CHILD AND YOUTH LEADERSHIP CAMPS

Project Activity Report January 2014

Global Camps Africa

Submitted June 6, 2014

Acknowledgements Global Camps Africa would like to express sincere thanks to all parties involved in this activity, organizations that sent children to the camps, parents, chaperones, Pact South Africa, and United States Agency for International Development/Southern Africa Health Office.

This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of Contract No: 027C0086 with Pact. The contents are the responsibility of Global Camps Africa and do not necessarily reflect the views of USAID or the United States Government.

Table of Contents Executive Summary ...... 1 1. Project Background ...... 2 1.1 Introduction to Global Camps Africa ...... 3 1.2 An ‘Intentional Camp’ Approach ...... 3 1.3 Pre-Camp Counselor Training ...... 5 2. Youth Leadership Camps ...... 6 2.1 Camp Curriculum ...... 6 2.2 Highlights of Camper Experiences ...... 10 3. Pre and Post-Camp Assessment and Results ...... 12 3.1 Participant Profile ...... 13 3.2 Knowledge, Attitudes, and Beliefs ...... 14 3.3 Goals, Hope, and Resilience (State of Mind Scales) ...... 19 4. Challenges and Recommendations ...... 22 5. Potential for Future Camp Activities ...... 26 6. Conclusion ...... 27 Annex I: USAID Partners ...... 28 Annex II: Personal Development Plan Guidance ...... 29 Annex III: Camp Schedule ...... 32 Annex V: Pre and Post-Camp Survey Questions ...... 33

Acronyms

AIDS Acquired immune deficiency syndrome CYCW Child and Youth Care Worker HIV Human immunodeficiency virus KZN KwaZulu Natal OVC Orphans and vulnerable children OVCY Orphans and vulnerable children and youth PLWHA People living with HIV/AIDS USAID/SA United States Agency for International Development/South Africa

Executive Summary

In December 2013, the United States Agency for International Development (USAID)/Southern Africa contracted Global Camps Africa to design and implement a Youth Leadership Camp curriculum targeting vulnerable children and youth. The Youth Leadership Camps focused on the specific needs of vulnerable children and youth to develop skills for healthy living and smart decision-making. Camp activities center on promotion of resilience for participants who have faced adversity in their lives, as well as to build capacity to address and deal with their daily needs and challenges. This USAID-funded project aimed at enhancing personal development for a targeted group of young people by addressing their specific needs and challenges and presenting these issues with awareness of the obstacles between them and a healthy, productive adulthood. The innovative approach Global Camps Africa brings to youth development and HIV prevention through specialized training and ‘intentional camp’ design provides a safe, positive environment of trust and acceptance where children gain self-esteem, have fun, meet other children in similar situations, and leave with the skills to help create a better future for themselves and their families. Global Camps Africa changes the lives of South Africa’s vulnerable children and youth by providing HIV and AIDS prevention education and training through high-impact residential and day camp experiences and continuing education, equipping young people with the life skills that will support them in becoming safe and productive adults who have hope for the future. Since 2004, Global Camps Africa has served more than 6,500 South African youth, working closely with local partner, Camp Sizanani Life Skills, to promote new skills, maturity, and independence in vulnerable children and youth. In January 2014, Global Camps Africa and Camp Sizanani reached 452 children and youth from eight of South Africa’s nine provinces through seven residential Youth Leadership Camps. Camp participants were comprised of children and youth that had participated in community development initiatives carried out by USAID implementing partners. During each camp, participants completed a pre and post-designed to assess knowledge, attitudes and beliefs about HIV and AIDS, as well as investigate participants ‘state-of-mind’ about goals, hope, and resilience. At the end of the camp, HIV knowledge scores were significantly increased. HIV related stigma beliefs and disclosure concerns were significantly decreased. Intentions towards HIV testing were also increased despite beliefs towards testing remained the same. In addition, campers showed increased scores on goals, sense of hope, and resilience towards life. This report provides an overview of Global Camps Africa’s activities to plan and implement the training and camp sessions. The following sections highlight the activities conducted, assessment results, challenges, and recommendations for future implementation. Separate reports highlight specific activities from each of the seven camps. 1. Project Background

In December 2013, the United States Agency for International Development (USAID)/Southern Africa contracted Global Camps Africa to design and implement a Youth Leadership Camp curriculum targeting vulnerable children and youth. The Youth Leadership Camps focused on the specific needs of vulnerable children and youth to develop skills for healthy living and smart decision-making. Camp activities center on promotion of resilience for participants who have faced adversity in their lives, as well as to build capacity to address and deal with their daily needs and challenges. Through this project, USAID/Southern Africa sought to reach orphans, vulnerable children, and youth with personal development initiatives through intentional youth leadership development camp programming. The main objective of the camps was to equip young people with life skills that will support them in becoming safe and productive adults who have hope for the future.

In January 2014, Global Camps Africa and Participating USAID Partners Camp Sizanani reached 452 children and Camp Province Organization youth from eight of South Africa’s nine Site  Africare provinces through seven residential Youth  CMR Uitenhage Leadership Camps. Camp participants were  Empilisweni EASTERN  East London High Carmel comprised of children and youth that CAPE Transmission Area (ELTA) Valley participated in USAID partner activities. The  Masakhane Peelton  Nyhwara Home Based Care USAID partners who participated in these and Rehabilitation  Famsa Kuruman activities are noted in the table here and NORTHERN Gum Tree  Famsa Gamagara CAPE Lodge included as Annex 1.  The Good Shepherd  Baphumele The camp program is part recreation, part  Child Welfare Cape Town WESTERN  Community Women Network HIV and AIDS and life skills education, part Manyano CAPE  Kumbulani Educational Health personal development, all wrapped up in a & Resource Centre spirit of fun and camaraderie. The theme of  The Caring Network  Child Welfare Bloemfontein HIV and AIDS prevention and other life skills FREE  Childline Bloemfontein Koppies Vlei are woven through the entire camp STATE  Siyathokoza OVC  Lesedi Youth Empowerment curriculum including sports, arts and crafts,  Child Welfare Tongaat KWAZULU  Kyalami OVC adventure, theater, and nutrition. The camp Camp NATAL  KZN Youth Empowernment Annerley experience is designed to ensure participants: (KZN)  Lelithemba Foundation  Whizzkids United  Learn new skills through experiential  Childline Limpopo  Litshani Vhana Foundation education Effaata LIMPOPO  ELTA Camp  Sharpen HIV and AIDS awareness and  Masakhane Peelton prevention skills  St. Joseph Community Center  Center for Positive Care  Expand their vision of what is possible in  Direleng GAUTENG  Future Families their lives after they leave camp & NORTH  Heart Beat The Retreat  Share experiences between different WEST  HIVSA  Orababaletse OVC ethnic groups, religions, and cultures  Sithandazingane

Global Camps Africa Youth Leadership Camps Program Report: January 2014 2 1.1 Introduction to Global Camps Africa

Global Camps Africa is a U.S. based 501(c)3, not-for-profit organization that provides enriching residential camping experiences for orphans and children from families affected by HIV and AIDS. Global Camps Africa (formerly known as WorldCamps) was founded in 2003 to promote camp as a vehicle to improve the attitudes and behaviors of children and youth regarding HIV and AIDS and their futures. Global Camps Africa’s mission is to change the lives of South Africa’s vulnerable children and youth by providing HIV and AIDS prevention education and training through high-impact residential and day camp experiences and continuing education, equipping young people with life skills that will support them to become safe, healthy, and productive adults. In 2004, Global Camps Africa established its first “Sizanani”, translated from a Zulu word, residential camp program in South Africa, Camp means to “help each other”. Camp Sizanani Sizanani, outside of Johannesburg in the Magaliesberg builds on the premise that youth with Mountain area. Global Camps Africa continues to work stronger support systems and life skills are closely with Camp Sizanani Life Skills, which is now likely be more successful at staying HIV free. established as an independent non-profit organization. Camp Sizanani provides an intentional camping experience away from home that promotes new skills, maturity, independence, awareness of public health issues, cross-cultural interchange, and fun in a residential setting. Camp provides a safe, positive environment of trust and acceptance where HIV and AIDS-affected children gain self-esteem, have fun, meet other children in similar situations, and leave with hope for a better future. Global Camps Africa and Camp Sizanani Life Skills provide a unique opportunity to children and youth from families, schools, and communities that have lived through significant trauma to gain new experiences and skills that they likely would not otherwise have had the opportunity to learn. The camp teaches essential life skills, primarily focused on HIV and AIDS prevention and how to recognize and avoid exploitation and abuse, while promoting nutrition, teamwork, and gender equality.

1.2 An ‘Intentional Camp’ Approach

Using camp to change young people’s lives in positive ways requires purposeful planning and expert leadership to move camps beyond a mere recreational experience to an enriching environment in which life skills can be learned and practiced. This variety of camp is referred to as an “intentional camp;” that is, the goals of the camp are kept clearly in mind and the program choices, even the casual games, are selected with those goals in mind. For a period of nine days, vulnerable children and youth are placed in an emotionally healing environment, in a setting of natural beauty. The social, cultural, family, and institutional environments in which these young people live profoundly influence their behavior, thus having an eight day experience in which they are provided with new skills and knowledge in a positive, enriching atmosphere away from the environment in which they live, strengthens the ability to change behaviors.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 3 The intentional camp approach employed by Global Camps Africa and Camp Sizanani is an ideal vehicle to support implementation of personal development and planning with youth. Personal development focuses on ensuring the transfer of skills and knowledge, while fostering positive attitudes to increase resilience and improve capacity to address and deal with challenges. Daily life skills session at these camps are facilitated by trained counselors and cover health, nutrition, self-esteem, and issues of Critical life skills that are integrated into camp activities adolescence such as dating, drugs, abuse, crime, and sexuality. include, but not are limited to: These empowering lessons on healthy living and smart decision-  Positive self-image making are not only taught in a curriculum of targeted classes,  Communication but are integrated into every aspect and activity of camp,  Conflict resolution  Cooperation including recreational activities such as sports, games, art,  Dealing with diversity drama, poetry, and music. The goal is that every camper will  Innovation and creativity receive knowledge and skills that will empower him or her to  Leadership look forward to a healthy and productive adult life.  Responsibility  Problem-solving The experience as a whole is designed to give the children a new sense of possibility for their futures, while the information they receive concerning HIV prevention and life skills development is critical to their personal safety and emotional health. The short time that campers spend in their camp programs is valuable, precious time that Global Camps Africa and Camp Sizanani believe should be used as intentionally as possible. To accomplish this, participants must be engaged in a meaningful and age appropriate manner. Intentional focus and framing of each camp activity leads to the more important character development lessons. Camp activities are structured to promote resilience for those who have faced adversity in their lives, and build capacity to address and deal with daily challenges. Each activity is a vehicle to develop:  Understanding of personal strengths and weaknesses  Leadership abilities  Organizational and planning skills  Team building and trust  Decision making and problem solving  Task orientation, analytical skills, and creative thinking.

