Integrated Regional Information Networks - August 16, 2000

Brash, candid and explicit, in a culture where children and youths may find it difficult to talk to their parents or teachers about sex, they seem to have little problem airing their concerns and attitudes on national television. Issues from AIDS to oral sex are covered on teen programmes such as 'Fresh' and 'S'camto', which deliberately set out to break taboos surrounding public discussion of sex.

"I think it's brilliant," said Judi Nwokedi of Lovelife, a national initiative aimed at awareness and outreach. However Nwokedi, who has helped develop some of the television shows, has reservations with a few of the programmes which now seem to favour titillation above an effective intervention.

"Talk is only a first step towards desired behavioural change," she told IRIN. "Some of these programmes are not located within a broader intervention strategy. They have to be anchored around outreach services," such as condom availability and Lovelife's telephone helpline.

An estimated four million people in South Africa are living with HIV/AIDS - roughly 20 percent of the population - with youths in particular regarded as a high-risk group, especially young women. But in South Africa, where media density is high, analysts argue that a state-driven advertising campaign on AIDS awareness is not enough. "There is so much media it's quite difficult to stand out in the crowd," one specialist said. "If you have a billboard in Johannesburg, you need a hundred to make an impact". But television, which is almost universal in urban areas, is an important avenue for reaching a South African audience.

Nwokedi said Lovelife's strategy was based on the Ugandan model spearheaded by President Yoweri Museveni, one of the few successful AIDS campaigns in Africa, who insisted that stereotypes must be broken through frank discussion. Nwokedi added that Lovelife's method is "not to talk about AIDS but talk taboos" - a more holistic approach to sexual health, which helps tackle the problem of people 'tuning out' when the subject of HIV/AIDS is broached.

"To keep promoting an HIV message and condom message has delivered zero behavioural change in South Africa because of a disconnect between sex and HIV," she said. Instead, the message must be internalised. "Firstly you get people talking", and then as part of that dialogue provide services. Nwokedi stressed that Lovelife's helpline was crucially not just about AIDS, but sex in general.

Warren Parker of the Beyond Awareness Campaign told IRIN that communication strategies in the past have revolved around targeting high-risk groups with messages filled with "imperatives and directives" on safe sex. He said that his research had demonstrated that young people already have a generally good understanding of HIV/AIDS transmission, but that may not translate into a behavioural change.

He pointed out that people do not fit into convenient categories that can be reached by a single slogan. With the AIDS epidemic, "there is space for thousands of messages as every context is different". Instead of the "fear-orientated" campaigns of the past where no solutions were offered, helplines and condom availability are important resources in the fight against HIV/AIDS, and improved sexual health in general. "The thing that drives uptake of condoms is not so much the message, but their availability at the local level," said Parker.

According to a Beyond Awareness Campaign report: "Condoms are widely available although there are still some constraints attached to acquisition and use. Eighty-four percent of respondents report that condoms are 'easy to get hold of'. Confidentiality in acquisition appears to increase chance of acquisition and use, as does the advertising of condom distribution points, and placing of such points in easily accessible places. These conditions are not met in all sites and it appears that condom distribution systems need to be developed more strategically."

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