Population Council Research that makes a difference

Mutual monogamy constitutes an integral part of the President’s Emergency Plan for AIDS Relief (PEPFAR) balanced "ABC" strategy for HIV prevention: abstaining from sex (A), being faithful or practicing mutual monogamy (B), and using condoms (C). But there has been little research on interventions to promote mutual monogamy.

To address this gap, Horizons initiated a partnership with the Eastern Cape Provincial Council of Churches, with the support of the South African Council of Churches, to implement a project that is aimed at exploring and increasing the involvement of faith-based organizations (FBOs) in HIV prevention activities, with a particular emphasis on the B component.

The study took place in two sites in South Africa's Eastern Cape, Alice and Butterworth. The main objective of the study was to develop and evaluate an FBO-based intervention package designed to promote mutual monogamy among church members in the two sites. In addition, the study built the capacity of service providers and program managers of two FBOs—Butterworth HIV/AIDS Ministry and Alice Hospice—to deliver mutual monogamy–related programs and services to church congregations in their localities.

The study was conducted in three phases. The intervention development phase (Phase I) consisted of (1) formative research to guide the development of the intervention; (2) development of the mutual monogamy intervention activities; and (3) pre-testing of the intervention package. Phase II entailed piloting the pre-tested intervention in four churches to determine acceptability and feasibility. Phase III consisted of using the lessons learned from the pilot to implement the intervention in a larger number of churches and conducting operations research to evaluate its effectiveness, acceptability, feasibility, and sustainability.