Media/Materials Clearinghouse (M/MC)

Notes:
Full report on the campaign's impact
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Two-page Communication Impact
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Article about the HEART Campaign
|The Helping Each Other Act Responsibly Together (HEART) Campaign is being conducted in Zambia between 1999-2002 with the goal of significantly reducing the sexual transmission of HIV among youth between the ages of 13 - 19 in Zambia. Its behavior change strategy is to encourage youth to abstain from sexual intercourse or use a condom every time they have sex with every partner. This campaign uses all relevant mass media channels, including radio, TV, print and billboards to reach youth on a daily basis.|According to the 1998 Zambian Sexual Behavior Survey, 84% of Zambian youth have had sex by the age of 19. Many have sex by the age of 15—37% of boys and 27% of girls (ZSBS.) And, 17% have sex by age 10 in urban compounds of Lusaka (CARE). HIV/AIDS prevalence is very high among young people (estimated 17% urban and 11% in rural areas (ZSBS)). A 1998 report by CARE indicated that 65% of adolescent girls reported receiving money/gifts for sex, and 71% of adolescent boys had given money/gifts for sex. In another set of surveys, 38% of unmarried females reported having sex for money (1996 DHS) vs. 57% of girls (ZSBS). Risk perception was also very low among 15-19 year olds: 64% of girls and 70% of boys thought they were not at risk of contracting HIV/AIDS (1996 DHS).

Condom use has remained low among youth in Zambia. A survey by the Society for Family Health highlighted the following reasons youth gave for not using condoms:
-62% disliked the product
-56% feared partner's objection
-47% trusted the partner
-25% alluded to unavailability

Although government and non-governmental organizations (NGOs) have implemented awareness campaigns for young people on a limited basis, these efforts have led to only minor changes in youth behavior.

Project Strategy: Historically, youth in Zambia have been involved in issues that concern youth on only a small scale, focusing on school, church and community-based outreach efforts. Donors and other stakeholders have a history of youth programming in Zambia on a somewhat larger scale. USAID, in partnership with the government of Zambia, for instance has supported a number of programs, such as the introduction of Youth Friendly Health Services. UNFPA has supported a relatively large-scale peer educator program. These activities have included youth in the capacity of peer educators, but they have been designed and managed by more senior (non-youth) technical staff.

In 1999, the government challenged the youth of Zambia to play a greater role in programs for their peers. Taking the challenge, collaborating youth-based organizations, with support from the Johns Hopkins University Population Communication Services (JHU/PCS,) launched a two-phase national mass media campaign. The campaign focused on promoting safer sex for young people, with emphasis on the leadership and full participation of youth in the planning, design, implementation, monitoring and evaluation of the campaign.

The campaign strategy featured partnerships of government, donors, youth organizations and other stakeholders. The behavior change objectives of the strategy were to increase knowledge among youth of the risks of HIV/AIDS, and to promote the idea that youth have two options: to abstain from sex, or to use condoms every time they have sex. Being faithful was not stressed, since part of the perception of low risk among youth included the belief that being in a faithful relationship meant there was no risk of HIV/AIDS.

Project Activities: Youth were involved in the design and implementation of the campaign at several levels:
1. A design team of communication specialists including five young people made key strategic decisions and implemented the campaign.
2. To achieve broader youth involvement, a Youth Advisory Group (YAG), was formed, made up of 35 young people from 11 youth organisations. The YAG serves as an advisory body to the design team. The YAG developed the communication objectives and messages for segmented target audiences, which included: abstinent males, abstinent female and inconsistent male condom users, all in the age range of 13 to 19 years.
3. Finally, message concepts (commercial scripts), were tested for appeal and comprehension through focus groups and in-depth interviews involving over 1200 young people (13-19 years), both in rural and urban settings, as well as in and out of school.

As a result of the above activities, 8 television and 25 radio spots in seven languages were produced and aired with messages focusing on abstinence and consistent use of condoms. An additional key campaign message, "You can't tell by looking," stressed that one can't tell a person has HIV by that person's appearance. IEC materials such as posters, car stickers, exercise books, messages on buses and two songs and musical videos complemented the above.

Results: Preliminary results indicated high levels of comprehension and acceptance of campaign messages as well as reported discussion of the spots with peers and parents. Preliminary data from a youth survey fielded in August 2000 showed significant impact in the behavior of young people related to safer sex (abstinence and consistent use of condoms) as a direct result of the intervention.

Although there was little public debate in the media and on the community level during the initial launch of the campaign, there was a high level of public outcry with the introduction of messages for girls about condoms in the campaign's second phase. This public debate was met with higher levels of youth involvement and leadership throughout the implementation of the campaign, as youth participated more prominently than ever before in public forums and debates. less

	The Health Communication Partnership Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs in partnership with Academy for Educational Development " Save the Children " The International HIV/AIDS Alliance Tulane University's School of Public Health and Tropical Medicine
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