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					loveLife 2002
Report on activities and progress
                    This repor t draws on a comprehensive review of loveLife’s
                    routine programme monitoring systems and data by Dr. Saul Johnson,
                    Gill Nelson and Gill Schierhout of Health and Development Africa.
                    Audrey Pettifor, Mbazo Mokoena and Pepukai Chikukwa of the
                    Reproductive Health Research Unit of the University of the
                    Witwatersrand also contributed to the development of the monitoring
                    framework for loveLife.


                    For information on how to obtain additional copies, please refer to the
                    back cover of this report.




About loveLife

loveLife is a new lifestyle brand for young South Africans promoting healthy living and
positive sexuality. Organised under the auspices of leading South Africans, loveLife
combines a high-powered media campaign with nationwide adolescent sexual health
services, and community-level outreach and support programmes for youth. loveLife’s
programmes are implemented by a consortium of leading South African public health
organisations: the Health Systems Trust, Planned Parenthood Association of South Africa
and the Reproductive Health Research Unit of the University of the Witwatersrand in
coalition with more than 100 community-based non-government organisations across
South Africa. Major funding for loveLife is provided by the Henry J. Kaiser Family
Foundation and the Bill and Melinda Gates Foundation. Additional funding is provided by
the South African Government, and the Nelson Mandela Foundation. For information visit
www.lovelife.org.za or call thethajunction on 0800 121 900.
Table of Contents
Executive Summary                                                                                                                                                                                3

Background                                                                                                                                                                                       4

Strengthening awareness of loveLife and stimulating scaled-up community dialogue about HIV and sexual health                                                                                      7
     Establishing and positioning the loveLife brand. ......................................................................................................................7
       Message development and execution................................................................................................................................... 7
       Scale.. .................................................................................................................................................................................. 9
       Distribution and targeting for maximum impact. ................................................................................................................ 9
       loveLife on national television........................................................................................................................................... 11
       Public service announcements .......................................................................................................................................... 11
       S’camto groundBREAKERS .............................................................................................................................................. 12
       loveLife Games. ................................................................................................................................................................. 13
       World AIDS Day, 1 December 2002 ................................................................................................................................. 14
     Expanded national and community dialogue and debate ........................................................................................................14
       Below the line media coverage.......................................................................................................................................... 14
       Calls to the national helplines........................................................................................................................................... 15
     National brand recognition and positioning. ...........................................................................................................................19

Promoting Active Participation in Dialogue on Key Issues of Concern for Young People                                                                                                21
      Radio programmes ............................................................................................................................................................ 21
      National helplines in supporting dialogue and debate...................................................................................................... 22
      S’camto groundBREAKERS audience participation ......................................................................................................... 25

Promoting positive lifestyles and developing aspirational ideals                                                                                                                           28
      High reach activities.......................................................................................................................................................... 29
      Print media ........................................................................................................................................................................ 29
      Other publications............................................................................................................................................................. 30
      loveLife Games. ................................................................................................................................................................. 32
      Celebrate Life .................................................................................................................................................................... 32
      High profile features.......................................................................................................................................................... 32

Local level best practice in youth leadership and seeding initiatives that promote positive lifestyles                                                                                        34
        Y-Centres ........................................................................................................................................................................... 34
        Franchises. ........................................................................................................................................................................ 35
        Volume of Y-Centre visitors............................................................................................................................................... 36
        Characteristics of Y-Centre visitors in 2002 ..................................................................................................................... 36
        Activities at the Y-Centres ................................................................................................................................................. 39
    Reaching out from Y-Centres and “bridging activities”..........................................................................................................39
        Positive lifestyle or motivational programme.................................................................................................................... 41
        loveTrain and loveTours.................................................................................................................................................... 42
        Placing reliable sources of information about HIV/AIDS in the context of debate and dialogue..................................... 42
        Call centre information packs.. ......................................................................................................................................... 43
        Specific research and information publications ................................................................................................................ 43

Promoting improved accessibility and acceptability of reproductive health services for youth                                                                                          45
      The National Adolescent Friendly Clinic Initiative (NAFCI)............................................................................................ 45
      System-level indicators...................................................................................................................................................... 46
      Clinic-level indicators. ...................................................................................................................................................... 46
      Voluntary Counselling and Testing ................................................................................................................................... 48
    Key challenges for loveLife... .................................................................................................................................................49




                                                                                                                                                                                         i
List of Figures

Figure 1. Diagrammatic representation of loveLife objectives and examples of linked indicators................................................6
Figure 2: Estimated distribution of South Africa’s 12-17 year olds by province.........................................................................10
Figure 3: Distribution of youth and parent campaign billboards by province..............................................................................11
Figure 4: Value of below the line print media coverage of loveLife during 2002…. ..................................................................15
Figure 5: Numbers of handled and total calls to the youthline and parentline during 2002.........................................................16
Figure 6: Breakdown of calls to the youthline by age in 2002.....................................................................................................17
Figure 7: Numbers of complete and incomplete calls to the parentline during 2002...................................................................17
Figure 8: Calls received by the youthline and parentline during 2002 expressed as a percentage of young people 12-17
     years in the province. ...........................................................................................................................................................18
Figure 9: Calls to the youthline during 2002 by where the caller heard of the number. ..............................................................19
Figure 10: Calls to the youthline during 2002 by language of caller…. ......................................................................................22
Figure 11: Calls to the parentline during 2002 by language of caller.. ........................................................................................23
Figure 12: Age profile of callers to the S’camto groundBREAKERS II voteline.........................................................................26
Figure 13: Numbers of e-mails received by talk@loveLife.org.za during 2002 ..........................................................................27
Figure 14: Summary of role of various campaign elements in promoting positive lifestyles and developing aspirational
     ideals amongst youth............................................................................................................................................................28
Figure 15: loveLife Y-Centres around the country.. ....................................................................................................................34
Figure 16: Distribution of Y-Centres and Franchises by Province ..............................................................................................35
Figure 17: Visitors to the Y-Centres by age in 2002 (Q3 and Q4) (clinical visits)......................................................................37
Figure 18: New versus repeat visitors to the Y-Centres during Q4 of 2002 by centre.................................................................38
Figure 19: Clinical services rendered expressed as a percentage of visitors................................................................................39
Figure 20: Participants in the Provincial Games in 2002.............................................................................................................41
Figure 21: Average number of monthly youth clients per quarter for NAFCI clinics in 2002.....................................................47


List of Tables

Table 1:     Average audience rating and reach of loveLife Games 2002 ........................................................................................13
Table 2:     Publications distributed or produced in 2002 in relation to aspirational ideals and positive sexuality..........................31
Table 3:     Total number receiving clinical services at Y-Centres during selected quarters of 2002.. ............................................36
Table 4:     Graduates of the MAI motivational programme from Y-Centres and Franchises by province in 2002.........................42
Table 5:      Research and information publications distributed in 2002..........................................................................................43
Table 6:     loveLife Website Statistics for Q4 2002........................................................................................................................44
Table 7:     NAFCI clinic status by province in 2002 ......................................................................................................................46


Annexes

Annex 1: Communication Strategy 2002. Informing loveLife’s multi-media campaign.............................................................51
Annex 2: Examples of outdoor media displayed and developed in 2002 ....................................................................................55




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                                                                                 loveLife 2002



Executive Summary

This report draws on and summarizes the available routine monitoring data from loveLife
programme activities conducted during 2002. The report provides a snapshot of the scale and
diversity of the activities that make up the comprehensive loveLife campaign, and documents
progress in roll-out and scale up of the campaign during its third year of operation.

loveLife is a deliberately designed comprehensive national adolescent behaviour change
intervention designed to reduce the rate of HIV infection, other sexually transmitted
infections and pregnancy among adolescents. The loveLife strategy combines a sustained,
high visibility media education and awareness campaign, with countrywide youth–friendly
service development in government clinics and community level outreach and support
programmes for young people. loveLife uses a broadbased motivational youth development
approach designed to shift young people out of the existing high risk patterns of adolescent
sexual behaviour. Within the context of informed choice, shared responsibility and positive
sexuality, loveLife specifically promotes delayed initiation of sexual activities among
teenagers, reduction of sex partners or abstinence among the already sexually active, and
consistent condom use.

This report illustrates that within the first three years, loveLife has established a clear
presence and recognition among young people with positive attributions that encourage
willing association with loveLife among South African teens. It also shows that this level of
association has to be driven at a broad national level in order to maintain high levels of
national awareness, and at community-level in order to ensure personal engagement with the
loveLife message.

loveLife’s greatest challenge is to sustain engagement among young people with the
campaign in a media saturated environment with many competing attractions, and in an
atmosphere of general cynicism among youth about conventional AIDS campaigns. Such
indicators as 40 000 calls per month answered by the loveLife telephone helpline, the
demand for loveLife print materials, growing youth attendance at loveLife associated
government clinics and at loveLife’s national network of Y-Centres are all evidence of a
significantly positive response from young people.

