South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008: The Health of Our Children

This 104-page report presents research findings from a population-based household survey that explored the general health status of infants, children, and adolescents in relation to the HIV epidemic in South Africa. Focus areas included morbidity, utilisation of health facilities, immunisation coverage, HIV status, and associated risk factors. The study also presents data on male circumcision and the acceptability of the practice, and investigates the exposure of children and adolescents to HIV communication programmes.

The present summary focuses on the latter, communication-related findings of the survey - the results for which begin on page 39 of the report. The reader learns that, in South Africa, a wide range of communication media include HIV/AIDS content. This includes news coverage and feature programming and articles, as well as the content of AIDS campaigns. Table 4.17 (page 40) shows media sources that were found useful for improving the understanding of HIV/AIDS. In short, the majority of children 12-14 and 15-18 years of age were exposed to communication about HIV/AIDS that was perceived to be useful. Television and radio were the most prominent media sources for those 12-14 years of age, while television and posters were most prominent for those 15-18 years of age. Newspapers and magazines were mentioned least often by both age groups. Data on language are presented only for teenagers in the 15-18 age group; Afrikaans and Tshivenda home-language speakers had lower mention across the range of communication channels in comparison to other language groups.

As detailed here, AIDS communication programmes at the national level use a range of South African languages to reach audiences, and include the government's Khomanani Campaign as well as non-governmental organisation (NGO)-led programmes such as Soul City, Soul Buddyz, and loveLife. These 4 main national programmes involve activities that include mass media, small media such as leaflets and posters, and events and other interactive activities. Soul Buddyz and loveLife are specifically oriented toward children and adolescents, whereas Khomanani and Soul City include youth as an intended audience. The majority of respondents 12-14 and 15-18 years of age were aware of the major national programme, with the exception of Khomanani in the younger age group (only half were aware of the programme). Table 4.20 on page 42 shows awareness of the national programmes by race. In short, among those 12-14 and 15-18 years of age, awareness was very low among white youth.

Table 4.21 on page 43 shows sources of information about HIV/AIDS that were useful to youth in the year prior to the study. Parents or caregivers were most likely to be mentioned by those 12-14 years of age, followed by friends and health workers. Among those 15-18 years of age, friends had the highest mention, followed by parents or caregivers, and health workers. Among both groups, traditional healers and telephone helplines achieved the lowest mention. With regard to HIV/AIDS activities engaged in during the year prior to the study (table 4.22), participation was found to be low overall - with the exception of attending an AIDS-themed play or an educational event, which was 4 times more likely to be mentioned than any other categories.

The following section explores communication and knowledge about HIV/AIDS-related issues. In short, there was very low overall communication about sex and HIV prevention/transmission by caregivers in the 5- to 11-year-old age group; however, sexual abuse was discussed with the majority of children in this age group. Among the 12-14 year old age group, sex was more likely to have been discussed with female children than male children, as was the case with sexual abuse. Overall, though, only half of the parents/guardians had spoken to children in this age group about sexual abuse.

A summary of the recommendations outlined in the report related to media and communication include:

• Communication campaigns need to conduct research among children to establish gaps and needs in relation to HIV/AIDS communication.
• The Khomanani campaign should include a strategy that is specific to reach children to communicate age-relevant information about HIV/AIDS via mass media channels. Content should be determined through a needs analysis and should take into account the need to complement information delivered through schools. This should include an emphasis on child sexual abuse and the rights of children.
• All national programmes should coordinate their efforts to reach rural communities to a greater extent, and also address the marginalisation of language and race groups identified in the study.
• The national toll-free AIDS helpline is a well-established resource that is under-promoted, and all programmes should actively seek to obtain high awareness of the number and encourage its use.

Editor's note: The 2 principal investigators and co-principal investigators' names are listed above. They are part of a larger research consortium which contributed to this report. These personnel were located at various organisations, including the Human Sciences Research Council (HSRC), Medical Research Council (MRC), Centre for AIDS Development, Research and Evaluation (CADRE), National Institute for Communicable Diseases (NICD), the Centers for Disease Control and Prevention (CDC), and the United Nations Children's Fund (UNICEF), among others.