Trained camp counselors are skilled at creating a youth-centered environment that enables the goals of the program to be met effectively. They model essential leadership skills to effectively work together and with young people, including managing behavior, building self-esteem and positive self-image, promoting good communication, and teaching life skills. Global Camps Africa’s training for the Camp Sizanani counselors assigned to the January Camps included specific guidance on helping campers with personal development plans, a new part of the camp curriculum. See Annex II for more detail. The addition of a specific personal development component to Global Camps Africa curriculum provides more intentional focus on transferring skills and planning for continued development after the camp experience. These plans help strengthen the intentional design of camp on an

Global Camps Africa Youth Leadership Camps Program Report: January 2014 4 individual level, and further promote making healthy choices, personal responsibility, problem solving, communication, confidence, independence, cooperation, character, and others. The role of the chaperones at these camps was to provide oversight to children during the camp, with some responsibilities overlapping with those of the camp counselors. More importantly, chaperones were intended to provide positive reinforcement after the camp. Chaperones were comprised of participants care givers, community child and youth care workers, and volunteers from the USAID partner organizations involved in this project. Because there was no pre-camp training for the chaperones on how to interact positively with children or on basic camp expectations and culture, they took time to understand the importance of intentional programming and the ultimate goals of camp. They will continue to contribute by bringing the camp ethic home with them to support youth. In this way, the campers will have some support for their camp knowledge and enthusiasm when they are back in what may be a less supportive environment.

1.3 Pre-Camp Counselor Training

While Camp Sizanani is coordinated by Global Camps Africa, Counselor training focuses on: most of the programming at camp is presented by the camp  Instructing and training the staff director or camp counselors. They have received specialized in different procedures for training from Global Camps Africa in working effectively with running a safe camp young people, and are generally between the ages of 18 to 30,  How to work effectively with and often reside in the area where the campers live. children  Teambuilding and staff bonding The role of a camp counselor is particularly challenging because  Preparing and creatively they must play a role of a parent, teacher and a mentor, while planning for the campers’ also serving as a role model in the way they behave, act, and arrival. speak at all times. After the training, counselors can:  Effectively plan activities and programs with and for children that they are working with  Foster resilience in campers and facilitate the learning and practice of key life skills  Plan at least 20 different activities that can be used to promote communication, teamwork, trust, and relationship building amongst the children under their care  Have a positive impact on the children with whom they come into contact.

In preparation for these Youth Leadership Camps, Global Camps Africa and Camp Sizanani organized a four-day, pre-camp training session for 33 Camp Sizanani Camp Directors and counselors from December 3-6, 2013. These Camp Sizanani counselors were then part of the 81 directors and counselors selected to staff the January camps. The training gave participants specific skills for camp, as well as the opportunity to bond with one another. Training also included guidance on helping campers with personal development planning, a new component of the camp curriculum.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 5 2. Youth Leadership Camps

The January 2014 Youth Leadership Camps in South Africa PROVINCE CAMP SITE provided an opportunity for a selected group of orphans and EASTERN CAPE Carmel Valley FREE STATE Koppies Vlei vulnerable children and youth from eight provinces to attend GAUTENG & The Retreat camps under the supervision of experienced professionals. NORTH WEST The camps were planned as nine-day residential experiences KWAZULU NATAL Annerley and were held concurrently in seven locations around the LIMPOPO Effata country between January 3 – 11th, 2014. NORTHERN CAPE Gum Tree Lodge WESTERN CAPE Manyano A total of 452 youth participated, with the majority of campers between 14 and 17 years old. 265 campers were female and 187 were male. Campers were referred to the Youth Leadership Camps by USAID and Pact South Africa partner organizations that actively implement programs targeting vulnerable children. Camps primarily served youth from the regions where they were held, however, several camps included campers from more than one province. For example, the Gauteng camp, also included campers from Limpopo and North West. The Youth Leadership Camps focused on the specific needs of vulnerable children and youth to promote resilience for participants who have faced adversity in their lives, as well as to build capacity to address and deal with their daily needs and challenges. The camp sessions presented opportunities for the campers to learn new skills in a conducive and relaxing environment far removed from their home life. The camps offered an inspiring environment in which life skills could be learned and practiced to build resilience among the children and youth. Using experiential education as a way to get the campers involved, camp counselors integrated life skills into activities such as sports, and theater. The theme of HIV and AIDS prevention was woven through the entire camp curriculum including sports, arts and crafts, adventure, theater, poetry, nutrition, and even swimming. Camp counselors incorporated HIV and AIDS education and life skills into games and activities, weaving together threads of information, while teaching how to deal with feelings of stigma and insecurity, and providing the needed support for children dealing with daily struggles of survival.

2.1 Camp Curriculum

A day at the Youth Leadership Camp involved five core curriculum modules, in addition to life skills sessions that provided peer-led HIV prevention, among other things. Global Camps Africa provided activities that appeal to specific interests in the campers, with life skills components in each. The theme of HIV and AIDS prevention was woven through the entire camp curriculum. Daily life skills session at these camps were facilitated by trained camp counselors and covered health, nutrition, self-esteem, and issues of adolescence such as dating, drugs, abuse, crime, and sexuality. These empowering lessons on healthy living and smart decision-making were not only taught in a curriculum of targeted classes, but were integrated into every aspect and activity of camp, including recreational activities such as sports, games, art, drama, poetry, and music. The

Global Camps Africa Youth Leadership Camps Program Report: January 2014 6 goal was for every camper to receive knowledge and skills for personal development that will empower him or her to look forward to a healthy and productive adult life. During the Youth Leadership Camps, participants roomed and attended activities in small groups (of approximately nine to twelve), participating in life skills, health/nutrition, swimming (when available), sports, adventure, drama, drumming and dancing, and other group activities. Camp counselors used competition and cooperation as mutually reinforcing contexts for group activity, something that many of the campers were learning for the first time. Camp counselors work to elicit participation that appeals to the imagination, using the arts, nature, games, and theater — not just to teach, but to educate in terms of the Latin word's root meaning, educere, which means to lead out. The counselor training is designed to help camp counselors create experiences that provide children with a new sense of possibility for their futures, while the information they receive concerning HIV prevention and life skills development is critical to their personal safety and emotional health.

Camp in session

Campers were organized into small groups, based on age and separated by gender. They attended sessions in hour-long blocks, led by trained counselors. The core curriculum covers the following themes:

 Life Skills: The life skills curriculum covered topics related to physiological, psychological, and emotional changes and challenges that occur during adolescence. Interactive sessions were held on several topics, including: HIV and AIDS, teen pregnancy and teen parenting, high risk behavior, drugs and alcohol abuse, physical abuse and violence and the rights of children and their responsibilities that accompany these rights. There was a focus on personal development planning to help participants translate camp experiences into future

Global Camps Africa Youth Leadership Camps Program Report: January 2014 7 Critical life skills that are integrated into camp activities include, but not are limited to: success. These sessions promoted development in the areas  Positive self-image of self-preservation, informed decision-making, survival skills.  Communication o HIV and AIDS education is the most important  Conflict resolution aspect of life skills. These lessons can have an  Cooperation enormous impact on whether they survive this  Dealing with diversity pandemic. Protecting themselves against the AIDS  Innovation and creativity  Leadership virus is one of the most important survival skills they  Responsibility can learn. Lessons cover: 1) what HIV/AIDS is; 2)  Problem-solving how HIV/AIDS is contracted; and 3) how to prevent HIV/AIDS, unwanted pregnancies, and other sexually transmitted diseases. o They also learned that HIV/AIDS is spreading more quickly among 15- to 24-year- olds than among other age groups. They have informal debates, participate in role playing actual and imagined social interactions and have a work book on HIV/AIDS and the Rights of a Child to complete during camp and take home to share with their family and peers. They also learn how to live a healthy life with an HIV infection. o Formal lessons regarding sex, sexuality, relationships, coping with peer pressure, drugs, violence and abuse were also conducted, with a major focus on sexually transmitted infections and teenage pregnancy. Participants were given information and encouraged to discuss these topics. o In addition, counselors who teach the classes also led campers in discussions of ethics and values as they apply to sexual behavior. The class format was highly interactive, with campers working together in small groups or teams for discussion, participation in educational games, and even practice in applying condoms to an anatomical model.

 Nutrition: Nutrition activities included learning about the food pyramid, as well as kitchen and personal hygiene. These activities gave the children the opportunity to learn about the benefits of healthy nutrition and how to prevent contamination of food. The campers learned to wash their hands before handling food or eating. These sessions promoted development in the areas of food security, environmental knowledge and appreciation. o Practical interactive lessons teach how to prepare simple meals with available and inexpensive products that create food security and healthy eating. Tasty demonstrations are part of the curriculum. o Campers designed and developed a menu plan that they could put into practice at home with foodstuffs that are available to them.