Behaviour change is complex and generally incremental. The true measure of loveLife’s
effectiveness will be in declining HIV infection rates in South Africans under 20 years. This
evidence will be measured through a large scale national surveillance study conducted every
two years combined with a 33 sentinel site survey tracking behavioural trends and HIV
prevalence among the target group. Baseline data from the first in this series of studies is
expected at end of 2003




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                                                                                  loveLife 2002



Background

This report summarizes routine monitoring data collected in the course of loveLife activities
during 2002 and is intended only to provide a snapshot of loveLife’s comprehensive strategy
and wide-ranging activities. Routine monitoring is one part of an ongoing comprehensive
evaluation programme designed to help inform the effectiveness of loveLife. The loveLife
evaluation also includes a national surveillance study of more than 10,000 teens nationally,
tracking HIV prevalence and sexual behaviour trends, and a 33 sentinel site-specific survey
comparing effects of different combinations of the loveLife intervention on HIV prevalence
and behavioural trends.

loveLife is a comprehensive national HIV education and sexual health services intervention
designed to effect change in the high-risk patterns of adolescent sexual behaviour in order to
reduce HIV infection in South Africa. The primary target group is youth aged 12-17 years.
loveLife’s communication and education strategy builds on the inherent optimism and
aspirational attitudes of South African youth and specifically promotes healthy living and
responsible sexuality based on informed choice and shared responsibility. loveLife
specifically encourages delayed initiation of teenage sexual activity, reduction in number of
sexual partners or abstinence among already sexually active teenagers, and condom use (see
Annex 1 for a description of the communication strategy).

loveLife’s activities are broad ranging in scope, content and the level of personal
engagement they are designed to elicit. They include a sustained, high visibility multi-media
campaign including radio, television, print and billboards; national access to information
provided primarily through a toll-free national telephone advice and counselling service
(thethajunction and a dedicated parent helpline); local community outreach (loveTrain,
loveTours, loveLife Games, groundBREAKERS); and improved youth access to sexual
health services including community youth “Y-Centres” and the National Adolescent
Friendly Clinic Initiative (NAFCI). Descriptions of each of these programmes can be found
on the website (www.loveLife.org.za)

Monitoring a campaign of this scope and diversity is challenging. This report explores
synergies between the different elements of the campaign and documents progress towards
loveLife’s goals. Because loveLife is a comprehensive strategy in which all the programme
elements are inter-related, this report does not examine the apparent effectiveness of
individual programme components, but rather their contribution to the following campaign
goals:

      •    Strengthening loveLife awareness and stimulating scaled-up community dialogue
           about HIV and sexual health
      •    Promoting active participation in dialogue on key issues of concern for young
           people
      •    Promoting positive lifestyles and developing aspirational ideals




                                                                                                 4
                                                                                          loveLife 2002


      •     Placing reliable sources of information about HIV/AIDS in the context of debate
            and dialogue
      •     Promoting improved accessibility and acceptability of reproductive health
            services for youth.

loveLife 2002, Comprehensive Monitoring and Evaluation

-   loveLife’s evaluation programme is one of the most comprehensive of its kind in the world
    combining a large-scale national surveillance study with in-depth surveys at 33 sentinel sites.
    Unlike most HIV prevention programmes, loveLife is tracking its impact over time not only on
    attitudes and self-reported risk behaviours, but also on HIV and STD infections and pregnancy
    rates. The evaluation programme was designed in partnership with the Reproductive Health
    Research Unit of the University of the Witwatersrand, the Medical Research Council of South
    Africa, and Cambridge University (UK), with expert review by an international reference panel.
    Independent external review of the methodology, data collection and analysis is provided by an
    expert review board convened by Prof. Tom Coates, executive director of the Center for AIDS
    Policy at the University of California at San Francisco. The data collected through the evaluation
    programme not only helps to improve the quality of loveLife’s services, but also helps in the
    development of prevention efforts for youth in countries around the world.

Components of loveLife’s monitoring and evaluation programme include:
- National Surveillance: A series of nationally-representative household surveys of young people
   ages 15-24 that track HIV prevalence and the impact of loveLife’s programmes on youth
   behaviour. Results from the first national surveillance survey are expected by the end of 2003.
   The survey includes anonymous HIV tests and interviews to assess young people’s sexual history,
   health knowledge and attitudes, and sources of information about sex and HIV/AIDS.

-   Community Based Study: An in-depth assessment of the impact of Y-Centres and adolescent-
    friendly clinics in 33 communities with these loveLife programmes. Data on sexual risk
    behaviours, HIV and STD prevalence, and pregnancy rates among young people in Y-Centre or
    NAFCI communities are being compared to data from young people living in communities without
    these programmes.

-   Monitoring and Quality Assurance: All of loveLife’s programme components monitor
    demographics of participants and the quality of services provided, and seek regular feedback from
    young people through surveys and focus groups.



This report examines the contribution of various loveLife activities to the campaign as a
whole. loveLife aims to effect individual behaviour change, as well as broad social and
institutional change. For that reason it is appropriate to explore to what extent the campaign
is moving towards influencing social norms and developing a supportive environment for
youth, as well as the campaign’s influence on individual choices and behaviour.




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                                                                                              loveLife 2002


    Figure 1. Diagrammatic representation of loveLife objectives and examples of linked
                                       indicators


                      Objectives                            Examples of Linked Indicators

                                                            MASS MEDIA INPUT; PROCESS; NOS. AND
        1. Developing brand awareness and
                                                            DISTRIBUTION; AR  BTL MEDIA
        scaling up community dialogue
                                                            GENERATED; CALL VOLUME TO HELPLINES;
                                                            TOPICS OF CALLS         BRAND RECOGNITION &
                                                            POSITION


        2. Promoting active participation in                RADIO & TV INPUT;            HELPLINE INPUT,
        dialogue on key issues of concern for               PROCESS;       NO.           PROCESS &
                                                            VIEWERS                      QUALITY; NOS. &
        young people
                                                            PARTICIPATION                DEMOGRAPHICS
                                                            ELICITED                     OF CALLERS



        3. Promoting positive lifestyles and                PRINT INPUT;                 PARTICIPANTS IN
        developing aspirational ideals                      RESOURCES &                  OUTREACH
                                                            DISTRIBUTION BY              ACTIVITIES
                                                            CHANNEL; MEDIA               PROCESS &
                                                            GENERATED FOR                OUTCOME OF
                                                            ‘POSTIVE ROLE                REPLICATION &
                                                            MODELS’                      SCALING UP



        4. Placing reliable information on                  PRINT INPUT; RESOURCES & DISTRIBUTION
        HIV/AIDS in the context of dialogue                 BY CHANNEL; CITATIONS & REQUESTS; WEB
                                                            SITE UTILISATION; INFORMATION
                                                            DISTRIBUTED BY HELPLINES


        5. Promoting improved accessibility and             SYSTEMS INPUT    NOS. PARTICIPATING
        acceptability of reproductive health                CLINICS; EFFECTIVENESS OF
        services for youth                                  INSTITUTUIONAL LINKAGES/PROGRAMME-
                                                            LEVEL PERFORMANCE           UTILISATION &
                                                            CLIENT SATISFACTION


        6. Providing models and approaches                  STAKEHOLDER DIALOGUE           LEVEL OF
        that are sustainable and replicable                 ACTIVITY OF NETWORKS REPLICATION &
                                                            SCALING UP ACROSS SECTORS



.
                      Positive choices around sexual partnerships, condom use, age of
                      sexual debut, pregnancy, treatment seeking behaviours and HIV
                      risk behaviours.

                      Reduced teenage pregnancy, sexually transmitted infections and
                      sexual coercion

                      Reduced incidence of HIV nationally among 15-20 year olds




                                                                                                           6
                                                                                  loveLife 2002



Strengthening awareness of loveLife and stimulating scaled-up
community dialogue about HIV and sexual health

The extent to which loveLife is acting as a catalyst for scaled up or national community
dialogue is explored in the following section. In order to achieve its strategy of shifting
youth into lower risk groups for HIV, loveLife deliberately from the outset positioned itself
as a national campaign. High coverage mass media (primarily outdoor media, radio and
television) enable loveLife to achieve a national presence, and to scale up dialogue about
sexual choices for young people. These media are supported by the national telephone
helplines, which help to focus the dialogue, provide callers with reliable information and
provide a referral service to appropriate services. Calls to the helplines also potentially
function as an important monitoring tool, assisting loveLife to gauge the scale and the nature
of the national response to its messaging and programme activities. A further important
monitoring tool is media monitoring, which tracks the below the line (unpurchased) media
coverage that loveLife receives in the national press. Media monitoring provides a good
indication of the broad social and political responses to the campaign within South Africa.


Establishing and positioning the loveLife brand

loveLife has adopted a unique approach for the promotion of the campaign nationally,
combining established public health communication methods with commercial brand
marketing techniques. The concept of loveLife as a brand with which young people want to
be associated capitalizes on the high levels of commercial brand awareness and brand
aspirations among young South Africans—driven by existing high levels of media
penetration throughout South Africa. The loveLife brand is positioned to elicit associations
of high aspirations, personal motivation, healthy living and sexual responsibility within the
context of fun-loving youth culture. The public positioning of the brand also is intended to
sustain fresh engagement with the campaign and on going discussion of its message and
objectives.

In 2002, loveLife branding comprised the main ‘mother brand’, with the loveLife logo and
pay off line, “talk about it”, as well as several sub-brands including thethajunction (the
national toll free helpline), S’camtoPRINT and thethaNathi (the youth magazines).

One of the main vehicles for establishing loveLife brand awareness and associations is
outdoor media, including billboards, taxi posters and posters on watertanks.

Message development and execution

Development of the concepts and messages displayed in the outdoor media during 2002 drew
on key findings from research conducted at the end of 2000 and 2001 which explored
message take out and acceptability of the first round of loveLife messaging. For example,
this research found that the dialogue-based outdoor media were more successful than creative



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                                                                                  loveLife 2002


treatments in which images had been used. In 2002 outdoor media employed dialogue more
than in the previous years.

loveLife’s outdoor media messaging has evolved since inception from an initial “teaser
phase” designed principally to create intrigue and curiosity about the brand to increasingly
more direct messaging focusing on key aspects of high-risk sexual behaviour. But the
outdoor messaging is not viewed by loveLife as an end in itself. Its main roles are to promote
brand awareness, to promote the telephone helpline, to provide a bridge to the service
dimensions of the programme and to keep young people engaged with the campaign

During 2002 loveLife billboards focused on three key behavioural messages: to delay one’s
first sexual experience, to reduce the numbers of sexual partners or abstain if already
sexually active, and consistent condom usage (see Annex 2).

Formative information was drawn from analysis of the helpline calls as well as regular focus
groups conducted with small samples of the target population. The overall concept and core
message for all billboard designs were developed internally through a process led by the
loveLife media team and involving input from the primary programme partners. Only the
creative execution was contracted out. Proposed billboard creative is pre-tested with focus
groups of young people. Two billboard creative executions were flighted during 2002.

