A Baseline Survey of Multiple and Concurrent Sexual Partnerships Among Basotho Men in Lesotho

This 78-page report, published by the C-Change Program for the United States Agency for International Development (USAID), presents the findings from a baseline survey of multiple and concurrent partnerships (MCP) in Lesotho. The objective of the survey, which was conducted in March 2009, was to collect population-based data related to the MCP knowledge, attitudes, and practices of Basotho men. Participants were 1,643 sexually experienced Basotho males, aged 18–65 years, from 55 urban and rural areas. The survey elicited information on participants' demographic characteristics, engagement in MCP, engagement in transactional and intergenerational sex, and knowledge and practice of HIV prevention as related to MCP. The study found that prevalence of MCP in Lesotho is high with over four in ten Basotho men in the study having more than one sexual partner at the time they were interviewed.

According to the report, most men who engaged in MCP had more than two concurrent sexual partners, and did not engage in MCP for material or status benefits. The three most common reasons for multiple partners were for fun, for company, and to have someone to fall back on. The study found that unmarried, younger,and relatively well-educated men were more likely to have multiple concurrent partners. They also believed that their sex partners have other partners. Condom use was inconsistent in MCP relationships, despite high levels of correct knowledge about HIV, and the fact that most respondents recognised that MCP is an HIV risk behaviour.

The report found that three in ten Basotho men engaged in transactional sex, and that this type of sexual partnership was more common if the relationship was with a casual acquaintance, a friend, girlfriend, or relative. Three in ten men had also engaged in intergenerational sex. It was also found that men who engaged in MCP were more likely to also engage in intergenerational and transactional sex than men who did not have multiple partners.

The study also looked at communication channels for HIV prevention messages, and found that radio was the most frequently used media among Basotho men, and that most men recall radio and television HIV messages. The most common HIV prevention messages they recalled were those that promoted condom use and awareness about HIV/AIDS.

The report suggests that in designing media campaigns, messages do not need to concentrate on the protective benefits of condoms or the dangers of MCP, per se, and recommends more nuanced messages that discuss the need to use condoms with steady partners, the high risk when MCP and intergenerational sex are combined, and the need to balance having fun with the risks associated with MCP. In addition, the study recommends increasing awareness of where men can obtain condoms, as well as encouraging the practice of carrying condoms, as this may be a cause of the relatively inconsistent condom use. According to the authors, men recall relatively few messages about abstinence, being faithful, or the benefits of HIV testing, so more messages on these topics may be beneficial. Also, since the priority audience (men aged 18-35) generally has at least some education, print media as well as radio and television may be effective communication tools. Since the study also found that there is relatively little reluctance to discussing HIV among peers, the use of interpersonal channels may also result in effective behaviour change communication.