TALKING A STUDY ON HIV, SEXUAL RISK BEHAVIOUR, POINTS AND ACCESS TO OPPORTUNITY AMONG YOUNG PEOPLE IN SOUTH AFRICA EVALUATING loveLife’s IMPACT ON THE LIFE CHOICES AND RISK TOLERANCE OF YOUNG 2012 PEOPLE Talking Points on loveLife 2012 Contents ACKNOWLEDGEMENTS & INTRODUCTION TO 3LOVELIFE 4 loveLife IMPACT ASSESSMENT STUDY 2011 TALKING POINTS OUTLINED BACKGROUND, METHOD & SAMPLE, LIMITATIONS 5 ELEVEN TALKING POINTS ON HIV AND SEXUAL BEHAVIOUR AMONG YOUNG 6-16 PEOPLE UNPACKED FIVE TALKING POINTS ON loveLife’s IMPACT17-21 2 Talking Points on loveLife 2012 Acknowledgements he loveLife Impact Assessment Study Rachel Bray, Nadia Sanger and Gabrielle loveLife would also like to thank the review 2011 was a collaborative project Garzouzie. At loveLife, Friederike Subklew- committee, consisting of fi ve experts in the Tbetween loveLife and the Human Sehume, Emilie Venables, Jennifer Koen, Scott fi eld of adolescent sexual behaviour and HIV, Sciences Research Council (HSRC). The study Burnett and Grace Matlhape contributed to for their input into this report. was overseen by Karl Peltzer, who also led the the design and review of the research and the This study would not have been possible quantitative study team including Shandir compilation of this summary document. without the 3,184 research participants who Ramlagan, Motlatso Mlambo, Julia Louw, The study was made possible by the took part in the qualitative and quantitative Gugu Mchunu, Khangelani Zuma, Lebogang Henry J. Kaiser Family Foundation. loveLife is arms, and we thank them for their input. Seutlwadi, Bomkazi Tutshana, Gladys Matseke, extremely grateful for the funding provided Suggested citation: loveLife (2012). Talking Witness Chirinda, Peter Njuho and Mpho by the foundation and the guidance and Points: A study on HIV, sexual risk behaviour, Satekge. The HSRC qualitative study team support that Michael Sinclair provided to the and access to opportunity among young consisted of Sharlene Swartz, Pamela Naidoo, loveLife team. people in South Africa. Introduction to loveLife oveLife is South Africa’s HIV-prevention health counselling skills and techniques for programme for young people. Since its eff ective outreach to other young people. linception by leading private funders and Since the inception of the groundBREAKER the South African government in 1999, programme in 2001 more than 10,000 loveLife has harnessed youth leadership groundBREAKERS have graduated from the to promote healthy lifestyles and an HIV- programme. free way of life among teenagers living groundBREAKERS are recruited from “loveLife in South Africa by linking HIV prevention a pool of over 6,000 volunteers called with youth development. loveLife mpintshis (vernacular for ‘friend’ or combines a nationwide multimedia ‘buddy’) who groundBREAKERS recruit and RECOGNISES campaign with programmatic face to face mentor. Together, groundBREAKERS and engagements, community-level outreach, mpintshis work in more than 8,000 schools THAT YOUTH systems strengthening and clinical and across South Africa from almost 900 hubs, psychosocial services. which include loveLife Y-Centres, youth- LEADERSHIP loveLife recognises that youth friendly clinics, social franchises and other leadership is critical in transforming South loveLife outlets. IS CRITICAL IN African society, and has based its approach This document makes reference to on addressing the individual, social loveLife’s face to face programmes and and structural factors driving high risk multi-media products. loveLife’s face TRANSFORMING tolerance and leading to a perception of to face programmes include modular scant opportunity among young people. programmes such as “lovingLife” which is SOUTH AFRICAN Every year loveLife recruits a national implemented in schools, loveLife Games corps of over 1,200 full-time young leaders events, and the loveLife Call Centre. SOCIETY.” known as groundBREAKERS, who volunteer loveLife has six multi-media products, for a period of 12 months to drive HIV which include the Make your Move TV prevention within their communities. series, public service announcements, and These young people, aged between 18 nationwide radio shows. loveLife is also and 25, go through a series of training active on Facebook and twitter and has its programmes to equip them with sexual own mobile application called MYMsta. 