Taxis were also used to promote loveLife messages. One set of creatives was used in 2002
(see Annex 2). As an additional value, all participating taxis received from loveLife a new
audio cassette tape every two months for playing in the taxis. loveLife infomercials were
included as part of the cassette. Messaging included information about the thethajunction
helpline.

loveLife also maintains a sub-campaign to encourage dialogue specifically between parents
and young people about sex and HIV/AIDS. This part of the loveLife initiative was
intensified in 2002 in response to data from loveLife’s 2001 survey of young people showing
limited communication between children and parents about sex, sexuality and relationships.
The parent campaign used the pay-off line “love them enough to talk about sex” and featured
prominent South Africans such as Nelson Mandela and Archbishop Desmond Tutu as
endorsees of the campaign. The parent campaign is a critical part of loveLife’s overall effort
to bring about more open discussion of sex and HIV, and to positively influence broader
societal attitudes, norms and values relating to sex, sexuality and relationships.




                                                                                               8
                                                                                 loveLife 2002


Scale

During 2002, there were approximately 798 billboards displaying youth campaign messages
across South Africa, and a further 1260 billboards displaying parent campaign messages.
Overall, the number of loveLife billboards across the country in 2002 doubled from the
previous year. This was largely attributable to the dramatic increase in the number of
billboards displaying parent campaign messages, which increased from 250 in 2001. This
substantial increase in billboards was made possible through an added value agreement with
the Clear Channel/Independent Group.

During 2002, there were approximately 850 commuter taxis in South Africa with loveLife
messaging. Approximately 160 watertanks carried loveLife messaging. The watertanks were
all in rural areas, and contained messaging on two sides, making a total of 320 messages
displayed on watertanks.

loveLife is able to maintain such an extensive national outdoor media holding through
agreements with the principal outdoor media companies that provide loveLife with
significant added value. These and other stakeholder partnerships are indicative of a degree
of active public and private support for loveLife and are critical to maintaining a national
scale campaign.

Distribution and targeting for maximum impact

The provincial share of the nation’s youth aged 12-17 years is shown in Figure 2. The
distribution of youth and parent campaign billboards is shown in Figure 3.

Comparisons with youth population distribution show the outdoor campaign was slightly
slanted towards the more urban and wealthier provinces. This is a consequence of the fact
that billboards generally are located where there are high population concentrations and
established infrastructure. This is also one of the reasons loveLife uses a multi-media
approach that relies heavily on radio to reinforce its rural reach. In 2002, almost 30% of
youth campaign billboards and 25% of parent campaign billboards were located in Gauteng,
a province which contains an estimated 13% of the country’s youth aged 12-17 years. The
Eastern Cape and KwaZulu-Natal with 18% and 22% of youth respectively each had a
maximum of 14% of youth billboards and 16% of parent campaign billboards.




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                                                                                   loveLife 2002




     Figure 2: Estimated distribution of South Africa’s 12-17 year olds by province




                                   W Cape                     E Cape
                       Limpopo
                                    8%                         18%
                          8%
                                                                         F State
              N West
                                                                           6%
               15%



                 N Cape                                                 Gauteng
                   2%Mpuma                                               13%
                       7%                       KZN
                                                23%




Within each province, the specific locations of the billboards are chosen to achieve maximum
visibility for the target population. Typical sites are alongside schools, taxi ranks and at the
main feeder roads to densely populated areas.

Around 25% of billboards were in rural areas, as defined by areas with a population less than
40 000 people. There was no change in the rural/urban distribution of billboards from the
previous year.




                                                                                              10
                                                                                                             loveLife 2002




      Figure 3: Distribution of youth and parent campaign billboards by province


                                                                                               N=55
                                                                                               N=198



                                                                                 N=239
                                                             N=95                                 N=48
                                                                                 N=326
                                                             N=120                                N=124



                                                                        N=82                            N=115
                                   N=8
                                                                        N=91                            N=150
                                   N=8




                                                                        N=98
                          N=58                                          N=200
                          N=43




              Numbers of youth campaign billboards in upper figure and parent campaign billboards in lower figure




loveLife on national television

A range of public service announcements (PSAs), the youth reality television programme
(S’camto groundBREAKERS) and national profiling of sports (the loveLife Games) were
regularly featured on national television during 2002. These were positioned to contribute to
the goal of promoting brand awareness and scaling up community dialogue on sexual choices
and to provide referral to appropriate services.

Public service announcements

Starting in February 2002 and running for a period of nine months 13, thirty second parent
PSAs were flighted on national television, (SABC 1, 2 and 3). These included high profile
endorsees: Patricia de Lille (Member of Parliament), Tim Modise (radio personality), Nelson
Mandela (former S.A. President), Manto Tshabalala-Msimang (Minister of Health), Jonty
Rhodes (cricket player), Shado Twala (radio personality), Archbishop Desmond Tutu, Pieter-
Dirk Uys (satirist) and Jacob Zuma (Deputy President). Using the pay-off line “love them
enough to talk about sex” these personalities encouraged parents to start talking to their
children about sex and HIV/AIDS. During the same time frame similar PSAs developed for


                                                                                                                       11
                                                                                 loveLife 2002


radio, were aired on national and local stations, including SAFM, Metro, East Coast, Channel
702, Radio Algoa, KFM, Good Hope, Ukhozi, Phalaphala, Motsweding, Thobela, Umhlobo,
Lesedi and Ligwalagwala. The on-air campaign was also reinforced by a series of print
advertisements published in the Sunday Times and Independent Newspaper Group
publications and billboards incorporating a countrywide dedicated parent helpline. Callers to
the helpline received a printed guide to initiating and maintaining communication with
teenagers. One of the parent publications, Talking and Listening to your Teenager, was also
distributed nationally through the Sunday Times, Sowetan and Independent Newspapers.

Although no formal evaluation of the parent campaign was undertaken in 2002, two measures
of the campaign’s reach are the volume of calls to the parent telephone helpline and the
number of Talking and Listening to your Teenager publications distributed. Between the
launch of the parent campaign in February 2002 and end of October 2002, overall around 80
000 calls were received to the Parentline (see Figure 8). Around 1.4 million publications
were distributed.

S’camto groundBREAKERS

This is a thirteen part reality television series for young people set in the outdoors using
adventure activities to explore informed choices, shared responsibility and healthy living.
The 2002 series was the fourth S’camto television series and was screened on SABC 1 from
May to August 2002 on Thursdays at 6:30pm. The promotional activities around the
television series included a radio and print publicity campaign and a competition-driven
strategy to heighten audience participation with S’camto groundBREAKERS II. An
independent post broadcast programme review that was conducted during September 2002
used a number of tools to measure the extent to which the programme had achieved its aims
of increasing brand awareness, increasing use of thethajunction and fostering dialogue “talk
about it”. Indicators related to brand awareness and national-level dialogue are summarized
here, and audience participation strategies and their impact are discussed later.

The publicity generated through the promotional campaign resulted in 68 articles that
reported and reviewed S’camto groundBREAKERS II across 18 newspapers and 2 magazines
to the value of approximately R309 000. This was approximately 13% of the total loveLife
below the line print coverage generated during that period. The press praised the emotions
elicited by the series and the difficult issues that it tackled. Interviews focused on the
aspirations of the groundBREAKERS and the difficulties facing young South Africans.

An average of 899 000 viewers 16 years and over watched S’camto groundBREAKERS II
each week. This was around 10% lower than the average weekly exposure for the
programme during 2001. More than a third of viewers were somewhat older than the target
age group (15-20 years). The decline in audience in 2002 is partly attributed to direct
competition in that time slot from a highly popular youth television drama on a competing
network.




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                                                                                     loveLife 2002


The S’camto groundBREAKERS series won the best edutainment programme at the
Children’s Broadcasting Festival at Sithengi Film Market in November 2002. Scamto@large
screened in 2000 won the Avanti Award in 2001 for the Best Youth and Children’s
Programme, judged by industry experts.

loveLife Games

The second series of the loveLife Games on television ran on SABC 2 from August to
November 2002. The TV series uses the year-long loveLife Games school sport competition
as a backdrop for the promotion of positive lifestyles and healthy living through sport and
motivational activities. It also supports loveLife brand awareness and promotion of the
thethajunction helpline. During 2002, a total of approximately 3 million viewers watched the
programme (Table 1).

Altogether, around 21% of 12-15 year olds and 19% of those 16 years and older are estimated
to have watched the programme at least once. Some 3.1% of 12-15 year olds and 3.5% of
those over 15 years old watched the programme twice, and 0.6% and 1.2% respectively
watched it three times.

A rise in numbers of calls to the call centre during this period is evident in Figure 6 shown
below reflecting viewer response to the show. Analysis by gender shows good balance —
55-57% female throughout the year. This is consistent with participation in the loveLife
Games, which tends to be roughly equivalent by gender.



           Table 1: Average audience rating and reach of loveLife Games 2002


                                                                                     Effective reach
                                  Average        No. of people                         (3 times or
Population       No Spots          rating Reach % reached % Average frequency             more)

              25 (including
Age: 12-15 repeat programmes)          1.1    21.5     380 335                 1.2                   0.8
                25 (including
Age: 16+     repeat programmes)        1.3    19.4   2 783 318                 1.6                   2.6




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                                                                                           loveLife 2002


World AIDS Day, 1 December 2002

Each year, loveLife produces special television programming for World AIDS Day. The
third World AIDS Day special was flighted on SABC 1 at 6.30 pm on 1 December 2002. It
achieved 1.1 million viewers 16 years or older.

The 2002 World AIDS Day special was screened on a Sunday evening and received a
relatively high audience rating for that timeslot. The show was recorded on the loveTrain as
it travelled from Johannesburg to Durban to the Mandeni Y-Centre in northern KwaZulu-
Natal. A brief summary is provided in the box below.

