Placement: Reach Out, Kampala, Uganda
Project Title: A Group Intervention for Risk Reduction
with Discordant Couples: A Facilitator’s Manual.
Abstract:
In a recent national survey, the Ugandan Ministry of Health
found that around 50% of all married HIV positive individuals are
living with an HIV negative spouse. With consistent exposure to
the virus, negative spouses in discordant couples are at an extremely
high risk of infection. A study in Rakai found that as much as 12%
of negative partners in discordant couples seroconvert in a year.
For community organizations trying to prevent the spread of HIV,
targeting this high-risk group is crucial.
Since learning of the prevalence of HIV-discordance, organizations
throughout the country have been struggling to devise workable programs
for discordant couples. However, targeting these couples has proven
challenging. A sizeable portion of the work is consumed by simply
relating knowledge to the couple, such as convincing them that discordance
is actually possible. But working with couples also involves talking
about things like relationships, communication and long-term planning.
Because of this, an intervention with discordant couples must be
fluid and multi-dimensional, addressing the couple from emotional,
intellectual and logical standpoints. This can be a challenging
task for small organizations with limited resources.
This manual aims to provide a template for organizations wishing
to address discordant couples’ issues. As organizations incorporate
this intervention into their larger programs, it is important for
all service providers to be knowledgeable about discordance and
to address the primary challenges faced by these couples. With this
manual, we hope to standardize the messages being disseminated to
discordant couples and the community at large.
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