a nation at war with hiv&aids national hiv/aids campaign to reduce multiple concurrent...

A NATION AT WAR WITH HIV&AIDS

NATIONAL HIV/AIDS CAMPAIGN TO REDUCE MULTIPLE CONCURRENT

PARTNERSHIPS IN SWAZILAND

Washington DC. USAOctober 2008


ANC Prevalence

NATIONAL PREVALENCE

16

2631.6

34.238.6

42.639.2

05

1015202530354045

94 96 98 0 2 4 6

HIV Prevalence Rates among the Population Age 15-49 by Sex (DHS)

26

20

31

Total Women Men

Percent HIV positive among population age 15-49

HIV Prevalence among Population Age 2 and Older by Age and Sex (DHS)

46

38

2

24

28

49

4

3

10

38

710

22

5

6 5

2

12

28

40

28

1317

28

45

44

2-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+

Female

Male

Percentage HIV positiveSwaziland DHS 2006-07


Recognizing The Problem

• Sex is the driver of the epidemic

• Societal norms/value changes

• Multiple concurrent partners very common

• Intergenerational sex a reality

• Gender inequity

• It is common practice especially among males to have MCP


Objective & Principles

BCC objective:

Cause for social movement for behaviour change

Principles:• Evidence driven • Clearly defined targeted audience• Local socio-cultural context• Commercial approach

BCC CAMPAIGNS

• 2002/3: 1st – Leadership campaign – “I HIV yindzaba yetfu sonke” (HIV is everybody’s problem)

• 2004/5: 2nd – Individual/personal focus – Likusasa ngelami (the future is mine)

• 2006: 3rd – MCP -Makwapheni (secret lover)

• 2007: 4th – Ngitawutfolani (you can get HIV)


Formative Assessment

• Reviewed literature on drivers of the epidemic with a focus on MCP

• CIET study of 2005

• FDGs conducted to define what concurrency and MCP is, define target for the campaign and

• Interviews conducted on general public using a questionnaire


Strategy

• Within the broader framework of the Likusasa Ngelami campaign, the national MCP was initiated campaign targeting sexually active adults, including youth, to stop the practice of multiple sexual partnerships. The campaign, titled “MAKHWAPHENI UYABULALA”, seeks to draw attention to the dangers of practicing multiple concurrent partnerships.


Strategy

Campaign objectives

• To encourage positive and responsible sexual behaviour.• To discourage multiple concurrent sexual partnerships

among sexually active adults, including youth.• To influence public debate on the issue of multiple

concurrent sexual partnerships• To encourage sexual active persons to reduce sexual

partners.• To encourage faithfulness among partners.



‘MAKWAPHENI’

(THE SECRET LOVER-MCP 3rd campaign)

• Targeting sex with m.C.P.• ‘Makwapheni uyabulala’• TEXT / VOICE MESSAGE CONCEPT

(cell/mobile phone)• ‘Temptation’• ‘Consequence’• ‘The fear factor’• Radio main medium• Supported by print media


‘MAKWAPENI CAMPAIGN’


PHASE 3 ‘A DECISION’

• SAME MESSAGE CONCEPT

• ‘TEMPTATION’

• ‘POSITIVE RESOLUTION’

• ‘THE FEAR FACTOR’


DECISION TO CHANGE


COMMUNITY CAMPAIGN‘LIKUSASA’

‘KUDLA’ INHLOKO’ DRAMA


EVALUATION OF THE CAMPAIGNS

BY CIET

• 12 sites (random sample, stratified U/R)

• 2120 adults (July 2005) and 2112 (July 2006) interviewed households

• Average age 28 years (both cycles)

CIET


2006: Exposure to Makhwapheni (“secret lover”) campaign

(% who answered yes)

78

72

84

91

86

60 70 80 90 100

could change your behaviour

can campaign impact AIDS

associate makhwapheni w. AIDS

agree with messages

heard about campaign


Subjective Norms: “People around here think it’s okay to

have” (in %):

14

11

19

15

0 5 10 15 20

a lishende

casual sex

20052006


Attitudes: “I think it’s ok to have” (in %):

5.3

5.5

17

6.4

6.9

21

0 5 10 15 20 25

a lishende

casual sex

sex withteenagers

20052006


Intentions… (in %)

9

5.5

12

7.3

0 5 10 15

intend tohave

multiplepartners

would notchange mybehav. if

HIV+20052006


Practices:

37

9

32

16

0 10 20 30 40

no other partner in last6 months

2 or more partners inlast 4 weeks

20052006

MCP campaign Outcomes/Achievements

• National dialogue created by the campaign

• Suggestive changes in attitude/norms and behaviour

• Media leadership embraced the campaign


Achievements

Buy-in from the media in support of the campaign resulted in widespread debate that was not driven by financial support.– Print media published opinion polls on people who

agree or disagree with the campaign issues. – News and current affairs on radio and television

voluntarily opened the matter to public debate.


Challenges

• Inadequate interpersonal communication platforms to reinforce the mass media component.

• Men forums (Sidla Inhloko) were unable to reach many communities at a time.

• There were also no established forums for other risk groups, including men in urban settings and women and girls.


Challenges

• The campaign was not adequately mainstreamed into various key sectors for further exploration of issues; notably Faith Based Organisations, Private Sector, Traditional Sector and Civil Society.


Challenges

• Mass media campaign relied on short and transient messages – which only spark interest and create awareness but are not to explore issues in-depth.

• However, there were radio talk shows which proved to be effective judging the number of listener responses (telephone, sms, letters).


•Advertising campaign relied on advertisements – short and transient messages – which only spark interest and create awareness but are not to explore issues in-depth. However, there were radio talk shows which proved to be effective judging the number of listener responses (telephone, sms, letters).

Lessons learnt

• Importance of inclusive planning with other sectors - The civil society was not included in the planning stages of the campaign hence the campaign was felt to be stigmatizing PLHIV and negatively directed to other groupings which was unintended and regrettable .


Recommendations/Next Steps

• Inclusive planning is important • Inclusion of Interpersonal communication is

important to ensure sustainability• Mainstreaming campaign at all levels and all

target age-groups• Follow-up campaign to ensure constant

reminder of the messages• Importance of assessments & evaluations before

and after mounting campaigns



CONCLUSION

• HUGE NATIONAL DEBATE PRECIPITATED

• > 90% AWARENESS OF CAMPAIGNS

• >80% UNDERSTOOD THE MESSAGE

• PARTNER REDUCTION - SUSTAINABLE???

Thank You


a nation at war with hiv&aids national hiv/aids campaign to reduce multiple concurrent...

Documents

population age

hiv yindzaba yetfu sonke

sex dhspercent hiv positive

commonintergenerational

hivaidsanc prevalence

hivaidshiv prevalence

urbanrura prevalence

leadership campaign