 Arts and Crafts: Activities encouraged self-expression in a safe, non-judgmental way. Lessons relied on finding things in the natural environment and using these materials in their creations to give them a sense of nature and enable them to learn how to be creative at home without spending money. These sessions promoted development in the areas of self- expression and personal accomplishment. o Campers made their own name tags (creative design and self-expression), created value charts and drew positive pictures of themselves. This provided creative outlets to express feelings and thoughts. The changes use of color and imagination in their drawing showed improved ability to express themselves through art.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 8  Theatre, Dance, and Drumming: These sessions provided an interactive, creative outlet for the children at camp. They were able to explore their imaginations and enter a safe space to be comfortable talking about personal matters. This improvement was shown through full participation in the sessions and confidence to use voice projection and other abilities during the session. These sessions promoted development in the areas of self- expression, coordination, cultural pride, and therapeutic value. o Campers created their own poems, and adapted traditional songs and dances into more contemporary themes. Most important was the encouragement from the camp counselors for the campers to express themselves fully and immerse themselves in the camp experience, knowing they would be fully supported by staff and fellow campers. o Children were also encouraged to learn drumming and dances from different cultural groups. This enabled them to take pride in their own culture and to be tolerant of different cultures. Children were encouraged to put together their own dramatic productions that teach life lessons as a means of peer education at home.

 Adventure: The adventure activities consisted of experiences in the form of games, involving facing ones fears, wall climbing, and blindfolded games where the camper had to follow instruction and guidance from a non-blindfolded person. These sessions promoted development in the areas of cooperation and problem-solving. o The campers were able to show improvement by working together and memorizing previous moves that were successful. Their success in these activities made it easier for them to realize that they can also be successful in life if they work together and work through their fears in a similar way. o These activities presented to the children the importance and necessity of working together as a team to accomplish a common goal. The children learned the value of cooperation while attempting to solve basic problems and learned how enjoyable it is to interact positively with one another.

 Sports: These sessions were used to teach life skills such as communication with team members, the importance of rules both in games and in life, physical development, and other skills with carry over value at home. Most important was the knowledge that how you play the game is more important than if you win or lose. These sessions promoted development in the areas of communication, decision-making, and sportsmanship. o While students engaged in sports, such as mixed gender soccer, they were able to exercise leadership and teambuilding skills that helped to improve trust and cooperation between the campers. This was exemplified by boys and girls working together as a team and assisting one another. o Swimming taught children to try something new even though it is frightening, how to overcome fear, and that they can accomplish anything that they set out to do. They often gain an enormous sense of pride and personal accomplishment from learning how to swim in such a short period. The camp setting allowed the youth to disconnect from their everyday lives and find possibilities for a different future: one in which they are empowered to translate knowledge into action. Personal development planning helped build control and resiliency skills that are

Global Camps Africa Youth Leadership Camps Program Report: January 2014 9 important because they affect our perception of how much control we have to influence what happens in our lives. Global Camps Africa believes that youth with stronger skills in these areas are likely to be more successful at staying HIV-free. The camp environment is a natural space to address these complex issues. Camp counselors worked under a strict code of conduct to ensure that all campers under their care were protected. Campers were escorted at all times and were instructed in defensive behaviors for abusive situations. They were all instructed in whom to see if abuse happened at camp, or how to report abuse that occurred before or after camp. See Annex III for a schedule of camp activities.

2.2 Highlights of Camper Experiences

The week at camp and their camp experience was worlds apart from their daily experiences at home. From being able to meet and make new friends from their geographical area to being treated with love and respect, it was a new and positive experience for them. Many campers reported that the experience has given them an opportunity to expand their circle of friends to include new people who understand them and do not evaluate them negatively. The campers had the common issues of new campers coming to camp for the first time. There were cultural issues, as many campers had not been far from their place of birth and were wary of new people and activities. There were language issues, as some of the campers at some sites came from very different locations. There were social issues, as most campers had not lived in a setting where they were lovingly cared for by people they had never met before. The counselors had to respond to these basic concerns before campers could experience the release of being in the camp environment. There were no participants with special needs during these camps. No injuries incurred as a result of the camp activities. After a few days, the campers and their chaperones were quite comfortable with the camp setting, schedule and expectations. Though language was still an issue, creative communication broke through the language barrier and the relationships among campers who had not known each other before camp, and camp counselors with the campers were extraordinary. To add to the bonding and feeling of community, all participants were given shirts and caps courtesy of USAID to wear for activities during the training and take home with them. By the end of the camp the counselors noted that campers had more confidence in themselves, they volunteered to say grace before meals, and spoke out clearly with confidence. Campers expressed that they felt they had new abilities and were more ready to take on new challenges then they had felt before they came to camp. Counselors saw how important self- confidence and direct communication was Participants from the Northern Cape wearing their camp shirts.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 10 for these campers. Most of them did not believe in themselves and did not trust that they had anything worthwhile to share. They required a lot of encouragement to reach out and trust that they had a definite value as a person and a member of the camp. By the end of the camp, they began to share their stories and started to gain confidence in themselves Many campers shared concerns about HIV and AIDS, substance abuse and how this affects both the individual and the community, and teenage parenting. The campers were able to share their own experiences and what they witnessed in their communities with regards to substance abuse and teenage parenting. They learned how substance abuse increases high risk behavior amongst teenagers and about the detrimental effects this can have on future goals. Many campers commented on the fact that they felt safe enough to share their challenges with the camp staff and relieved to be able to share their burdens. This resulted in a number of the campers coming forward to ask for assistance. Campers discussed the difference between dreams and goals, and the importance of having goals so they have something positive to work towards in their future. They showed improvement in setting out realistic achievable goals. This was exemplified by the way in which they completed their personal development plans. Using new camp sites created new opportunities to introduce campers to even more diverse activities than usually offered. Global Camps Africa adjusted the program according to the availability of facilities available:  In Kimberley (Gum Tree Lodge), the indoor facilities were so limited that a session on debating skills that could be held outside was designed to replace the nutrition course, which required a refrigerator, water, and utensils.  In KwaZulu Natal, a ropes course was available for use and was integrated into the Sports and Adventure programs.  In Free State, the owner was an avid amateur astronomer and environmentalist, so a night hike to view the stars and organic gardening was made part of the program.  In North West, the campers could stay within the site and hike to a game park to view zebras, giraffes, buck, and baboons. While the camp program focuses on critical life skills, it is important for campers to feel safe and secure. For the majority of campers, it was special to have three full meals a day through the entire camp stay and for each to have a bed of his/her own. Many campers had never learned to eat with a knife and a fork, but by the end of the camp, they were comfortable doing so. For more detail on the specific camp activities and experiences of campers at each site, please see the separate camp specific reports.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 11 3. Pre and Post-Camp Assessment and Results

Campers completed the survey independently, but were given help when English language was a challenge. The pre-camp survey was completed just prior to camp so as not to interfere with the welcome and adjustment to camp. The post-camp survey was completed at the end of camp just prior to departure. Parental permission to conduct these surveys was included in the camp application that was completed by the parent/guardian. Surveys were designed so that each participant name was replace by a unique code to mark their submissions, so that pre and post-surveys could be analyzed anonymously to measure change in knowledge level and attitudes of trainees. The assessment was conducted by Dr. Su-I Hou, Associate Professor, College of Public Health, University of Georgia and Dr. Gwynn Powell, Associate Professor, College of Health and Human Development, Clemson University. The results were analyzed across all seven camps and then broken down by specific locations. Missing responses were primarily due to names that were unable to be matched. It was not compulsory for anyone to complete the survey. Some participants may have chosen not to complete the survey or specific questions within the survey. Global Camps Africa used a paper-pencil, self-report pre and post-camp questionnaire designed to assess knowledge, attitudes and beliefs about HIV and AIDS, as well as investigate participants ‘state-of-mind’ about goals, hope, and resilience referred to as state-of-mind areas. The two sets of responses were compared with regard to change of attitude and specific content or knowledge gains. The HIV knowledge questions explored common myths regarding how HIV is contracted and facts about its prevention. The discussions between campers and staff allow for the questioning of long-held beliefs and integrating factual information from trusted adults to potentially change incorrect assumptions about HIV and its prevention. Investigation of the three state-of-mind areas (goals, hope and resilience) provides an indicator of the campers’ ability to use the newfound HIV content knowledge. The overall camp program provided more than just knowledge; it provided the context and complementary skills that increase the likelihood that campers will be able to transfer the knowledge from camp to home. The majority of survey questions were based on an ordered Likert scale, which allows respondents to choose one option that best aligns with their view. Likert scales are often used to measure attitudes by asking the extent to which they agree or disagree with a particular question or statement. A typical scale might range from “Strongly disagree, Disagree, Neutral, Agree, Strongly agree.” The questions were based on the goals and objectives of the training so provided an accurate assessment of the learning. The balance of question types (perception and content) was important in that understanding the content is only part of the equation. The confidence use of the content is equally important as the participants went back to their homes. Questions were structured in sets that contributed to different scales. Each question was intended to make up variables, or indicators, within a composite measure, which are summarized below. The scores for each of the statements were combined for each respondent

Global Camps Africa Youth Leadership Camps Program Report: January 2014 12 to create an overall score for the scale. The individual question responses do not have reliability testing on their own and so have not been presented at this level. The use of such scales was intended to take advantage of differences in intensity among the indicators of a variable. This survey was designed for the comprehensive look at the Global Camps Africa and Camp Sizanani approach, with a longitudinal view. As designed, the survey results were not intended to be reported at the individual camp level and are therefore presented at aggregate level. Annex V includes the survey questions.