Description of the loveLife World AIDS Day programme 2002, “One Love”

The programme “One Love” is a train journey of discovery, enlightenment and entertainment that
aimed to frankly explore youth sexuality and the life affirming choices that can be made by youth today.
Six young people embarked on a train ride, revealing their stories of struggle and triumph in relation to
HIV/AIDS. Part of the viewer’s journey was to identify the five incognito celebrities who appeared
throughout the journey. The celebrities were SABC 1 audience favourite Zandi Nhlapo, Metro FM
deejay Penny Lebyane, Soul City actress Sonia Mbhele, Isidingo’s Tshepo Maseko, Gazlam’s Israel
Makoe and radio personality Andile Gaelesiwe and Zola. These personalities guide the viewers
through pertinent issues as they interact with the central characters and explore the choices and
decisions that the characters have made. At the end of the journey the characters and other passengers
on the train arrive in Mandeni to watch a concert featuring some of South Africa’s hottest young talent
including Mafikizolo, Afro Z, and newcomers Pebbles and Alcupoem.




Expanded national and community dialogue and debate

Two sets of indicators are presented below in relation to monitoring loveLife’s progress
toward stimulating expanded and national level dialogue and debate. These are indicators
related to below the line media coverage, that is, media coverage that is independent of the
campaign, reporting on issues or activities in a positive, negative or neutral way, and
secondly, the volume of calls from monitoring data available from the national telephone
helplines.

Below the line media coverage

loveLife attracted considerable independent media coverage during 2002. The total value of
below the line media coverage received by loveLife was around R29 million. The value of
media coverage was split between radio (23% of the total value received), television (46%)
and print (31%). A higher proportion of coverage was received in the second half of the
year. Data on print coverage for 2002 are presented graphically below. The total value of
print media coverage is estimated at around R8.9 million during 2002, below the line print
coverage of loveLife peaked in May and December (see Figure 4 below).



                                                                                                      14
                                                                                       loveLife 2002




    Figure 4: Value of below the line print media coverage of loveLife during 2002


   1400000

   1200000

   1000000

    800000

    600000

    400000

    200000

          0
              Jan   Feb   Mar     Apr   May June       July   Aug   Sept   Oct   Nov   Dec

                                  positive   neutral    negative




This coverage was achieved through a total of 1195 print articles during 2002, with a total
circulation of around 66 million for the whole of 2002 (all publications combined).

Overall, most media coverage (80% of the value) was estimated to be positive, 20% negative
and 2% neutral. Negative coverage peaked during December 2002. The peak in the value of
positive press generated in May coincided with the launch of S’camto groundBREAKERS II.

Calls to the national helplines

During 2002 the two national helplines, the youthline (thethajunction) and the parentline
were staffed by 33 full time operators and there were 24 lines open during operating hours.
Lines were open between 1pm to 9pm weekdays and 12pm to 5pm on weekends. The
number of operators was increased to 33 from 12 in 2001.

The call centre managers reported that a total number of 2 405 504 calls were received in
2002, with a monthly average of 200 466; this total includes calls to both the youth and
parentline. Total calls include those made both during and outside operating hours – some
months almost three times the volume of calls was received outside of operating hours.

On average 40 000 calls were handled by call-centre operators monthly during 2002. Calls
increased steadily from a low point in January, and then remained fairly consistent from mid-
year. This is shown in Figure 5 below.




                                                                                                 15
                                                                                                    loveLife 2002


As a comparison, the government national AIDS hotline which is a 24 hour/7 day a week
service received on average 12,475 calls per month in 2002. Approximately 32% of callers to
that line fall in the 15-19 age range.



    Figure 5: Numbers of handled and total calls to the youthline and parentline during
                                         2002
                                      S’camto
                                      groundBREAKERS
                                                                                        loveLife Games
                                      II was broadcast
                                                                                        broadcast Aug-
                                      from 21st May for
                                                                                        Nov 2002
                                      13 weeks

      250,000


      200,000

      150,000

      100,000

       50,000


             0
                 Jan Feb Mar Apr May Jun                  Jul Aug Sep Oct Nov Dec

                                       Handled      Total Calls




The extraordinarily high level national response to the campaign as evidenced by the volume
of calls to the call centre is a significant achievement. Analysis of the age distribution of calls
to the youthline indicates that the youthline is utilized by people of all ages, with around one
half of callers during 2002 falling within loveLife’s target age range of 12-17 years1. The
definition of “incomplete calls” includes premature termination of calls prior to counselling,
and calls in which counselling is complete, but personal information (age, gender etc) is not
completed. In the future, these categories will be separated.




1
 Note that demographic information is only available from a portion of calls handled as this information is not
captured from all calls



                                                                                                                  16
                                                                                                     loveLife 2002


                  Figure 6: Breakdown of calls to the youthline by age in 2002



                                                   3% 1%       7%     2%

                             35%




                                                                             52%




                              unknow n            7-11 years          12-17 years
                              18-25 years         26-35 years         36 years and up




The parent line, a dedicated telephone counselling service providing guidance to parents on
communicating with their children about sex, relationships and HIV, was launched in
September 2000. loveLife did not promote the line until launch of the parent media campaign
in February 2002. During 2002, calls to the parent line increased steadily with peaks in
July/August and then declining again as the parent media campaign tailed off (Figure 7)2.
Overall, through out the year, some 80,000 calls were received.

    Figure 7: Numbers of complete and incomplete calls to the parent line during 2002

                                                Radio and TV parent campaign ran from 17 Feb to October 2002



      10000
       9000
       8000
       7000
       6000
       5000
       4000
       3000
       2000
       1000
            0
                Jan Feb Mar         Apr   May Jun       Jul    Aug Sep Oct          Nov Dec

                                      Complete      Incomplete



The province with the greatest share of parentline calls was Free State (20%) followed by
Gauteng and KwaZulu-Natal (17% and 16%). The lowest share of parent line calls came
from the Northern and Western Cape.

2
  Note that this data comes from demographic forms and is not reflective of the total number of calls coming into
the call line by parents



                                                                                                                17
                                                                                                                           loveLife 2002




In Figure 8 below, the numbers of all calls are presented as a proportion of the young people
in the target age range in each province, in order to better illustrate the scale of the response
by young people and their parents via the helplines. Overall, there was a spread of calls
across the provinces roughly commensurate with their respective population sizes.



  Figure 8: Calls received by the youthline and parentline during 2002 expressed as a
                percentage of young people 12-17 years in the province


            7.0%
                                  1.4%

            6.0%
                                                                                               3.2%

            5.0%
                                              0.6%

                                                                                                          0.2%
            4.0%

            3.0%
                              4.7%
                                                                   0.3%
            2.0%                          3.5%          0.3%                                           3.5%         0.6%
                      0.3%                                                           0.1%

            1.0%                                                                             1.8%
                                                                   1.4%
                    0.9%                                .1
                                                        1%                     1.0%
                                                                                                                 0.7%
            0.0%
                    E Cape


                             Free State


                                          Gauteng



                                                     Kwa-Zulu


                                                                 Mpumalanga


                                                                              North West


                                                                                            N Cape


                                                                                                      Limpopo


                                                                                                                 W Cape
                                                       Natal




                                                     youthline      parent line



The Free State and Northern Cape ranked highest in the number of all calls received as a
proportion of young people in the province, followed by Gauteng and Limpopo provinces.
Although KwaZulu-Natal contributed the third highest numbers of calls to the helplines, the
large number of young people in KwaZulu-Natal mean that the calls as a percent of young
people, rank as one of the lowest when expressed as a percent of young people (Figure 8).
This may, in part, be a function of more limited telephone access in that province.

Most callers to thethajunction had heard of the number from friends (approximately 31%)
(Figure 9). This is important because it provides evidence that loveLife is causing
communication among young people. In 2001, only 15% of callers had received the number
from friends. Television was the second most commonly reported source of the helpline
number in 2002.




                                                                                                                                     18
                                                                                   loveLife 2002


  Figure 9: Calls to the youthline during 2002 by where the caller heard of the number



                                           6%                  12%
                                                                          2%
                                                                            4%
                     31%                                                      9%




                                  13%                                    23%



                  Billboard                                  Ycentre/Franchise
                  loveLife Information Pack                  Newspaper/ Magazine
                  Televison                                  Radio
                  Friend                                     Other


                                Based on 93 588 calls with complete information


Consistent with previous years, callers to thethajunction most commonly called about
relationship issues. In 2002, for 32% of calls this was the main reason for the call compared
to 49% of calls in the first year. Relationship concerns included physical attraction, dating,
abusive relationships, ending relationships and forced sex in relationships. Another common
reason for calling the line was in connection with HIV, sex issues and STIs. These
discussions included questions of HIV transmission, safe sex, and treatment and recognition
of STIs, as well as broader issues of sexuality such as foreplay and body image.


National brand recognition and positioning

Since the start of loveLife, a number of surveys have been undertaken that included questions
on the loveLife brand. Some of these were surveys external to loveLife and others were
commissioned by loveLife to supply independent monitoring and other research data for the
campaign. The findings from these surveys show that loveLife has been successful at
achieving and sustaining high levels of brand recognition among young people, in the order
of 60-70% in all surveys.

The most recently available brand association data indicate associations in keeping with the
goals of the campaign. This is an improvement over brand association in the first two years,
which was generally less clearly in line with the intended attributions. The improvement in
brand association may be related to the rollout of loveLife service and outreach programmes
over the two years since the campaign’s inception, increasing substantially the number of
exposure opportunities to the loveLife campaign.




                                                                                             19
                                                                                         loveLife 2002




Summary of National data on Brand Recognition and Positioning

In the first year of loveLife (1999/2000), a household-based survey commissioned by loveLife found
that around 65% of the sample had heard about loveLife and among those who knew about it, around
90% identified the campaign as a safe sex campaign aimed at promoting healthy living for young
people.
- The sample comprised 1000 people, including 600 adolescents aged 12-17 years, and 400 adults
     over 25 years.

