South Africa’s high HIV prevalence has been described as the biggest challenge facing the country since apartheid. In light of this, one would expect to be bombarded with Aids-prevention messages on radio, television, billboards and bus stops. Yet some say that not enough of these messages are available.
The Khomanani: Caring Together for Life campaign is the government’s main communication initiative on HIV/Aids. Its aim is to spread knowledge about HIV and shape attitudes towards Aids through radio, television and newspapers, as well as through large meetings and public events. (Khomanani is a Tsonga word meaning “caring together”.)
The campaign received a substantial budget from the government — of just more than R165-million for the 2004-to-2006 period. Yet, the 2005 South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey — one of the highest-rated HIV/Aids research reports in the country — showed that of all the Aids information campaigns under way, Khomanani reached the fewest people.
Only 33,8% of teenagers aged between 12 and 14, and 46,7% of young people between 15 and 24, were aware of the campaign, according to the survey. For those aged 25 to 49, the figure was 41,7%.
The United Nations Joint Programme on HIV/Aids puts adult HIV prevalence in South Africa at 21,5%.
“The fundamental problem is that [the government’s] communication on HIV reflects the overall failure to treat this as an issue that requires national mobilisation and effort,” says Neva Makgetla, head of the policy unit at the Congress of South African Trade Unions — and one of the most vocal critics of the official Aids communication strategy.
“We would expect that the country would be inundated with information about the epidemic, including efforts to end stigma, promote safe sex and understand treatment options,” she says. “Instead, we see only occasional ads and virtually no other use of the media such as placing columns or interviews — or distribution of educational material.”
These sentiments are echoed by Nathan Geffen, spokesperson for the Treatment Action Campaign, a non-governmental group that lobbies for greater access to anti-retroviral drugs (ARVs). He says the substance of Khomanani’s message is acceptable, “but there isn’t enough of it. These adverts should be running on most radio and television stations continuously, every day.”
Even more importantly, he says, high-level officials need to become more vocal about safe sex and ascertaining HIV status — something that would not cost a cent.
“We need President [Thabo] Mbeki and Minister [of Health Manto] Tshabalala-Msimang to go on radio and television every day to encourage people to get tested and, if necessary, treated. They should also be encouraging people to use condoms if they have penetrative sex,” says Geffen.
Mbeki and Tshabalala-Msimang have both been accused of fuelling the spread of the pandemic by questioning the safety of ARVs — and entertaining claims that HIV does not lead to Aids.
Making a difference
But can the type of wall-to-wall Aids messaging that Makgetla and Geffen advocate — and media coverage in general — really make a significant difference in the fight against HIV?
Research done last year indicated that the media had virtually no effect on behaviour related to the spread of the disease — and that more emphasis should be placed on face-to-face programmes, such as those in clinics and youth centres.
However, the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey found that of those who were being reached by the campaigns, a large proportion saw the information as useful.
The survey also noted that work still needs to be done in reaching rural areas and informal settlements. As newspapers and television sets are luxuries in many South African homes, radio remains an important means for communicating with such audiences.
loveLife, South Africa’s best-funded campaign, receives just less than R26-million a year from the government — and eight times that from other sources such as the Global Fund to Fight Aids, Tuberculosis and Malaria, and the Kaiser Foundation, a non-profit group that concentrates on health issues. The youth are the focus of this initiative.
David Harrison, CEO of loveLife, says the campaign has tailored its communication strategy to make the most of the magazines, and the television and radio outlets that are supported by young people.
loveLife produces weekly radio programmes on South Africa’s most popular youth radio stations, for instance, and works with other stations to ensure that anti-Aids messages are communicated in all 11 official languages. About 72% of young people aged 15 to 24 are aware of loveLife, according to the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey.
However, Makgetla pays this figure scant attention.
“It [loveLife] sets up reference teams of hand-picked individuals, rather than engaging with broader organisations,” she says, noting that civil society groups should be among those consulted.
The advertisements of loveLife can be unclear, Makgetla adds, a criticism also heard elsewhere.
Angie Dlamini, a teenager from Soweto, says the messages confuse her: “People in the ads look cool. They don’t seem to have anything to do with Aids.”
Geffen agrees, saying of loveLife’s messages that they are “too obscure and insipid”.
The government also funds a number of other campaigns, such as Soul City, which uses television and radio dramas to warn people about HIV (the remaining initiatives are run by NGOs).
The South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey noted that awareness of Soul City — the longest-running campaign, operating since 1992 — was the highest across all age groups.
“No campaign or programme has exclusive reach into any particular audience and there is clearly a high degree of overlap,” the report said.
On World Aids Day, December 1, a campaign of a different sort was launched, backed by trendy radio station Metro FM. Flighted on television and in newspaper advertisements, the campaign uses reverse psychology.
“Don’t use a condom — increase your chance of contracting HIV/Aids,” it states, while presenting real people who are HIV-positive to make the point about how dangerous unprotected sex can be. — IPS
The South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey was commissioned by the Nelson Mandela Foundation