3.1 Participant Profile

A total of 452 youth ranging from 10 to 23 years old attended the camps. 265 campers were female and 187 were male. Overall there were only two twenty year olds and four 11 year olds, while the majority of campers were 14-17 year olds. There were no incidents of participants dropping out or being asked to leave for disciplinary reasons. A total of 449 campers participated in the survey process with matching pre and post questionnaires. Distribution by Province  The distribution of campers between the seven sites was: 0% 10% 20% 30% 40% Free State (11.7%), Limpopo (8.8%), KwaZulu Natal (11.9%), Eastern Cape Free State Northern Cape (9.3%), Gauteng (34.1%), Western Cape Gauteng (10.6%), and Eastern Cape (14.6%). KwaZulu Natal Limpopo  Ninety-eight percent of the campers were between 11 and Northern Cape 18, with a mean age of 15.19 years. Over 62% were female. Western Cape

Number of Campers Per Site by Number of Campers Reached by Age Gender 100 100 80 80 60 60 40 20 Male 40 0 Female 20 0 10 11 12 13 14 15 16 17 18 19 20 21 22 23

 The majority reported they were single and had no boyfriend or girlfriend (65.4%). Over 30% indicated having boy or girl friends, and a small percentage (2.7%) reported having friends with benefits (involved in a relationship where they have sex, but do not consider their partner to be a boyfriend or girlfriend).  Although the majority indicated they were heterosexual (62.8%), about 10.4% reported they were either bisexual or gay/lesbian. There were also a significant portion of the campers said they were not sure about their sex-orientation (26.9%).

Global Camps Africa Youth Leadership Camps Program Report: January 2014 13

What is your current relationship Which of the following best describes status? you?

80% 65% 0% 20% 40% 60% 80% 60% 32% Heterosexual/Straight (boy 40% dates girl, girl dates boy) 20% 3% 0% Bisexual or Gay/Lesbian Single, no boyfriend Single, has boy or Friends with benefits or girlfriend girl friend(s) (have sex with them, but not boy/girl Not sure or other friend)

 Approximately 37.5% reported they knew someone with HIV/AIDS.

3.2 Knowledge, Attitudes, and Beliefs

Overall, the pre-test, post-test evaluation documents that the camp had a statistically significant impact among youth campers on almost all of the measures. The scales used for HIV knowledge, attitudes, and beliefs all indicated positive movement. HIV knowledge significantly increased. HIV related stigma beliefs and disclosure concerns significantly decreased. Intentions towards HIV testing also increased despite beliefs towards testing remained the same. At post-test, although campers scored significantly higher on HIV/AIDS knowledge test, and perceived higher knowledge levels on both HIV/AIDS in general and testing specifically, the overall knowledge scores were lower than expected after the camp. Given the ingrained nature of some of the HIV/AIDS myths, they may need to be reinforced in different ways.

3.2.1 HIV Knowledge The section of the questionnaire to measure knowledge about HIV and AIDS had 11 questions. The options to respond to each question were ‘True’, ‘False’, and ‘Not Sure’. 1. A person can get HIV/AIDS from mosquito bites. 2. A person can get an HIV from oral sex. 3. A person can get HIV even if he/she has only has unprotected sex once with an HIV infected person. 4. People with HIV quickly show serious signs of being infected. 5. A person with HIV can look and feel healthy. 6. A pregnant woman with HIV can give the virus to her unborn baby. 7. It is harder for women to get HIV from men, than for men to get HIV from women. 8. Showering, or washing one’s genitals/private parts, after sex keeps a person from getting HIV. 9. It takes a couple of weeks or months for HIV to show up on a test. 10. Coughing and sneezing DO NOT spread HIV. 11. A person can get HIV by swimming in the same pool with a person who has HIV.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 14 The overall HIV knowledge scores of the campers reported after the camp were statistically significant in their improvement. The campers scored an average of 5.52 out of 11 knowledge questions correctly before the camp, and 6.33 questions correctly after the camp. Although knowledge scores were increased after camp, there is still room for improvement on educating youth campers regarding HIV related knowledge and transmission.

Change in Mean Scores for Knowledge

0 1 2 3 4 5 6 7

All Camps Eastern Cape Free State Pre-Test Gauteng Post-Test KwaZulu Natal Limpopo Northern Cape Western Cape

The knowledge items where fewer than 50% of the campers answered correctly were mostly about how HIV and AIDS could or couldn’t be transmitted, such as oral sex, pregnant mother to unborn baby, washing one’s genitals after sex; as well as the latent period of AIDS, or window period of HIV testing. Overall, campers perceived increased levels of knowledge towards HIV/AIDS in general as well as HIV testing, specifically after the camp program.

3.2.2 Campers’ HIV Stigma Related Beliefs and Disclosure Issues Five scales were used to measure campers’ beliefs of HIV related stigma: (1) negative beliefs towards people living with HIV/AIDS, (2) negative beliefs towards self, if infected with HIV/AIDS, (3) comfort level being around people living with HIV/AIDS (PLWHA), (4) discrimination towards PLWHA, and (5) disclosure concerns. Campers were asked to indicate ‘To what extent to do agree or disagree?’ to each question. Options to respond were ‘Strongly Disagree’, ‘Disagree’, ‘Not Sure’, ‘Agree’, ‘Strongly Agree.’

Scale for negative beliefs towards people living with HIV/AIDS

1 I feel people with HIV should be ashamed of themselves. 2 I feel people with HIV/AIDS are unclean. 3 I feel a person with HIV is disgusting. 4 I feel HIV is punishment for things they have done. 5 I feel people with HIV are was not as good as other people. 6 I feel people who get HIV/AIDS (through sex or drug) have ‘‘gotten what they deserved.’’ 7 I feel people with HIV/AIDS are cursed.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 15 Scale for negative beliefs towards self if they were infected with HIV/AIDS

1 I would feel ashamed if I had HIV. 2 Having HIV would make me feel unclean. 3 Having HIV in my body would be disgusting to me. 4 If I had HIV, I would think it was a punishment for things I’ve done. 5 If I had HIV, I would feel I was not as good as other people. 6 If I had HIV, I would think that I have gotten what I deserve. 7 I would feel cursed if I had HIV.

All of the stigma related scales measured were statistically significant in their decrease at the end of the camp program. Specifically, campers’ negative beliefs about people living with HIV and AIDS were greatly reduced. After the camp they were less likely to agree that people with HIV/AIDS are unclean, or HIV is a punishment for things they have done, etc. The negative beliefs towards self if they were infected with HIV/AIDS were also significantly decreased. At the end of camp, youths disagreed more with thinking that they would feel ashamed, unclean, cursed and not as good as other people if they were to have HIV. They also disagreed more that they would think HIV was a punishment for things they have done and that their family would be ashamed of them.

Scale for comfort level being around people living with HIV/AIDS

1 I would feel comfortable hugging a close friend who has AIDS. 2 I would feel comfortable swimming in a pool with someone who has HIV/AIDS. 3 I would feel comfortable staying friends with someone who has HIV/AIDS. 4 I would feel comfortable kissing a good friend or relative who has HIV/AIDS. 5 I would feel comfortable making friends with someone who has HIV/AIDS. 6 I would feel comfortable playing sports with someone who has HIV/AIDS.

Scale for discrimination towards people living with HIV/AIDS

1 It is ok if people with HIV/AIDS are not able to go to a doctor or nurse. 2 It is ok if people with HIV/AIDS cannot go to school. 3 It is ok for children not to go to school if their parents have HIV/AIDS. 4 It is ok if people with HIV/AIDS cannot get a job. 5 It is ok, if no one takes care of children whose parents died from AIDS.

Campers were also asked: If you tested positive for HIV, would you intend to tell any of the following individuals about your HIV test result?

Yes No I Do Not Have a. Your parents b. Your friends c. Your brothers/sisters d. Other relatives e. Your partner / spouse f. Your children g. Your co-workers

Global Camps Africa Youth Leadership Camps Program Report: January 2014 16 If you had HIV and chose to tell people your HIV status, do you think that the following outcome(s) might happen to you?

Yes No Does Not Apply a. Be looked down on by other people b. My family being hurt by others c. Not permitted to go to school d. Discrimination by doctors/nurses e. Break-up of marriage or partner(s) f. Physical abuse by spouse or partner(s) g. Other worries, please tell us:

The campers reported that after the camp they feel more comfortable around someone who may have HIV. They were also more strongly disagreed with hassling or verbally threatening someone with HIV, children not being able to go to school if their parents have HIV, or people who have HIV not being able to get a job. They also disagreed more with family, spouses or partners rejecting people with HIV. By the end of the camp, the campers were less worried about people judging them if people found out that they had HIV. They also expressed less fear that they would lose friends, or that their family would reject them if someone found out that they had HIV.

Scale for disclosure concerns

1 If I had HIV, I would worry that people would tell others. 2 If I had HIV, I would tell people close to me to keep it a secret. 3 If I had HIV, I would not feel I could not be open with other people. 4 I would worry that people may judge me if they learn I had HIV. 5 I fear I would lose my friends if they learned I had HIV. 6 I fear that my family would reject me if they learned I had HIV. 7 I feel I wouldn’t get good health care if people knew I had HIV. 8 I would avoid getting medical treatment so no one would find out if I had HIV.

Although there were still some negative beliefs, the level of HIV related stigma beliefs was not high, and campers were generally feel comfortable being around PLWHA. The disclosure scales showed that levels of concern were average among these youth campers.

Change in Mean Scores for Stigma

0 5 10 15 20 25

All Camps Eastern Cape Free State Pre-Test Gauteng KwaZulu Natal Post-Test Limpopo Northern Cape Western Cape

Global Camps Africa Youth Leadership Camps Program Report: January 2014 17 3.2.3 Campers’ HIV Testing Related Beliefs To gauge these HIV testing related beliefs, campers were asked to respond to the following questions.