A higher proportion of rural (71%) compared to urban respondents (46%) had heard of loveLife and
knowledge was lower in peri-urban areas (51%).

Ratings of effectiveness of loveLife messages were fairly positive, higher amongst black respondents
than white respondents.

In the second year of loveLife (2001), the BMI Sport Info. Survey conducted on 13-18 year old
scholars, found that 67% of the sample were aware of loveLife,
- Sample size was 2000, stratified by race, with an over-representation of white respondents (1000).
- More Black respondents than other race groups had heard of loveLife.
- Although awareness was fairly high, understanding of loveLife was low (less than 1/3 identified the
     campaign as AIDS prevention and around 5% saw it as promoting positive lifestyles)
- Less than a quarter of respondents were aware of thethajunction.

A nationally representative survey of 12-17 year olds commissioned by loveLife and conducted at the
end of 2002, found that around 62% of the sample was aware of loveLife.
- Sample size was 2204.
- There were no substantial differences between urban and rural respondents with regards to brand
    awareness.
-   Around 70% of those who had heard of loveLife said that loveLife “made them think about safer
    choices” and around 60% of respondents who had heard of loveLife said that it caused them to talk
    to family and/or friends about sex, sexuality and relationships and a similar proportion reported
    positive adaptive behaviour in response to the campaign.




                                                                                                       20
                                                                                                          loveLife 2002



Promoting Active Participation in Dialogue on Key Issues of
Concern for Young People
While all elements of loveLife contribute to increasing dialogue about lifestyle issues and
HIV, radio and television backed by the telephone helpline contribute most directly.
Important monitoring indicators for youth participation in dialogue include the numbers and
socio-demographic characteristics of participants in the various media-driven competitions
and give-aways, as well as the participation of the target group in loveLife’s radio talk shows,
and the audience reach of local radio stations. In addition, the national telephone helplines
provide a useful means of monitoring the extent to which previously marginalized
communities are actively participating in dialogue.

Radio programmes

Programmes using a talk and music format were broadcast on nine mainstream ethnic
language and English radio stations in 2002 (up from six in 2001) with a combined potential
audience reach of about 6 million, of whom 1.5 million are aged between 15 and 24 years.
Radio programming reinforced the primary campaign themes for 2002: delay sexual debut;
and once sexually active, reduce partners and protect through assertiveness and consistent
condom use.

All loveLife radio programming is produced internally by the loveLife radio team using an
in-house radio production facility. The precise format and content of each show, while
reflecting loveLife’s key themes and messages, is developed in partnership with the host
radio stations.

loveLife had also established fixed radio broadcast capacity in eight Y-Centres around the
country.3

The Y-Centre based radio studios provide on-going narrowcast programming for Y-Centre
users, regularly hook up with regional mainstream radio stations, and also secure their own
broadcast licences for special events (e.g. Youth Day and World AIDS Day) enabling Y-
Centres to broadcast to their local communities. Y-Centre radio studios are entirely run by
local youth trained in production, reporting and broadcast skills. In 2002, there were
approximately 144 young people trained in radio broadcast skills capacity with around 1746
hours spent on formal training.

In addition to loveLife’s own programming, a substantial number of radio talk shows on a
variety of radio stations, at their own initiative, featured loveLife during 2002. Topics tend
to cover current issues of concern and interest to young people.



3
 a.) Acornhoek, Limpopo; b.) Emathulini, Hibberdene, KZN; c.) Hlatloanang, Jane Furse, Limpopo; d.)Kutloanong, Welkom,
Free State; e.) Langa, Cape Town; f.) Lenyenye, Tzaneen, Limpopo; g.) Mandeni, KZN; h.) Orange Farm, Gauteng; i.) Umtata,
Ngangelizwe, Eastern Cape.



                                                                                                                        21
                                                                                                         loveLife 2002


National helplines in supporting dialogue and debate

The language diversity of callers is an important reassurance that the helplines provide
opportunities for dialogue for young South Africans from different backgrounds. Proportion
of calls by language is presented in Figures 10 and 11 for the youthline and parentline
respectively. The language breakdown was almost identical for callers to the youth and
parentlines.

The most common language spoken by callers during 2002 was South Sotho (21-22%)
followed by Xhosa (16%). Some 3-4% of callers were Afrikaans speaking, and 9-10%
English speaking (Figures 10 and 11).

           Figure 10: Calls to the youthline during 2002 by language of caller



                                                            3%             10%
                               20%

                                                                                          11%
                                                                                            0%


                 16%

                          3%                                                         21%
                                      11%                 4% 1%



                 Afrikaans     English        N.Sotho        Ndebele        S.Sotho       Seswati
                 Tsonga        Tswana         Venda          Xhosa          Zulu



                   Based on 104 816 youthline calls with complete information, or 85% of calls handled




                                                                                                                   22
                                                                                  loveLife 2002


          Figure 11: Calls to the parentline during 2002 by language of caller



                                               3%         9%
                         21%
                                                                       10%
                                                                         0%



              16%
                                                                       22%
                         4%
                                    12%             2% 1%



             Afrikaans   English    Nsotho      Ndebele     Ssotho      Seswati
             Tsonga      Tswana     Venda       Xhosa       Zulu



The gender breakdown of callers to the parentline was approximately even, with at least as
many males as females (51% and 49% respectively). The youthline was utilised by more
women (56%) compared to men (44%).

A call quality assessment was conducted in August 2002. Methods used were: Post call
interviews conducted with 130 randomly selected thethajunction callers and 20 parentline
callers; mystery calls (n=80) conducted using different scenarios around sexual and
reproductive health issues and focus group discussions conducted with two groups of 10
operators. Telephone operators also completed a self-administered questionnaire (n=33) to
complement the focus group.




                                                                                             23
                                                                                            loveLife 2002


The main findings of the quality assessment are summarised in the box below.

Main findings of call centre quality assessment, 2002.

Demographics of callers
- As expected, in general the demographics of callers included in the post call interviews similar to
   the demographics of the routinely collected call centre data.
- There were however a slightly greater proportion of female callers to the youthline (59%) than
   reflected in call centre data for 2002 (56%) and substantially more female parentline callers
   interviewed (65% versus 51% in the call centre data). Reasons for this are unclear, but may
   suggest a selection bias in the sample used for quality assessment, particularly the parentline caller
   sample.
- A large proportion of callers to the parentline were from Gauteng (40%)
- More than 2/3 of both youthline and parentline callers used public telephones to make the call,
   suggesting that loveLife is reaching a caller profile that is not affluent.
- Around 2/3 of the callers to both lines lived in the townships.

Caller perceptions of quality
- The majority of callers to the youthline (93%) and all callers to the parentline (>95%) were
    satisfied with the quality of the service.
- The majority of callers (>95%) described operators in positive terms, identifying with words such
    as friendly, direct, helpful, honest, respectful and very few callers (<5%) identified with negative
    descriptors.

Source of the numbers
- Television was the most popular source of the thethajunction number (25.7%), particularly from
    the loveLife adverts that appear on TV. Other sources cited were loveLife's S’camtoPRINT
    (17.1%), friends (16.2%), radio (16.2%) and billboards (10.5%). This breakdown differed from
    that in the routine call centre data, with a far lower proportion of callers having obtained the
    number from friends (16% compared to 31% in the call centre database information).

Reasons for call
- 90% of callers to the parentline called for information in order to help their children, most related
    to sexual issues. The most common reason for calling the youthline was for help with relationship
    issues.

Quality of information
- The quality of information provided was assessed by means of mystery calls. Most of the mystery
   callers (85%) were positive about the attitude of call operators and 65% of mystery callers felt that
   the information given to them based on pre-defined criteria was accurate and covered major aspect
   within each topic.




                                                                                                       24
                                                                                    loveLife 2002


S’camto groundBREAKERS audience participation

This national reality television series utilised a number of media and interactive strategies
that aimed to encourage active audience participation. These included:
    • voteline, whereby viewers could vote for their favourite groundBREAKER
    • talking news line
    • e-mail campaign
    • dedicated website
    • board game circulated nationally through the print media partnerships
    • advertorials in S’camtoPRINT and thethaNathi
    • posters and postcards directed at 130 youth clinics and centres nationwide
    • competitions on national radio and television
    • a print publicity campaign in national and regional newspapers
    • promo spots on radio and television

loveLife contributed around R4.2 million to the production, research, publicity and
interactive strategy. SABC provided financial support toward the production to the value of
R1.9 million and the income to the SABC generated through sponsorship, publicity and
broadcast totalled around R1.7 million. The interactive strategies resulted in a number of
opportunities for active participation by youth. Uptake of these opportunities is described
below.

The voteline received around 13 000 calls over the 13 weeks, averaging about 1000 calls a
week, with peaks on days the programme was broadcast.

A large proportion of callers (43%) to the voteline were from Gauteng. Data on age of
callers were available for only around a quarter of callers (Figure 12). Where age was
recorded, just under half (44%) of callers were in 12-17 year age band.




                                                                                                25
                                                                                   loveLife 2002


     Figure 12: Age profile of callers to the S’camto groundBREAKERS II voteline



                                                 3%             11%
                                                                        5%
                                                                          3%
                                                                           2%




                       76%




                     9-11 years    12-17 years    18-24 years    25-34 years
                     35-50 years   Unknown




S’camto groundBREAKERS II website received around 18 000 visitors during the 13 weeks
of the show, with an average duration of 13 minutes per visit.

Calls to the helplines: The post-programme review analysed calls received by thethajunction
in the weeks preceding the broadcast, following the broadcast and during the 13-week
broadcast. A peak during the broadcast period of S’camto groundBREAKERS is clearly
evident (Figure 5). The peak is sustained beyond the period of the television series, possibly
owing to further publicity from other media.

