Survey results show that increasing numbers of South Africans are being exposed to HIV education material, yet basic knowledge of HIV and AIDS has decreased. These statistics underline the importance of well-structured, targeted education initiatives that focus on the transfer of basic information relating to HIV prevention.
The 2008 South African National HIV Prevalence, Incidence, Behaviour and Communication Survey provides detailed information on HIV prevalence, awareness and behavioural aspects related to the epidemic. An overview of the results show a number of encouraging trends, but the survey report also identifies certain challenges. A key issue raised by the report is the significant decrease in knowledge of HIV prevention. Correctly identifying ways to prevent sexual transmission of HIV has significantly declined among the population 15–49 years at national level, from 64.4% in 2005 to 44.8% in 2008. The percentage of most-at-risk populations who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission has also declined over time.
Surprisingly, this dramatic decline in the knowledge of HIV prevention has occurred over a period in which the exposure to HIV education programme has increased. In order to measure exposure to HIV education material, the survey focused on four large-scale ongoing national programmes. The reach was defined as having heard or seen at least one component of the communication programmes – for example, a radio advertisement, and/or television programme and/or other components. The reach of these programmes, which was fairly high in 2005 (74%), had increased further to 80.9% in 2008.
The survey results clearly show that, while a large proportion of South Africans are exposed to HIV education, the desired knowledge transfer is in many cases not effective. All of us involved in HIV education should seriously consider the implications of these results. While there is a need to make HIV education interesting and accessible, it may be that some programmes emphasise entertainment and activities without ensuring that the basic information on HIV prevention is effectively communicated. Significant funds are dedicated to HIV education in South Africa, and agencies involved in these efforts have an ethical obligation to ensure that these funds are used effectively. Impact assessments are an important tool through which agencies can measure the effectiveness of their programmes and identify areas that require improvement.
Of course, impact assessments are only the starting point for a process of organizational learning and improvement; and it has been well documented that too often the recommendations of impact assessment reports do not lead to concrete action and the lessons learned by implementers on the ground are not diffused throughout the organization.
It is helpful to distinguish between HIV awareness raising and HIV education. While certain programmes effectively use television, print media, concerts, radio and other means to raise awareness of HIV, it remains important to support these efforts with HIV education programmes that will provide audiences with further information on HIV prevention.
HIV&Me was was designed to ensure the effective transfer of HIV prevention knowledge through a series of classroom-based lessons. Educators are provided with lessons plans and also receive training in HIV education. Feedback sessions, on site observation, and written reports are used to ensure that the programme is effectively implemented, and to record the necessary information to address any challenges that may arise. In 2009 HIV&Me conducted a detailed impact assessment, which confirmed the positive impact of the programme, while also highlighting certain challenges. The study provided a useful tool through which to further improve HIV&Me. Of course, the learning process is ongoing, and HIV&Me will continue to evolve and further engage with young learners in schools across South Africa.