1 I am scared to find out if I am infected with HIV. 2 If I get tested and my friends find out they may not want to be friends with me. 3 It is likely that I might be infected with HIV in my lifetime. 4 I have no interest in finding out whether I am HIV infected. 5 I think everyone needs to know his or her HIV status.

Overall, the campers showed no significant changes on beliefs towards getting tested for HIV. Except that campers indicated they felt less scared about finding out their HIV status at the end of the camp, the rest of the HIV testing related beliefs remained similar after the program.

3.2.4 Campers’ HIV Testing and Sexual Behavior Campers were asked to respond to the following questions related to HIV testing:  Have you ever thought of having an HIV test? o If no, why not?  Have you ever had an HIV test?  Do you intend to have an HIV test in the next 6 months? Approximately 40% of all campers indicated having had an HIV test. Only about a third of the campers had ever asked their partners or been asked about their own HIV status. The intention of getting an HIV test in the next 6 months was significantly increased after the camp. Additional questions on sexual behavior included:

 Have you ever asked a boyfriend or girlfriend about his/her HIV status?  Has a girlfriend/boyfriend ever asked you about your HIV status?  In the next 6 months, if you have sex, do you plan on using a condom?  How confident you are that you can convince your partner to use a condom the next time you have sex? It was interesting to note that campers perceived increased confidence on convincing partners to use condoms, yet reported decreased intention of using condom in the near future. Specific underlying reasons and interpretation of the question need to be further explored. One explanation could be that campers felt overall less likely to engage in sexual behavior at all; therefore, they would be less likely to need to use a condom in the next six months. At post-test, although campers scored significantly higher on HIV/AIDS knowledge test, and perceived higher knowledge levels on both HIV/AIDS in general and testing specifically, the overall knowledge scores were lower than expected after the camp. Recommendations include analyzing the data by camps rather than as a whole to determine if some camp programs were more effective in their content delivery regarding overcoming specific myths that are perpetuated within South African society. In addition, a re-examination of the life skills curriculum should be done to be sure all content areas are thoroughly covered.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 18 3.3 Goals, Hope, and Resilience (State of Mind Scales)

Investigation of the three state-of-mind areas (goals, hope and resilience) provides an indicator of the campers’ ability to use the newfound HIV content knowledge. It is one step to have a gain in knowledge or a change in perceptions of stigma; yet, the confidence to use that knowledge is another process. At the end of the camp, the goals, hope, and resilience scales indicated campers had positive growth in these areas. The findings regarding change in goals, resilience and hope are particularly heartening in that these psychological measure are difficult to measure in a short period of time, yet when change is found it is linked to the ability to implement the new knowledge gained. At post-test, campers showed increased scores on goals, sense of hope, and resilience towards life. When analyzed as a whole, across all 452 campers at all the sites, the scores on all three state-of-mind scales indicated a statistically significant increase during the camp programs. The before and after overall scores were 26.36 vs. 27.28 for the Goals Scale (p<.01), 72.92 vs. 76.52 for the Resilience Scale (p<.01), and 48.10 vs. 49.12 for the Hope Scale (p<.01). While these score seem small numerically, they represent a composite score of questions within each scale. The gains were determined to be statistically significant based on a t-test that allows for precision demonstrating that the change is not based on chance. As change in these areas is extremely complex, the measurement of large gains was not expected.

3.3.1 Goals Scale The Goals Scale used in this assessment is based on the Children’s Hope Scale (Snyder et al., 1997), a six-item self-report measure. The scale measures goal-oriented thinking using youth- appropriate items. Each item has response options rated on a six-point Likert-type scale ranging from one (None of the Time) to six (All of the Time). The total score represents the mean of the responses across all items (if at least 85% of the items are completed). All items are positively worded, with a high total score indicating positive goal-oriented thinking. Youth who rate their hopefulness as high believe that they have strategies for achieving their targeted goals, and they can institute and continue using those strategies. Campers were instructed that, ‘There are no right or wrong answers, just tell us what you think’ for each question. Options to respond were ‘None of the time’, ‘Some of the time’, ‘A lot of the time’, ‘Most of the time’, and ‘All of the time.’ The Goals Scale was comprised of the following questions:

1. I think I am doing pretty well in life. 2. I can think of many ways to get the things in life that are most important to me. 3. I am doing just as well as other people my age. 4. When I have a problem, I can come up with lots of ways to solve it. 5. I think the things I have done in the past will help me in the future. 6. Even when others want to quit, I know that I can find ways to solve the problem.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 19

Change in Mean Scores for Goals

Western Cape Northern Cape

Limpopo

KwaZulu Natal Post-Test Gauteng Pre-Test

Free State

Eastern Cape

All Camps

21 22 23 24 25 26 27 28 29 30

3.3.2 Hope Scale The Hope Scale is similar to the Goals Scale in structure and scoring. The 14-item self-report tool is measure of youth hopefulness. Hope is seen as a way of thinking about goals in broad terms and as a motivational process that can affect behavior and subsequent thoughts and feelings. This scale is based on the concept of hope as the perceived ability to produce strategies to attain goals and move on the path toward those goals. Campers were instructed that, ‘There are no right or wrong answers, just tell us what you think’ for each question. Options to respond were ‘None of the time’, ‘Some of the time’, ‘About half of the time’, ‘Most of the time’, and ‘Almost All of the time.’ The Hope Scale was comprised of the following:

1. When faced with a problem I try to forget about it. 2. I change my opinion when someone I admire/respect/like disagrees with me. 3. If I want something I work hard to get it. 4. I like to have a say in any decisions made by any group I'm in. 5. What other people think makes a big difference in my behavior. 6. When something good happens to me I feel it is because I earned it. 7. I enjoy being in a position of leadership. 8. I need someone else to tell me my work is good before I am satisfied with what I've done. 9. I stick to my opinions/ideas when someone disagrees with me. 10. I do what I feel like doing, not what other people think I should do. 11. I get discouraged when doing something that takes a long time to finish. 12. When I am part of a group I want to let other people make all the decisions. 13. When I have a problem I follow the advice of friends and/or relatives. 14. Having someone important tell me I did a good job is more important to me than feeling I've done a good job.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 20 For the Hope Scale, the scores were relatively unchanged and were close to the overall mean (48.03 and 48.65).

Change in Mean Scores for Hope 43 44 45 46 47 48 49 50 51 All Camps Eastern Cape Free State Pre-Test Gauteng Post-Test KwaZulu Natal Limpopo Northern Cape Western Cape

3.3.3 Resilience Scale The Resilience Scale (Wagnild and Young, 1993) contained items pertaining to playfulness, sense of purpose, control, self-esteem, and self-belief/self efficacy, as well as humor. The 14‐item Resilience Scale measures the degree of individual resilience through five components: equanimity, perseverance, self-reliance, meaningfulness, and existential aloneness. The scale is derived from interviews with “resilient” individuals and measures personal attributes associated with resilience. Campers were instructed that, ‘There are no right or wrong answers, just tell us what you think’ for each question. Options to respond were ‘Strongly Disagree’, ‘Disagree’, ‘Not Sure’, ‘Agree’, ‘Strongly Agree.’

The Resilience Scale was comprised of the following:

There are no right or wrong answers, just tell us what you think.

1. I usually manage one way or another. 2. I feel proud that I have accomplished things in life. 3. I usually stay on track even if bad things happen. 4. I like myself. 5. I feel that I can handle many things at a time. 6. I am determined. 7. I can get through difficult times because I’ve experienced difficulty before. 8. I have self-discipline. 9. I keep interested in things. 10. I can usually find something to laugh about. 11. My belief in myself gets me through hard times. 12. In an emergency, I’m someone people can generally rely on. 13. My life has meaning. 14. When I’m in a difficult situation, I can usually find my way out of it.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 21 The Resilience scale documented more improvement from pre (71.47) to post (77.26) and a much smaller standard of deviation by the end of the camp session, indicating both growth and less difference among the campers.

Change in Mean Scores for Resilience 62 64 66 68 70 72 74 76 78 80

All Camps

Eastern Cape

Free State Pre-Test Gauteng Post-Test KwaZulu Natal

Limpopo

Northern Cape

Western Cape

4. Challenges and Recommendations

Despite the many successes of the project, there were a number of challenges during implementation. Global Camps Africa addressed these issues as they arose, as needed. They are discussed here, with recommendations for future implementation, where possible.

Planning

 Planning for camp activities requires advanced planning prior to camp activities. Based on GCA’s experience, we recommend at least two months advance notice so that discussions can be held with organizations to better inform them and assist them with preparations for both the campers and their caregivers. o These camps occurred under very difficult circumstances: little notice to the campers and chaperones limited the dissemination of information before camp started; last-minute reservations at facilities limited the choice; and no time for staff training, which limited the breadth of staff selection (only veteran Camp Sizanani staff were selected) when new staff from the areas represented should have been brought into the process.  This activity required a rapid start up with a very short implementation period. For long- term impact, OVCY camps like these require enough time for preparation. Material procurement, camp site identification, chaperone preparation and counselor training require a minimum of three months advance notice to do it optimally.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 22  One of the most difficult parts of the camp experience was in getting the correct number of campers to mesh with the space available. o The original invitations went out and acceptances were made. A follow-up to reconfirm took place in mid-December, however, two groups of 10 campers, who were not confirmed arrived at the Eastern Cape camp. As there was no space to house them, counselors worked together to accommodate them for the night, but they had to leave the following morning.