Focus group discussions conducted as part of the post-programme review reported learning
gains that were in line with the aims of the programme. These included messages that: It is
important to talk about sex and other issues facing you; to work as a team; to share
responsibility; to protect oneself and others; to respect women’s bodies; to face challenges; to
persevere; to communicate; to be confident; to be non-racist; to be tolerant; to take care of
the environment. Probes around core messages on sexuality, influencing decisions around
sex and other topics showed good take-out.

Emails to talk@lovelife.org.za: During 2002, around 2000 email messages were directed to
the loveLife talk email address. These seem to be mostly related to the parent campaign on
radio and print, as peaks were evident during heightened periods of media activity for this
campaign (see Figure 13 below).




                                                                                              26
                                                                                             loveLife 2002




      Figure 13: Numbers of e-mails received by talk@lovelife.org.za during 2002


            300


            250


            200


            150


            100


             50


              0
                  Jan   Feb March April   May   June   July   Aug   Sept   Oct   Nov   Dec




While the number of emails received is small, it indicates an engagement with the messages
of the campaign by the sub-sector of people with e-mail access (only about 3% nationally).
As a channel for interaction with loveLife messages, it is clearly under-used. On the other
hand, as greater numbers of people become connected to the Internet, this component may
gain importance in the overall campaign.

The print media, discussed in more detail later, also aimed to maximize reader participation
through invited participation in the following: Book, CD & movie reviews; Pen pals; Kodak
competition; Billboard competition; Cartoon competition; Celeb Q&A; Giveaways;
Information exchanges with Trendsetters. More than 400 unsolicited letters were received in
2002 by the youth magazine S’camtoPRINT of which about 85% were very positive about
the publication and 15% were neutral (e.g. wanting job, wanting to know why didn't win
competitions etc.)




                                                                                                       27
                                                                                    loveLife 2002



Promoting positive lifestyles and developing aspirational ideals

A range of loveLife initiatives are intended to promote positive lifestyles and aspirational
ideals amongst South Africa’s youth. In the section below, we report on these initiatives,
divided into “high” level (national) and local level activities connected through so-called
bridging activities (Figure 14).

High reach activities include publication and national distribution of print media designed
with youth aspirations in mind, as well as various initiatives which profile positive role
models, such as participants in the national and provincial loveLife Games, the S’camto
groundBREAKERS television series and outreach activities such as the loveLife Mission
Antarctica and the “Celebrate Life” initiative which seeks to elicit the public support of
appropriate youth celebrities to convey loveLife messaging. Typically these initiatives are
run on a national scale, but most also have local, community-level dimensions.

The second category of positive lifestyle initiatives are those developed at local level, which
are intended to create opportunities for more direct interaction between loveLife and young
people. The success of these initiatives is primarily assessed by an ability to generate
enthusiasm and provide an enabling environment for replication and scaling up of successful
activities with or by partners and other stakeholders. These “low reach” activities include
local regional “hubs” of loveLife activity such as the loveLife Y-Centres which act as a
springboard for regional outreach, as well as provide training, motivation, lifeskills and other
services to local youth and adolescent friendly public clinics.

Connecting “high reach” and “low reach” activities are a set of “bridging” initiatives like the
sports and recreation programme, motivational programme, loveTrain, loveTours and other
outreach, where meaningful numbers of young people are reached. The significant aspect of
these initiatives is not to effect individual level behaviour change, but to help “seed” new
focal points of more intensive local level work in areas of high need and to promote
associations with positive lifestyle.

    Figure 14: Summary of role of various campaign elements in promoting positive
               lifestyles and developing aspirational ideals amongst youth

         High coverage for youth           Bridging and outreach                Low coverage
                 aspiration            -    loveTrain, loveTours,       -   with one-on-one service
     -     Print                            sports and recreation,          provision, drop-in youth
     -     National profiling of            debating, motivational          centres, motivation,
           loveGames                        programme                       lifeskills and other
     -     Celebrate Life                            Role                   services
                    Role               -    Seeding out of Y-Centres                 Role
     -     High coverage/                   & other activities &        -   Regional hubs of
           promoting national level         scaled up brand                 excellence & promoting
           youth aspiration                 association with positive       individual level youth
                                            lifestyle                       aspiration




                                                                                                28
                                                                                 loveLife 2002


High reach activities

At the national level, print media, profiling of the loveLife Games, the S’camto
groundBREAKERS television series and related competitions and promotions and the
Celebrate Life campaign, are used to promote positive lifestyles and develop aspirational
ideals amongst youth. These assist loveLife in consolidating associations with positive
lifestyles and raising awareness of high-risk behaviour.

Print media

loveLife produces two weekly youth lifestyle magazines: S’camtoPRINT and thethaNathi.
S’camtoPRINT, launched in early 2000 and published in partnership with The Sunday Times
(circulation 480 000 per week) is a youth magazine with sexual health and lifestyle features
aiming to provide young people with positive, accurate and holistic sexual health information
in a broadly educational and entertaining format.

Research, formative focus groups with the target audience and reader surveys are used to
obtain feedback on the publication, and guide future issues. A 2002 reader survey showed a
high level of appreciation for the magazine among respondents. The survey aimed to
ascertain who is reading S’camtoPRINT and their lifestyle; and to obtain feedback on the
editorial content. Some 680 responses were received and 600 of these were analysed. Key
findings are highlighted in the box below.




                                                                                            29
                                                                                           loveLife 2002




Selected findings from S’camtoPRINT reader survey, 2002

Respondents comprised 47% males and 53% females. Approximately 37% of respondents were over
19 years of age, 33% were 12-19 years and 29% were under 16 years. The age profile differed for
females and males, with a greater proportion of younger women and a greater proportion of older men
(75% of respondents under 16 years were female, and 69% of respondents over 25 years were male)
responding to the survey.

-   Almost half respondents (44%) had called thethajunction.
-   The majority of respondents rated the publication as excellent (78%) or good (18%) in terms of
    being a lifestyle magazine for South African teens.
-   Some 15% of respondents listed the publication as being amongst their three favourite magazines.
-   Most respondents (68%) said that loveLife or loveLife and Sunday Times are the publishers of the
    magazine.
-   Message take-out was in keeping with the campaign goals.
-   The majority of respondents (88%) said they talk about the publication with their friends, 54% talk
    about the publication with siblings; and 53% with classmates; 35% with their mother.
-   The publication was widely circulated, indicating reach beyond the distribution numbers; 80%
    shared the publication with friends, 46% with classmates; 57% with siblings.
-   About half the respondents said they had first heard of the publication through seeing it in the
    newspaper, 31% had heard of it from television, 17% had heard of it from radio and 11% from
    outdoor media. Word of mouth accounted for about 3.3% of responses.


In addition to the reader survey responses, during 2002, approximately 400 unsolicited letters
were received from readers, the vast majority of which were complimentary.

thethaNathi, loveLife’s second youth magazine, was launched in December 2001 and is
published in partnership with the Independent Newspaper Group. In its first year, this youth
newspaper supplement focused on youth sexual health messaging, and also aimed to
reinforce loveLife’s motivational message. Approximately 550 000 copies were circulated
every second week during 2002; through regional papers of the Independent Newspaper
Group and through special drop off delivery to loveLife’s school partners, franchises,
loveLife affiliated clinics and Y-Centres.

Other publications

loveLife also has produced a core series of sexual health information publications, which are
distributed to callers to the helpline and through all loveLife platforms such as Y-Centres,
NAFCI clinics, franchises and outreach activities.

A summary of publications, print runs and distribution channels for 2002 are provided in
Table 2 below.




                                                                                                       30
                                                                                                       loveLife 2002




    Table 2: Publications distributed or produced in 2002 in relation to aspirational ideals
                                    and positive sexuality

                                                                Distribution vehicle                   Number printed
                                                                                                          in 2002
    Publications to act as resources for youth and parents on youth sexuality
    Talking & Listening to your Teenager        Sunday Times; Sowetan; Citizen; Y-Centres,                      1 370 000
                                                Clinics, parentline, franchises
    Love them enough to talk about sex          Y-Centres, Clinics, parentline, franchises                        260 000
    thethaNathi                                 Distributed to all Centres, Clinics, Franchises, via   1 909 950 (run-ons)
                                                thethajunction, Comutanet taxis & loveLife
                                                Games as well as an insert into a national
                                                newspaper (2x a month)
    S’camtoPRINT                                Distributed to all Centres, Clinics, Franchises, via   1 641 350 (run-ons)
                                                thethajunction, Comutanet taxis & loveLife
                                                Games as well as an insert into a national
                                                newspaper (2x a month)
    Tell me more                                Y-Centres, Clinics, thethajunction, franchises                 1 600 0004
    loveFacts                                   Y-Centres, Clinics, thethajunction, franchises;                 1 600 000
                                                also in Sunday Times and Sowetan
    Publications to support loveLife Initiatives for promoting positive lifestyles
    Motivational Manual & Workbook              Outreach                                                      Unavailable
    Communicating loveLife Manual               Outreach                                                      Unavailable
    NAFCI Values Clarification Manual           NAFCI                                                         Unavailable
    NAFCI Rights Leaflet                        NAFCI                                                             200 000
    Positive Lifestyle, Positive Sexuality      Outreach                                                                500
    Manuals, for facilitators and
    participants
    Folders                                     Outreach                                                           10 000
    SgB video boxes                             Outreach                                                            2 800
    Positive sexuality certificates             Outreach                                                            1 000
    Y-Centre posters                            Outreach                                                           15 000
    Train posters                               Outreach                                                            1 000
    Posters of new billboards                   Y-Centres, NAFCI and other                                          2 500
    Folders                                     loveLife Games                                                     10 000
    Debaters manuals                            loveLife Games                                                      3 000
    loveLife Games video boxes                  loveLife Games                                                      3 040
    loveLife Games programme                    loveLife Games                                                     12 000




4
    An additional 124 000 were produced for distribution at loveLife Games



                                                                                                                   31
                                                                                     loveLife 2002


loveLife Games

The second series of the loveLife Games television show ran from August through November
2002. This series aimed to demonstrate healthy living and positive lifestyles, using sports to
foster youth aspiration and the sense that youth are participants on the ‘national stage’. The
series took place against the competitive backdrop of the year-long loveLife Games schools
sports competition, and featured participants in the Games. Episodes were 25 minutes in
duration and captured different loveLife Games activities at various stages of the year-long
competition and featured the real life stories of young competitors, particularly those that had
overcome significant odds to compete—such as poverty and the lack of recreational facilities,
training and equipment. The shows were broadcast on SABC 2 Topsport on Saturdays at
12.00pm and repeated again during the following week in varying time slots.