3 loveLife Impact Assessment Study 2011 Background This study was conducted to evaluate the “loveLife 2011”. In 2003, loveLife conducted a impact of loveLife, South Africa’s national HIV national survey of HIV and sexual behaviour prevention campaign for young people, on among young South Africans1. The study, HIV and related risk behaviours. In addition, referred to as “loveLife 2003” throughout this two concepts on which loveLife’s approach is document, also assessed the early impact of built were explored: risk tolerance and access loveLife’s interventions on young people in to opportunity, with a particular focus on South Africa. young women. The talking point document The South African National HIV Prevalence, presented here gives an overview of the main Incidence, Behaviour and Communication research fi ndings and loveLife’s impact on the Survey 20082 conducted by HSRC is also used lives of young people in South Africa today. In for comparison and is referred to throughout this document the study will be referred to as as “HSRC 2008”. Methods and Sample The mixed-methods study incorporated the qualitative research involved in-depth qualitative and quantitative research interviews with young people who had methodologies and was conducted in four participated in loveLife programmes. South African provinces. The two provinces These young people then carried out social with the highest HIV prevalence in the network interviews in their communities. A country (KwaZulu-Natal and Mpumalanga), total of 3,123 young people, aged between were selected along with the most urban 18 and 24 years took part in the quantitative province (Gauteng) and one rural province survey, and 61 young people between (Eastern Cape) to represent the diff erent 18 and 26 years were interviewed in the dynamics of South Africa as much as qualitative component. An additional 239 possible. The quantitative team conducted social network interviews were conducted a randomised household survey, while by the qualitative research participants. Qualitative Quantitative Number 61 3123 Age range 18-26 18-24 Average age 21.4 20.5 Gender 52.5% men 54.6 % men 47.5% women 45.4 % women Exposure to loveLife Interviewees were 50% master sample enumerator groundBREAKERS, mpintshis or areas and 50% loveLife sample loveLife programme participants enumerator areas Table 1: Characteristics of research participants Limitations 1Pettifor, A. E., Rees, H. V., Steff enson, A., All HIV and STI data presented in this the 2003 study results have not yet been Hlongwa-Madikizela, L., MacPhail, C., & Vermaak, document are self-reported, which leads to recalculated for the same age range as the K., et al. (2004). HIV and sexual behaviour among the potential for under- or over-reporting. 2011 study. Further analysis is on-going to young South Africans: a national survey of Actual HIV prevalence rates are likely to be address this gap. It also needs to be pointed 15-24 year olds. Johannesburg: Reproductive higher and the biases in self-reported sexual out that the qualitative and quantitative Health and HIV Research Unit, University of the behaviour are diffi cult to determine. Even components of loveLife 2011 did not involve Witwatersrand though loveLife 2011 looked at many of the same participants, so survey responses 2Shisana O, Rehle T, Simbayi LC, Zuma K, the same indicators as loveLife 2003, direct and in-depth interviews cannot be directly Jooste S, Pillay-van-Wyk V, Mbelle N, Van Zyl comparisons are at this point limited because compared. J, Parker W, Zungu NP, Pezi S & the SABSSM III Implementation Team (2009) South African national HIV prevalence, incidence, behaviour and communication survey 2008: A turning tide 4 among teenagers? Cape Town: HSRC Press Talking Points on loveLife 2012 1. Young people in South Africa accept high levels of risk as part of everyday life 2. More young people are getting tested for HIV, and are doing so more frequently 3. Young men report close to 100% condom use with their most recent casual partners, but condom use overall is inconsistent 4. One in fi ve sexually active young men and women have had transactional sex 5. Whilst young people are beginning to recognise their risk of ELEVEN contracting HIV they do not always do so accurately 11 6. Intergenerational communication about HIV/AIDS has increased TALKING dramatically but the engagement of young people with their male guardians remains limited POINTS ON HIV 7. Young people are accepting of people living with HIV, but stigma AND SEXUAL around HIV testing and disclosing one’s status still exist 8. Almost three out of four fi rst pregnancies are unintended BEHAVIOUR 9. The majority of young people had not drunk alcohol in the past year, but more than half of those who did drink, drank AMONG excessively YOUNG 10. Young people know what they want out of life, but not all believe they will have the opportunity to achieve their goals PEOPLE 11. A cluster of individual, social, and structural factors predict risky behaviour 1. Nearly all young people know about loveLife; one in three had participated in one or more of loveLife’s programmes 2. loveLife programmes have a positive impact on young people’s FIVE TALKING communication with community members, relatives, teachers 5 and friends POINTS ON 3. Exposure to loveLife improved young people’s sexual health 4. Participation in loveLife gave four out of fi ve young people a loveLife’s sense of purpose in life IMPACT 5. While almost all young people said all South Africans should participate in loveLife, three quarters felt loveLife needs to reinvent itself to remain relevant 5 Talking Points on loveLife 2012 11Eleven Talking Points on HIV and Sexual Behaviour Among Young People 6 Talking Points on loveLife 2012 1.