Camp Staff and Chaperone Training

 Camp is not a casual operation. The direction at the top has to be focused, structured without being dictatorial, and well thought out. It is essential that there be staff buy-in for what is going to occur at camp. This necessitates a rigorous staff training of, optimally, 4 days immediately before camp starts. This should include all chaperones and staff members, including the administrative staff, though not necessarily the kitchen or maintenance staffs.  Because there was no pre-camp training for the chaperones on how to interact positively with children or on basic camp expectations and culture, they took time to understand the importance of intentional programming, by which no program components without their being a tie-in to the ultimate goals of camp. o In the Eastern Cape, the camp director had a meeting with the chaperones and explained the importance of working together for the benefit of the campers. He also explained the importance of treating all of the campers in the same positive way and not to treat campers from their own organization better than those from the other organizations.  Chaperones were identified by organizations serving the OVCY in the provinces and were sent to the camp sites with the children and youth from their province. Chaperones were not adequately informed beforehand what would be expected of them during the camp and what the general code of conduct is within the camp. This resulted in many chaperones not knowing that they would be expected to participate fully in the camp itself. It would be beneficial to bring all the chaperones together for a four-day training with the Camp Sizanani counselors before the camp begins.

Communications

 Many campers were not fluent in English or dominant local languages. Due to the time pressures, the language constraints were not successfully communicated. This made communication difficult and counselors had to rely on translations and improvised sign language.  Most of the children’s literacy skills were also extremely poor; many instructions had to be given verbally, which was also difficult because of the language barrier. o Counselors and chaperones worked as a team and through translation, gestures, and assistance, communication at camp was successful.  Communication and self-expression are the hallmarks of camp. If there is no commonality of language, this places strains on the entire program. It was quite amazing that so many

Global Camps Africa Youth Leadership Camps Program Report: January 2014 23 gains occurred despite the language issue. Conversely, the campers learned through experience that someone speaking another language is not an enemy or a risk. o In the future, we need to take into consideration language differences and basic literacy issues among campers. With campers coming from different areas in the provinces there were a variety of local languages being spoken. At times campers themselves had to be used as translators. o In the future, the contractor should address language abilities and competencies of staff and campers to make sure all campers benefit to the maximum from activities and training during their camp stay.

Cultural Customs and Taboo Topics

 In Xhosa culture young men have to undergo a customary practice of going to the mountains for a certain period of time as initiation of becoming a man through circumcision. It is believed if you don’t undergo this ritual circumcision, you are regarded as a boy, regardless of age. o Some of the boys (in the Eastern Cape) had undergone this procedure and discriminated against those who hadn’t done it yet. It got to a point where those who had been circumcised did not want to share cabins and showers with those who had not been circumcised. o The counselors managed to turn this around by getting the campers to agree that, at Sizanani, we are all one family and, therefore, we should not discriminate and isolate one another.  Another challenge was dealing with sensitive topics during life skills like HIV and AIDS, sex, menstruation, and circumcision, to name a few. For many of the campers in the Northern Cape these subjects were taboo and never discussed. o Counselors had to re-assess how to approach these topics with the campers in order to get them to open up and share what they did or didn’t know. o With the continued life skills sessions, inroads were made, but the time spent preparing the way prevented the full program from being presented.

Gang Affiliation

 Many of the campers were involved in gangs in their communities, creating barriers among participants. o Through mediation it was agreed that there were to be no gang affiliations during the camp session and everyone belonged to the “gang” of Camp Sizanani. There were no further issues after this discussion. HIV and AIDS Related Issues

 The nature of stigma and HIV can be taught but is not overcome at camp. Real health consequences and complications arise when a camper is on ARVs, but still is reluctant to take them in front of the other campers.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 24  Communication and self-expression are the hallmarks of camp. If there is no commonality of language, this places strains on the entire program. It was quite amazing that so many gains occurred despite the language issue.  On the other side, the campers learned through experience that someone speaking another language is not an enemy or a risk.  Although knowledge scores were increased after camp, there is still room for improvement on educating youth campers regarding HIV related knowledge and transmission.

Enforcing Camp Rules

 Chaperones and campers were expecting a fun camp with no rules or lessons and at first were reluctant to engage. However, due to the energy of the staff and positive communication, the campers and chaperones soon enthusiastically participated and adapted to the camp schedule.  There is a strict no smoking rule at camp. One of the campers obtained a cigarette from one of the ground staff at the facility and smoked it. In response to this incident, team leaders had to speak to campers, chaperones, and ground staff to ensure that the rule was not broken again.

Camp Venue and Logistics

 Overall, the camp facilities were excellent, but there were minor issues at some sites. o For example, in the Western Cape, the site was not private and was shared with another group for most of the camp. o In the Northern Cape, a primary challenge was the lack of facilities. The activities had to be held in areas not entirely suited to them. There were also safety issues on the premises that camp counselors had to consider. Counselors were able to adapt the program as and when the need arose. o The Eastern Cape site was small and sleeping arrangements and activity rooms were limited. Despite a thorough search, the only site suitable for our numbers was not even located in the Eastern Cape, but in George, Western Cape. Through compromise and team work, the staff and campers managed to accommodate most needs.  There was also minimal familiarity with the site by the counselors and director beforehand due to the use of so many new sites. Although pre-camp visits were conducted when sites were selected, it was not possible for the counselors and director to have additional time on site.  Campers were housed together, but, at times, counselors were housed separately. It may lead to a greater sense of community if there were a facility that could accommodate 10-15 in a multi-room complex so the counselors and the campers could live together.  There were logistical challenges including transporting all materials to be used during the camp session from Johannesburg. There were a limited amount of materials that could be transported, so counselors had to work creatively with the most basic materials.  In many of the camps, campers and chaperones from the different organizations all arrived at different times. The welcome and introduction games that were planned to introduce the

Global Camps Africa Youth Leadership Camps Program Report: January 2014 25 campers to each other had to be repeated and changed several times in order to keep the earlier arrival campers engaged. o Repetitive activities can cause children to disengage, so the counselors made every effort to make the first interactions entertaining and to enroll the campers from the early group into teaching roles for the later arriving campers.

Post-Camp Follow-Up

 For campers to fully grasp and practice what they have learned during their camp stay, we recommend a follow up program for the campers in their organizations to ensure reinforcement of lessons learned, as well as emotional care and support. A nine-day period is fairly short for observations, support, and reminders on good practices for what the campers learned.  In an effort to effectively build the capacity of organizations working with OVCY on a daily basis, beyond the camp stay, we recommend a survey to view the efficacy on OVCY of relevant interventions.

5. Potential for Future Camp Activities

The camp planning, management, training, logistics, and implementation were carried directly by South African personnel. This is the way Camp Sizanani has implemented its programs and initiatives from the first time they established a camp in South Africa. Global Camps Africa has valued this approach as the best way for building the capacity within the organization and throughout the country. Some Camp Sizanani counselors were campers in previous years. In this project, all camp directors and counselors were South Africans. In the January 2014 camps, they got a chance to work with different groups of campers and work in a different setting. The counselors had a chance to share their skills and experience with the chaperones from the partner organizations. Initially, the counselors thought this was not going to work out, as the chaperones had very different expectations about camp from theirs. After camp ended, the directors thought it was a good idea to have had the chaperones at camp, not because the campers needed them, but because they could provide a useful link between camp and the campers after camp was over. They could also provide positive reinforcement of the activities that took place and could help launch the campers into additional activities, indicated after camp was complete. Directors were unanimous in wanting to continue to work with campers from the organizations selected and to have additional camps in the provinces. The directors and counselors thought the need was great and the possibilities for improved attitudes and behaviors were enormous.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 26 Global Camps Africa seeks to replicate the successes of Camp Sizanani in other parts of South Africa and in other heavily HIV/AIDS impacted areas on the continent. To that end, it has partnered with several other NGOs that have expressed an interest in joining the mission of Global Camps Africa to establish camps as a vehicle for change and education about HIV/AIDS.

6. Conclusion

Through this USAID-funded project, Global Camps Africa provided youth leadership development camps for 452 young people. The innovative approach Global Camps Africa brings to youth development and HIV prevention through specialized training and ‘intentional camp’ design provided a safe, positive environment of trust and acceptance where HIV and AIDS- affected children gain self-esteem, have fun, meet other children in similar situations, and leave with the skills to help create a better future for themselves and their families. Overall, the camp appears to have been extremely successful in imparting knowledge and skills. The evaluation documents that the camp had a significant impact among youth campers on almost all of the measures. The scales used for HIV knowledge, attitudes, and beliefs all indicated positive movement. HIV knowledge significantly increased. HIV related stigma beliefs and disclosure concerns significantly decreased. Intentions towards HIV testing also increased despite beliefs towards testing remained the same. The goals, hope, and resilience scales indicated campers also had positive growth in these areas. Since many of the campers come from poverty-stricken families, it is common for the campers to believe that this will be their future as well. It is important for them to continue to learn attitudes that can broaden their vision of what their future can be. By improving themselves, there will also be expanded possibilities for their families and communities. At camp, the campers opened up and saw some of the ways in which they could enter into a productive future and faced some of the challenges of youth they needed to overcome. Continued camp, or camp-like, programs would do a great deal to instill in the campers the confidence and give them the skills they need in order to make choices about their future. They need to be encouraged to set goals and create a vision for a future that will include a fulfilling life. This camp experience has shown them their worth as individuals and contributing members of society. It was gratifying to think that any camp with more planning and training would be immensely more powerful, although it was clear from the campers that they thought it was the best time they ever had and a very powerful life skills experience. The details on the activities provided in this report, along with the results, challenges, and recommendations provide valuable information for other organizations that may be considering implementation of a similar program.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 27 Annex I: USAID Partners

Camp participants were comprised of children and youth whom participated in USAID implementing partners HIV and AIDS prevention, care, treatment and support programs.

