One-on-One Communication for Risk Reduction: A Tool for Working with Girls and Boys 12 – 17 Years Old

This communication tool was developed by FHI360 as part of the Basha Lesedi project, which worked to reduce HIV infection among youth ages 10-17 through evidence-based interventions that engaged individuals, families, communities, and institutions. Funded by the Centers for Disease Control and Prevention in Botswana (BOTUSA), the Basha Lesedi Project (BLP) was a 5-year programme led by Family Health International (FHI 360) in partnership with Botswana Network for AIDS Service Organisations, Botswana Network for People Living with AIDS, Botswana Christian AIDS Intervention Programme, Makgabaneng, Humana People to People, and Stepping Stones International.

The tool is designed to be used in one-on-one communication sessions with youth ages 12-17 to raise their awareness of HIV risks and to promote the adoption of risk reduction behaviours to avoid HIV, sexually transmitted infections, and pregnancy. This tool provides a step-by-step process for behaviour change and was developed to be used by any organisation with field staff trained in interpersonal communication for HIV prevention. The behaviours addressed within this aid are: delayed sexual debut/abstinence, multiple concurrent partners/faithfulness, condom use, alcohol and HIV, intergenerational sex, and transactional sex.

Funded by the United States Centers for Disease Control and Prevention (CDC) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the guide is comprised of five sections, including an introduction. The sections build on each other and should be conducted over several sessions, depending on the young person's availability.

• Section 1: Introduction - This section provides a script that field staff can use to introduce themselves to a young person.
• Section 2: Getting Started - Field staff are guided as to how to assess a young person's knowledge of HIV, AIDS, pregnancy, and prevention and to convey accurate information on these subjects.
• Section 3: Risk Assessment - Field staff use picture-based scenario cards to assess a young person's level of understanding of the various risky behaviours associated with HIV and pregnancy. There are gender specific scenario cards for delayed sexual debut/abstinence, multiple concurrent partners/faithfulness, condom use, alcohol and HIV, intergenerational sex, and transactional sex.
• Section 4: Risk Reduction Plan - Field staff are provided with questions that will help a young person consider his/her level of risk. Based on the responses, an individualised Risk Reduction Plan is developed.
• Section 5: Role Plays - There are 3 steps in this section:
  1. "Using the questions provided field staff should ask the young person to consider the challenges he/she may face in adopting a behavior. Also included are tables of potential challenges for each behavior [e.g., delayed sexual debut/abstinence] and ways to overcome these challenges.
  2. The field staff should conduct role plays with the young person.
  3. At the end of the session field staff should show the young person the commitment card and explain its purpose."

"Within a month of completing the session with the young person, field staff should visit the person again to see if he/she has been able to keep their commitment and to offer support and guidance, as needed."