The average number of viewers per screening was 201 385 (16 years and older); 28 615 (12-
15 years); and 54 385 (7-15 years). There was an increase in monthly call volume to the
thethajunction helpline coinciding with the show.

Celebrate Life

In the Celebrate Life initiative, celebrities and artists are trained to understand and effectively
communicate the loveLife message. Some 65 celebrities were trained in loveLife messaging
in the first two quarters of 2002, and then utilised specifically at the loveLife Games and Y-
Centre launches.

High profile features

A number of outreach activities designed to capture the imagination of the public have been
created. These work both on the national level, and on more local levels as described below
for one significant example, the loveLife Mission Antarctica below.




                                                                                                32
                                                                                       loveLife 2002




The loveLife MISSION ANTARCTICA ROADSHOW, is a joint initiative between loveLife
and the Mission Antarctica/ Earthship South Africa (MASA). MASA is an environmental
programme, led by UN Goodwill Ambassador Robert Swan. He conceptualised Mission
Antarctica after the first World Environmental Summit in Rio, almost 10 years ago. His
Mission was to remove 1000 tons of trash that accumulated over several decades of research
and exploration at a Russian base in Antarctica. With the help from the groundBREAKERS,
Swan completed his mission.

The six groundBREAKERS joined Robert Swan on the ‘2041 Yacht’, their means of travel
around the continent, between the 29th of January to the 17th of February 2002. The overall
objective of loveLife’s participation is to aid young people to live positively, by cleaning up
their lifestyles, increase awareness of HIV/ AIDS, and combat social ills facing South African
youth. A road trip, to share the Antarctica experience with South Africa’s youth and to localize
this experience in the loveLife philosophy, commenced on the 21st of May.

Pre-event phase

During each stop, the groundBREAKERS visited a total of 60 schools in each province (more
than 700 schools in total). They promoted the positive lifestyle message, and also carried out a
motivational training session. They also introduced a “loveLife Slogan” Competition. The
winning schools received a total of R80 000 in school equipment

Actual event phase

During the weekend at each stop there was a loveLife Games hosted at each venue. Integrated
into the existing loveLife games programme, was a Motivational/ Edutainment line-up hosted
by the groundBREAKERS. Included in the programme were give-aways and a performance by
an artist. The majority of the events took place during July, August and September with visits
to schools in the Eastern Cape, Free State, Gauteng and KwaZulu-Natal.

An estimated 120 000 young people participated in the events of the road-show.




                                                                                                   33
                                                                                                         loveLife 2002



Local level best practice in youth leadership and seeding initiatives
that promote positive lifestyles
Y-Centres

The Y-Centre initiative, within the campaign as a whole, aims to promote the development of
positive lifestyles and aspirational ideals amongst South African youth. The centres offer
services and facilities in keeping with this aim. These include a wide range of educational,
recreational, sporting and training resources and activities (positive lifestyle, positive
sexuality, computer training, training in radio production, sports and recreation (basketball,
netball and others), and more) as well as reproductive health clinical services.

Y-Centres specifically provide services for youth in under-resourced communities and whilst
they aim to directly benefit the communities they serve, they also aim to serve as practical
demonstrations of the positive lifestyles that loveLife tries to promote. Y-Centres also
provide the regional hubs for various of loveLife’s outreach programmes.

Roll out of the Y-Centre initiative began in 2000 with the establishment of five Y-Centres
that year, and by the end of 2002, there were 15 Y-Centres in operation across all 9
provinces.

                         Figure 15: loveLife Y-Centres around the country5




5
  a.) Hlatloalanang, Acornhoek & Lenyenye in Limpopo; b.) Vryburg in North West; c.) Orange Farm in Gauteng; d.)
Emalahleni in Mpumalanga; e.) Colesberg in Northern Cape; f.) Kutloanong in Free State; g.) Emathulini, Nongoma & Mandeni
in KwaZulu-Natal; h.) Langa in Western Cape; i.) Bizana, Sakhulutsha & Umtata in Eastern Cape



                                                                                                                      34
                                                                                 loveLife 2002


Franchises

The franchise concept is a demand-driven response to interest shown in the loveLife outreach
approach by local community based organizations and NGO’s. Franchise holders are
community-level youth-serving organizations that have endorsed the aims and approach of
loveLife. Franchise holders constitute a broad-based community-level coalition that provides
loveLife with local focal points for the promotion of activities and messages. loveLife
provides franchise-holders with personnel training to ensure the approach and messages used
are consistent with loveLife strategy. The franchise holders also provide a base for
Mpintshi’s (peer educators) and groundBREAKERS, as well as distribution points for print
media.

By the end of 2002, there were some 93 loveLife franchise holders across the country. This
was an increase from 17 in 2001.

Provincial distribution of franchises and Y-Centres is shown in Figure 16.

             Figure 16: Distribution of Y-Centres and Franchises by Province


        Western Cape

        Northern Cape

           North West

         Mpumalanga

              Limpopo

        Kwa-ZuluNatal

              Gauteng

             Free State

        Eastern Cape

                          0           5              10             15            20

                 Y centres 2001   Y centres 2002   Ycentres 2003    franchises




                                                                                           35
                                                                                                loveLife 2002


Volume of Y-Centre visitors

The number of young people receiving clinical services at Y-Centres in 2002 is illustrated in
Table 3.

As shown in the table, the median number of clinical visitors to a single Y-Centre lies
between 500 and 800 per quarter, or around 200-300 visitors per month. The number of first-
time visitors almost doubled in 2002 compared to the previous year.

Table 3: Total number receiving clinical services at Y-Centres during selected quarters
                                        of 2002


                       Y-Centre                  Q1                   Q3           Q4

               Sakhulutsha                            1 003                1 080        1 428
               Bizana                                                        11           72
               Umtata                                                       527          792
               Kutloanong                              418                  773
               Orange Farm                             103                  843          726
               Mandeni                                 196                  567          447
               Emathulini                         10 473#                   241          244
               Acornhoek                               576                 1 037        1 216
               Hlatlolanang                                                              343
               Langa                                                        785          576
               Colesberg                                                    208          162
               Vryburg                                 654                  978         1 242
               Total                               13 909                  7 050        7 565
               Mean                                   1 739                 641          630
               Median                                  531                  773          512
               Range                           103 – 1003            11 – 1080     72 – 1428


                                  #
                                      This outlier probably represents an error


Characteristics of Y-Centre visitors in 2002

The reported volume of visitors to clinical services at the Y-Centres does not represent the
total number of users or intended impact of the centres, as described above. The centres are
used as hubs for local community and regional outreach extending well beyond the
immediate vicinity of the Y-Centre, and helping create focal points of loveLife related
activities in surrounding districts. Nonetheless, tracking the characteristics of Y-Centre
clinical service users is an important starting point for monitoring.

An early assessment of four Y-Centres at the end of 2000 highlighted that most youth visited
the centres for educational and recreational purposes, rather than for reproductive health
services. This is in keeping with the centres’ aim of acting as a regional hub to promote
positive lifestyles and youth aspiration. Systems of monitoring the numbers and
characteristics of young people using the centres were still being developed; thus data for


                                                                                                          36
                                                                                           loveLife 2002


2002 were only available for a sub-set of Y-Centre users who came into contact with the
clinical services offered at Y-Centres.

Demographic data that were available for these clinical visitors may not be representative of
all visitors to Y-Centres, for example, more young women than young men generally use
clinical services.

Around 43% of clinical visitors to the Y-Centres in 2002 were within loveLife’s target age
range of 12-17 years. Around 9% were in the lower segment, 12-14 years (Figure 17).
Around a fifth were over 20 years and 3% were under 12 years. Some of these younger
visitors may represent children or younger siblings of visitors in the target age range.

    Figure 17: Visitors to the Y-Centres by age in 2002 (Q3 and Q4) (clinical visits)




                                                      3%           9%
                             19%




                                                                                     34%

                       35%




                    <12 years      12-14 years   15-17 years   18-20 years   >20 years




                                                                                                     37
                                                                                                                                   loveLife 2002




  Figure 18: New versus repeat visitors to the Y-Centres during Q4 of 2002 by centre


     100%
      90%
      80%
      70%
      60%
      50%
      40%
      30%
      20%
      10%
       0%
                Motherwell

                               Bizana

                                          Umtata


                                                   Orange

                                                                Mandeni

                                                                                Emathulini

                                                                                                Acornhoek

                                                                                                            Hlatlolanang

                                                                                                                           Langa

                                                                                                                                    Colesberg

                                                                                                                                                Vryburg
                                                    Farm



                                                                          new                repeat

                             Data based on a total of 7033 visits for whom repeat status was available.




Figure 18 shows that about 40% of visitors in Q4 of 2002 were new visitors. The
approximately 60% of clients who are returning to the Y-Centres are likely to indicate a core
group of young people who are finding a valuable service in the centres.

More girls than boys visited Y-Centres (recorded as clinical visits) during 2002; of the total
27 888 visits for which gender was recorded, around 65% were girls and 34% boys. This
pattern of more clinical visits by girls was consistent across Y-Centres, with the exception of
Acornhoek, where approximately equal proportions of boys and girls received clinical
services during 2002.

The specific type of clinical services received by visitors to the Y-Centres in 2002 is shown
in Figure 19.