Participating USAID Partners Province Organization Camp Site  Africare  CMR Uitenhage  Empilisweni EASTERN CAPE Carmel Valley  East London High Transmission Area (ELTA)  Masakhane Peelton  Nyhwara Home Based Care and Rehabilitation  Famsa Kuruman NORTHERN CAPE  Famsa Gamagara Gum Tree Lodge  The Good Shepherd  Baphumelele  Child Welfare Cape Town WESTERN CAPE  Community Women Network Manyano  Kumbulani Educational Health & Resource Centre  The Caring Network  Child Welfare Bloemfontein  Childline Bloemfontein FREE STATE Koppies Vlei  Siyathokoza OVC  Lesedi Youth Empowerment  Child Welfare Tongaat  Kyalami OVC KWAZULU NATAL  KZN Youth Empowerment Annerley (KZN)  Lelithemba Foundation  Whizzkids United  Childline Limpopo  Litshani Vhana Foundation LIMPOPO  ELTA Effata  Masakhane Peelton  St. Joseph Community Center  Center for Positive Care  Direleng  Future Families GAUTENG & NORTH  Heart Beat The Retreat WEST  HIVSA  Orababaletse OVC  Sithandazingane

Global Camps Africa Youth Leadership Camps Program Report: January 2014 28 Annex II: Personal Development Plan Guidance

Personal Development Plan

Camp has the ability to be a transformative experience during the camp session, yet equal attention needs to be paid to the transference of the skills learned to life back home. One tool to help campers connect their learning at camp to their future is through a forward looking Personal Development Plan. At the beginning of the camp each camper will be given instruction and inspiration regarding how to develop their own personal development plan. They will make a plan for the camp week and project forward to develop one for the next 3 years. During the camp they will be assisted by the camp counselors to structure their own development plans according to their personal goals and objectives. This step will insure that they have a better realization of the skills they are gaining and help them think about how they can apply those skills at home and in their future. Through the various activities that the campers will take part in, they will be able to develop their skills and so meet many of the objectives of their personal plans for the camp week. For example, each of the activities are specifically targeted to teach much more than simply the activity. Intentional focus and framing of the activity leads to the more important character development lessons. The activities are a vehicle to accomplish:  Develop of personal qualities and leadership abilities  Organizational and planning skills  Team building  Decision making and problem solving  Task orientation and creative thinking  Development of analytical skills  Understanding personality strengths and weaknesses  Develop trust amongst participants.

Lesson plan and activity notes for leader: Personal Development Plan Discuss three reasons to have a personal development plan include:  Clarity. Knowing what I am trying to accomplish  Define The Why. Having a personal development plan shows me why I’m doing what I’m doing – even on days I don’t feel like it  My Compass. A personal development plan keeps me headed towards consistent goals.

Please use examples from your life that show how you have grown and changed as a result of the camp experience and other opportunities to develop skills.

What Is In A Personal Development Plan? Answer: Write down what you want, why you want it, and how you plan to get there. Personal Development Plan Example Sections  Your Life Purpose. What were you born to do? What is the meaning of your life?  Your Dreams. Those far reaching thoughts and hopes that inspire you to action. How can you put your life purpose into action to accomplish something that is meaningful to you?

Global Camps Africa Youth Leadership Camps Program Report: January 2014 29  Short, Medium and Long Term Goals. I like to have at least some goals I can accomplish in the span of a few months along with multi-year goals. This lets me see that I have measurable progress towards my goals. What is one thing I can do differently next week when I am at home? What is something that I can do, but might take me a month or two to build up to doing?  Your Beliefs and Values. What do you stand for? What do you think is important? What offends you? And perhaps, what do you wish your actions showed you stand for? When others think about you, what would they say are the things that are important to you?  Success and Milestones. As you accomplish goals and dreams, celebrate your successes. Even something small that helps you see you can keep the promises you make to yourself, tell someone and celebrate your discipline!

Personal Development Plan Template One of the areas many people don’t take time to do is set goals. There is a tool a called SMART (Specific, Measurable, Achievable, Relevant, Timely) goal. For example, if I want to improve my overall health, I could say that I want to exercise 30 minutes a day, three times a week for the next month. I will be able to chart my progress, and look back to see if I accomplished my goal. Goals can be set in all areas of our life. We might say that we want to finish our schoolwork before spending time talking with our friends on each night that we have homework. Then when we do that, talking with our friends is a celebration that our homework is finished. We also can then ask them for help on homework that was difficult for us. How can you get a good overview of the direction you want your life to head? You should sketch out some goals in the most important areas in your life, at regular intervals. By doing this, we can see the connections between what we are doing now and how it will help us with our longer term goals. A very simple personal development plan template for goals might look like this: One One Six One Three Goal Area Five Year Ten Year Week Month Months Year Years Career Finances Physical/Body Social Personal

For each box, answer these questions:  What specifically do I want to accomplish?  Why?  Who can help me?  How do I get there? (What actions do I need to take?)

Personal Development Planning Tools In addition to the information above, consider other tools to help you with your personal development

Global Camps Africa Youth Leadership Camps Program Report: January 2014 30  Events. Especially for career and education goals. Conferences? Meetings where people similar to you gather? Volunteer your leadership skills to organize something for your friends and community.  Classes/Books/Educational material. Sometimes the first step is finding the resources we need. It can start with paying attention in school and grow as you learn more things that interest you.  Mentors and Supporters. Who can you reach out to that can help you with your goals? Try to find people who are doing what you want to be doing and ask them questions.

Close the activity session with a reminder of what you have done and also what you dream about. Bring in examples of famous people in South Africa and share what their dreams were and what you know about how they were able to do it. Together you can inspire each other to see what the future might hold.

Global Camps Africa Youth Leadership Camps Program Report: January 2014 31 Annex III: Camp Schedule The following provides a detailed example of the camp schedule: Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8

8:00 Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast

9:00 Cabin A&B Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

Cabin C&D A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Cabin E&F Theatre A&C Nutrition Swimming Adventure Life-skills breakfast

Cabin G&H Life-skills Theatre A&C Nutrition Swimming Yoga/Sports and depart

Cabin I&J Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure for home

Counselor Planning Adventure Yoga/Sports Life-Skills Theatre A&C Swimming

Counselor free period Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition

10:00 Cabin A&B Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition

Cabin C&D Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

Cabin E&F A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Cabin G&H Theatre A&C Nutrition Swimming Adventure Life-skills

Cabin I&J Life-skills Theatre A&C Nutrition Swimming Yoga/Sports

Counselor Planning Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure

Counselor free period Adventure Yoga/Sports Life-Skills Theatre A&C Swimming

11:00 Cabin A&B Adventure Yoga/Sports Life-Skills Theatre A&C Swimming

Cabin C&D Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition

Cabin E&F Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

Cabin G&H A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Cabin I&J Theatre A&C Nutrition Swimming Adventure Life-skills

Counselor Planning Life-skills Theatre A&C Nutrition Swimming Yoga/Sports

Counselor free period Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure

12:00 L U N C H

13:00 Rest Hour just Chill kids

arrival Cabin A&B Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure

Cabin C&D Adventure Yoga/Sports Life-Skills Theatre A&C Swimming name games Cabin E&F Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition and getting to Cabin G&H Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C know you Cabin I&J A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Counselor Planning Theatre A&C Nutrition Swimming Adventure Life-skills

Counselor free period Life-skills Theatre A&C Nutrition Swimming Yoga/Sports

14:55 Cabin A&B Life-skills Theatre A&C Nutrition Swimming Yoga/Sports cabin Cabin C&D Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure allocation and Cabin E&F Adventure Yoga/Sports Life-Skills Theatre A&C Swimming site Cabin G&H Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition introduction Cabin I&J Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

Counselor Planning A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Counselor free period Theatre A&C Nutrition Swimming Adventure Life-skills

15:55 Cabin A&B Theatre A&C Nutrition Swimming Adventure Life-skills

Cabin C&D Life-skills Theatre A&C Nutrition Swimming Yoga/Sports nurse and t- Cabin E&F Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure shirts Cabin G&H Adventure Yoga/Sports Life-Skills Theatre A&C Swimming

Cabin I&J Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition

Counselor Planning Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

Counselor free period A&C Nutrition Swimming Adventure Yoga/Sports Theatre

16:55 Cabin A&B A&C Nutrition Swimming Adventure Yoga/Sports Theatre

Cabin C&D Theatre A&C Nutrition Swimming Adventure Life-skills

egg toss Cabin E&F Life-skills Theatre A&C Nutrition Swimming Yoga/Sports

Cabin G&H Yoga/Sports Life-Skills Theatre A&C Nutrition Adventure

Cabin I&J Adventure Yoga/Sports Life-Skills Theatre A&C Swimming

Counselor Planning Swimming Adventure Yoga/Sports Life-Skills Theatre Nutrition

Counselor free period Nutrition Swimming Adventure Yoga/Sports Life-Skills A&C

17:55 Dinner Dinner Dinner Dinner Dinner Dinner Dinner

evening programs run from 19:30 - 21:00

Global Camps Africa Youth Leadership Camps Program Report: January 2014 32 Annex V: Pre and Post-Camp Survey Questions

Part 1 of 3

Directions: The sentences below describe how people think about themselves and how they do things in general. Read each sentence carefully and think about how you are in most situations. Place a check the box that describes YOU the best. Please answer every question by putting a check in one of the boxes.

There are no right or wrong answers, just tell us what None of Some of A lot of Most of All of you think. the time the time the time the time the time 7. I think I am doing pretty well in life. 8. I can think of many ways to get the things in life that are

most important to me. 9. I am doing just as well as other people my age. 10. When I have a problem, I can come up with lots of ways

to solve it. 11. I think the things I have done in the past will help me in

the future. 12. Even when others want to quit, I know that I can find

ways to solve the problem. 1997 Snyder et. al.

Directions: In this section, the sentences below describe how people think about themselves and how they do things in general. Read each sentence carefully and think about how you are in most situations. Place a check the box that describes YOU the best. Please answer every question by putting a check in one of the boxes.

