facilities have adequate information on SMC –service providers at health facilities and the media personnel have capacity to disseminate and report correct and accurate messages on SMC and HIV prevention to the general public. –political and social leaders at all levels advocate for SMC. –SMC stakeholders effectively communicate facts on SMC in line with the SMC short term communication strategy. Provide a baseline levels for the role out of SMC in Botswana Provide Knowledge, Attitudes and Practice (KAP) levels.

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18. Washington D.C., USA, 22-27 July 2012www.aids2012.org Conclusions Cont. Generally the higher the knowledge levels the better the results;, regardless of whether the knowledge is on a negative factor or not; ie NO KNOWLEDGE of HCT as a requirement for SMC did not have negative impact on SMC uptake. –It is important to increase knowledge across all SMC facts. –Hence strive to achieve high levels of correct knowledge (deemed positive or negative knowledge), to take advantage of positive outcomes brought about by higher knowledge. Fear for pain/complications/death is a key challenge that needs to be addressed. Interpersonal communications are important vehicles for SMC message delivery and motivators to SMC. –However radio provides the best coverage. Community leaders are willing to mobilize for the program but are not empowered.

19. Washington D.C., USA, 22-27 July 2012www.aids2012.org SAMPLE SLIDE 2 Speaking at AIDS 2012 What to think about? –Keep it simple –Larger text is easier to read –Single words rather than sentences Bullet points are there to remind you, not to tell the whole story

20. Washington D.C., USA, 22-27 July 2012www.aids2012.org SAMPLE SLIDE 3

21. Washington D.C., USA, 22-27 July 2012www.aids2012.org SAMPLE SLIDE 4 Credits and Acknowledgements List credits and acknowledgements –Insert organization credits acknowledgements as opposed to individuals –Insert Organization logo’s where required and with the permission of the organizations being acknowledged.