Strongly Not Strongly There are no right or wrong answers, just tell us what you think. Disagree Agree Disagree Sure Agree 15. I usually manage one way or another. 16. I feel proud that I have accomplished things in life. 17. I usually stay on track even if bad things happen. 18. I like myself. 19. I feel that I can handle many things at a time. 20. I am determined. 21. I can get through difficult times because I’ve experienced difficulty before. 22. I have self-discipline. 23. I keep interested in things. 24. I can usually find something to laugh about. 25. My belief in myself gets me through hard times. 26. In an emergency, I’m someone people can generally rely on. 27. My life has meaning. 28. When I’m in a difficult situation, I can usually find my way out of it.

Su-I Hou, DrPH, CPH, MCHES, RN © 2011 ©2009 Gail M. Wagnild and Heather M. Young. Used by permission. All rights reserved. “The Resilience Scale” is an international trademark of Gail M. Wagnild & Heather M. Young, 1993

Directions: This section is a chance for you to tell us how you think about yourself when you make decisions. Think about your life in general and how often the statement is true about you.

About Some Most Almost half Almost of of There are no right or wrong answers, just answer the way you feel. never of all of the the the the time time time time 15. When faced with a problem I try to forget about it. 16. I change my opinion when someone I admire/respect/like disagrees

with me. 17. If I want something I work hard to get it. 18. I like to have a say in any decisions made by any group I'm in. 19. What other people think makes a big difference in my behavior. 20. When something good happens to me I feel it is because I earned it. 21. I enjoy being in a position of leadership. 22. I need someone else to tell me my work is good before I am satisfied

with what I've done. 23. I stick to my opinions/ideas when someone disagrees with me. 24. I do what I feel like doing, not what other people think I should do. 25. I get discouraged when doing something that takes a long time to

finish. 26. When I am part of a group I want to let other people make all the

decisions. 27. When I have a problem I follow the advice of friends and/or relatives. 28. Having someone important tell me I did a good job is more important

to me than feeling I've done a good job.

Su-I Hou, DrPH, CPH, MCHES, RN © 2011 PART 2 of 3

How do you feel? We want to know how you feel about different ideas about HIV/AIDS. Please read the statement and then mark how much you agree or disagree with the statement. Although some statements may sound similar to you, it is important that you respond to each of them. We ask the same question in different ways to help us understand better what you think and feel.

A. OTHER PEOPLE living with HIV/AIDS B. MYSELF if I had HIV/AIDS

To what extent do you agree or disagree? To what extent do you agree or disagree?

Strongly Dis- Not Strongly Strongly Dis- Not Strongly Agree Agree Disagree agree Sure Agree Disagree agree Sure Agree I feel people with HIV I would feel ashamed if 1 should be ashamed of I had HIV. themselves. I feel people with Having HIV would 2 HIV/AIDS are unclean. make me feel unclean. Having HIV in my I feel a person with HIV is 3 body would be disgusting. disgusting to me. If I had HIV, I would I feel HIV is punishment think it was a 4 for things they have punishment for done. things I’ve done. I feel people with HIV are was not If I had HIV, I would 5 as good as feel I was not as good other people. as other people. I feel people who get If I had HIV, I would HIV/AIDS (through sex or think that I have 6 drug) have ‘‘gotten what gotten what they deserved’’ I deserve. I feel people with I would feel 7 HIV/AIDS are cursed. cursed if I had HIV.

C. How would you feel? These questions ask you about how comfortable you would feel in a situation. Please read the statement and check your response about the extent you agree or disagree.

Strongly Strongly To what extent do you agree or disagree? Disagree Not sure Agree Disagree Agree 1 I would feel comfortable hugging a close friend who has AIDS. I would feel comfortable swimming in a pool with someone 2 who has HIV/AIDS. I would feel comfortable staying friends with someone who 3 has HIV/AIDS. I would feel comfortable kissing a good friend or relative who 4 has HIV/AIDS. I would feel comfortable making friends with someone who 5 has HIV/AIDS. I would feel comfortable playing sports with someone who has 6 HIV/AIDS.

Su-I Hou, DrPH, CPH, MCHES, RN © 2011 D. What do you think? These questions ask you about what you think about different situations. Please read the statement and check your response about the extent you agree or disagree.

Strongly Strongly To what extent do you agree or disagree? Disagree Not Sure Agree Disagree Agree 1 It is ok if people with HIV/AIDS are not able to go to a doctor or nurse. 2 It is ok if people with HIV/AIDS cannot go to school. 3 It is ok for children not to go to school if their parents have HIV/AIDS. 4 It is ok if people with HIV/AIDS cannot get a job. It is ok, if no one takes care of children whose parents died from 5 HIV/AIDS.

E. These questions ask you about what you think you might do. Please indicate to what extent you agree or disagree with the following statements.

Strongly Strongly To what extent do you agree or disagree? Disagree Neutral Agree Disagree Agree 1 If I had HIV, I would worry that people would tell others. 2 If I had HIV, I would tell people close to me to keep it a secret. 3 If I had HIV, I would not feel I could not be open with other people. 4 I would worry that people may judge me if they learn I had HIV. 5 I fear I would lose my friends if they learned I had HIV. 6 I fear that my family would reject me if they learned I had HIV. 7 I feel I wouldn’t get good health care if people knew I had HIV. I would avoid getting medical treatment so no one would find out if I 8 had HIV.

1. If you tested positive for HIV, would you intend to tell any of the following individuals about your HIV test result?

Yes No I do not have h. Your parents i. Your friends j. Your brothers/sisters k. Other relatives l. Your partner / spouse m. Your children n. Your co-workers

2. If you had HIV and chose to tell people your HIV status, do you think that the following outcome(s) might happen to you?

Yes No Does Not Apply a. Be looked down on by other people b. My family being hurt by others c. Not permitted to go to school d. Discrimination by doctors/nurses e. Break-up of marriage or partner(s) f. Physical abuse by spouse or partner(s)

Su-I Hou, DrPH, CPH, MCHES, RN © 2011 h. Other worries, please tell us:

Part 3 of 3

Section 1: For each statement please tell us whether you think it is “true”, “false” or “not sure”.

Not True False Sure 12. A person can get HIV/AIDS from mosquito bites. 13. A person can get an HIV from oral sex. 14. A person can get HIV even if he/she has only has unprotected sex once with an HIV infected person. 15. People with HIV quickly show serious signs of being infected. 16. A person with HIV can look and feel healthy. 17. A pregnant woman with HIV can give the virus to her unborn baby. 18. It is harder for women to get HIV from men, than for men to get HIV from women. 19. Showering, or washing one’s genitals/private parts, after sex keeps a person from getting HIV. 20. It takes a couple of weeks or months for HIV to show up on a test. 21. Coughing and sneezing DO NOT spread HIV. 22. A person can get HIV by swimming in the same pool with a person who has HIV.

Section 2: The following are a series of statements about HIV testing. For each statement, please tell us what you think.

Strongly Not Strongly Disagree Agree Disagree Sure agree 1. I am scared to find out if I am infected with HIV. 2. If I get tested and my friends find out they may not want to be friends with me. 3. It is likely that I might be infected with HIV in my lifetime. 4. I have no interest in finding out whether I am HIV infected. 5. I think everyone needs to know their HIV status.

Section 3: Please answer the following questions on HIV testing as honestly as possible.

3.1 Have you ever thought of having an HIV test? ____ No ____ Yes

If no, why not? ______

3.2 Have you ever had an HIV test? ____ No ____ Yes

3.3 Do you intend to have an HIV test in the next 6 months?

Absolutely not Probably not Not sure Probably yes Absolutely yes

Su-I Hou, DrPH, CPH, MCHES, RN © 2011

Section 4: Sexual behavior (Please circle your answer)

The following questions are about your sexual behavior. You do not have to answer questions that you are not comfortable with. All information will be kept strictly confidential. Your honest response is important and can help us develop appropriate educational programs in the future.

4.1 Have you ever done any of the following sexual activities? (If you don’t know what they are, please ask for help).

4.11 Oral sex (using mouth) No Yes

4.12 Vaginal sex (using private parts) No Yes

4.13 Anal sex (using the bum) No Yes

4.2 In the next 6 months, if you have sex, do you plan on using a condom?

Definitely Yes Probably Yes Not Sure Probably No Definitely No

4.3 How confident you are that you can convince your partner to use a condom the next time you have sex?

Very Confident Somewhat Somewhat Not Not Confident at Confident Confident All

4.4 What have you learned about yourself and HIV at Camp?

Su-I Hou, DrPH, CPH, MCHES, RN © 2011 Section 5: Information

5.1 How old are you? ______(years old)

5.2 Are you? Male Female

5.3 What is your current relationship status?

1. Single, no boyfriend or girlfriend 2. Single, has boy or girl friend(s) 3. Friends with benefits (have sex with them, but not boy/girl friend) 4. Engaged 5. Married 6. Separated or divorced, or other (specify ______)

5.4 Which of the following best describes you?

1. Heterosexual/Straight (boy dates girl, girl dates boy) 2. Bisexual (boy dates both boys and girls, girl dates both girls and boys) 3. Gay/Lesbian (boy dates boy, girl dates girl) 4. Not sure or other 5.5 Do you personally know someone with HIV or AIDS? ___No ___Yes ___I don’t know

5.6 Have you ever asked a boyfriend or girlfriend about his/her HIV status?

__No __Yes __I don’t know __ I have no partner

5.7 Has a girlfriend/boyfriend ever asked you about your HIV status?

__No __Yes __ I don’t know __ I have no boyfriend or girlfriend

5.8 How many of your close friends do you think (make a guess) have engaged in sexual activities of any kind (oral sex, vaginal or anal intercourse)?

5.111 Oral sex (using mouth) None Few Some Most All

5.112 Vaginal sex (using private parts) None Few Some Most All

5.113 Anal sex (using the bum) None Few Some Most All

5.9 How would you rate your knowledge about HIV / AIDS in general? Very low Low Medium High Very high

5. 10 How would you rate your knowledge specifically related to HIV testing?

Very low Low Medium High Very high

Su-I Hou, DrPH, CPH, MCHES, RN © 2011