                                                                                                                                                     38
                                                                                                                loveLife 2002


       Figure 19: Clinical services rendered expressed as a percentage of visitors


                             45%
                             40%
                             35%
                             30%
                             25%
                             20%
                             15%
                             10%
                              5%
                              0%




                                     injectables



                                                   contraceptive


                                                                   pregnancy

                                                                                counselling


                                                                                              IEC


                                                                                                    VCT


                                                                                                          STI
                                                                      tests
                                                        pill               Q4         Q3



            Owing to incomplete data for the other quarters in 2002, these are based on the 7565 total Y-Centre visits
                                        for Q4 and the 7050 total Y-Centre visits for Q3.




Activities at the Y-Centres

Lifeskills training, peer education training, IEC events, computer literacy training, debating,
dance, drama and sports are regularly convened at Y-Centres. There is anecdotal evidence
that Y-Centre activities have had a significant spill over effect in the communities where they
are located involving schools, churches and youth-serving groups, but there is no empirical
documentation of this effect available. Outreach activities from the Y-Centres and other
loveLife hubs are described in the following section.



Reaching out from Y-Centres and “bridging activities”


“Bridging activities” include the sports and recreation programme, the debating programme
and positive lifestyle programme, the loveTrain and loveTours.

Sports and recreation activities increased dramatically over 2001. Participation in the sports
and recreational programme has increased from 1900 in 2001 to 10 515 in 2002, i.e. > 500%.

In 2002, the programme rolled-out basketball training and activities to franchises and NAFCI
clinics across the country. In addition, volleyball and netball were rolled out to Y-Centres
during this year. During 2002, the sports and recreation programme included over 10 000
participants nationally, recording 7 136 basketball players, 1 640 volleyball players and 1739
netball players.
A new personal fitness training programme, called Body Y’s was piloted during 2002 for
implementation in 2003.




                                                                                                                          39
                                                                                   loveLife 2002


The debating programme was launched in April 2002 and rolled out to 11 Y-Centres during
the first half of the year. All leagues were completed by June 2002 and top debating
achievers participated in provincial loveLife Games. During August 2002, the debating
programme was rolled out to franchises in the Eastern Cape and KwaZulu-Natal. The
debating competition included some 258 schools across 7 provinces. The highest number of
schools came from the Eastern Cape (n=85 schools) followed by KwaZulu-Natal (n=73
schools). A total of 2271 debaters were trained and participated in debating events around
the country.

The loveLife Games is a year-long school sports competition organised in partnership
between loveLife and the United School Sports Association of South Africa (USSASA). The
loveLife Games use sport to reach young people, promoting of healthy living, personal
motivation and responsible sexual behaviour. loveLife messaging and motivational elements
of the campaign are integrated into the activities of the Games. loveLife also introduced non-
athletic events in the Games like debating, chess, art and drama to ensure participation by as
broad a range of students as possible. Part of loveLife’s contribution is to professionalise the
management of school sports competition in South Africa and to increase participation in
school sports by historically disadvantaged students, particularly from farm and rural schools.

The loveLife Games 2002 involved several thousand teachers and more than 250 000 actively
participating learners.

During the first two quarters of 2002, there were a total of 1150 teachers trained. The
greatest proportion of teachers was from the Limpopo Province (17%) and KwaZulu-Natal
(17%) followed by the Eastern Cape (13%).

There were an estimated 117,237 participants in the loveLife regional games during 2002.
These included both primary and secondary school learners from approximately 44 regions,
averaging around 2,664 participants per region.

There were approximately 40 000 participants in the provincial games, approximately equal
numbers of boys and girls (Figure 20). This was very similar to participation achieved in
2001.




                                                                                             40
                                                                                                           loveLife 2002


                   Figure 20: Participants in the Provincial Games in 2002


  9000
  8000
  7000
  6000
  5000
  4000
  3000
  2000
  1000
       0
             Northern



                        Western


                                  Limpopo



                                            Eastern Cape



                                                               Free State



                                                                            Gauteng



                                                                                           KZN



                                                                                                    Mpumalanga



                                                                                                                        North West
              Cape



                         Cape




                   Primary Boys   Primary Girls            Secondary Boys             Secondary Girls            Officials




The publicity generated by the Games, screening on national television and the focus on
young people as active participants in the nation, are all potentially important intermediate
indicators promoting heightened youth aspiration and ultimately social level impact on
behaviour change.
Anecdotally, implementers report positive feedback from the Games. In particular,
involvement of the groundBREAKERS, training in public speaking and presentation, has
received positive comment and feedback. Implementers also report dealing with many
enquiries from participants regarding how they can get involved in loveLife activities, and
these young people are apparently linked into other loveLife programmes and activities.



Positive lifestyle or motivational programme

The motivational programme was launched in July 2000 as a core part of the loveLife
approach. Based on the premise that low self-esteem and lack of personal ambition are
predictors of high-risk behaviour among adolescents, loveLife uses a motivational context in
all its activities.

All groundBREAKERS and other loveLife employees undergo motivational skills training.
In addition, an ongoing motivational training programme is run at the Y-Centres, adolescent
friendly clinics and franchises.


                                                                                                                                     41
                                                                                     loveLife 2002




The motivational programme aims to help young people develop assertiveness, self-
confidence, defined life goals and a clear path for accomplishing their aspirations.

The motivational programme was rolled out to NAFCI clinics in 2002. In the first quarter of
2002, some 38 guidance teachers were trained how to facilitate motivational programmes and
a further 147 facilitators were trained. In 2002, there were approximately 17 000 graduates of
the programme (Table 4), compared to 1 854 in 2001. Just over half of the graduates in 2002
were from loveLife franchise partners and the rest from Y-Centres.

 Table 4: Graduates of the motivational programme from Y-Centres and Franchises by
                                   province in 2002

              Cluster            Y-Centres       Franchises         Total           % of target for
                                                                                        2002
 Eastern Cape                            847              361               1 208              54%
 Free State/ N Cape                     1 041           1 237               2 278              99%
 Gauteng                                 754             1451               2 205              84%
 KwaZulu-Natal                          2 027           3 033               5 060             203%
 Limpopo/ Mpumalanga                    2 310           1 333               3 643             125%
 North West                              384            1 675               2 059             429%
 Western Cape                            273              670                943              106%
 Total                                  7 636           9 760           17 396                123%


loveTrain and loveTours

The loveTrain and loveTours aim to extend programmes into hard to reach areas of South
Africa and act in synergy with other aspects of the campaign. For example, the loveTrain
was critical in the loveLife World AIDS Day programming screened on SABC 1 on 1
December 2002. The show was recorded on the loveTrain as it travelled from Johannesburg
to the Mandeni Y-Centre in KwaZulu-Natal.

Between March and October 2002, the loveTrain stopped off at some 32 towns in more
remote areas of the country, with an average of 5-7 schools visited at each stop. The
estimated numbers of participants involved in events ranged between 300 and 3 600 per
town. During the first half of 2002, the loveTours visited some 138 schools in the Eastern
Cape Province and some 81 schools in KwaZulu-Natal. For the six month period,
approximately 16 000 young people altogether participated in events around the tours. The
impact of the loveTrain and loveTours in stimulating new local youth-serving activities has
not yet been formally documented.

Placing reliable sources of information about HIV/AIDS in the context of debate and
dialogue

loveLife acts as a resource for many national and international organisations seeking reliable
information about the HIV/AIDS epidemic in South Africa.



                                                                                                  42
                                                                                 loveLife 2002




The provision of information acts in synergy with other aspects of the campaign. The call
centre is an important provider of information to callers both during the call and via
distribution of information packs to callers.

The 2002 call centre quality assessment rated appropriateness of information received by
callers against pre-defined criteria; this was rated high for around 65% of calls.

Call centre information packs

Distribution of information packs via the call centre has increased almost three-fold since
2001. In 2001, approximately 20 000 packs were distributed, an average of 1 700 per month.
In 2002, the monthly average was around 4800 packs. In October 2002, a new system of
tracking the distribution of information packs was implemented to enable disaggregation by
source of the order; from 20 October 2002 – 31 December 2002, thethajunction distributed
10 728 call centre packs.

Information packs contain the following:

    Parent Pack:         - LoveFacts
                         - Talking & Listening: Parents and Teenagers Together
                         - Love Them Enough to Talk about Sex.

    Youth Pack:          - LoveFacts
                         - Tell Me More
                         - NAFCI Health Rights
                         - S’camtoPRINT & thethaNathi.

Specific research and information publications

Additional specific research and information publications developed for dissemination in
2002 are detailed in Table 5 below.

           Table 5: Research and information publications distributed in 2002

                                    Publication                    Number
               Impact Survey entitled “loveLife’s for Us”              25 000
               Impending Catastrophe Revisited                         20 000
               Hot Prospects, Cold Facts                                 2000
               Corporate brochure                                      10 000
               Talking & Listening                                    137 000
               Love Facts                                            1 600 000




                                                                                            43
                                                                                      loveLife 2002


The loveLife website receives approximately 100 000 hits per month or around 3000-4000
hits per day (Table 6). Some 30% of visitors are from outside of South Africa, and for a
further quarter, the country of origin is unknown. loveLife also handles a continuous stream
of local and international media inquiries and interviews.

                      Table 6: loveLife Website Statistics for Q4 2002

                       STATISTICS                        October      November     December

      Hits         Entire Site (Successful)                 92,510       105,767      119,716

                   Average Per Day                            3,083        3,525        3,861

                   Home Page                                  2,644        4,077        5,764

      Page Views   Page Views (Impressions)                 29,345        33,484       37,130

                   Average Per Day                             978         1,116        1,197

                   Document Views                           19,477        24,402       28,440

      Visitor      Visitor Sessions                           4,074        5,690        9,348
      Sessions
                   Average Per Day                             135          189          301

                   Average Visitor Session Length          00:06:55     00:08:26     00:05:25

                   International Visitor Sessions           31.56%        23.7%       26.42%

                   Visitor Sessions of Unknown Origin       23.66%       27.71%       35.47%

                   Visitor Sessions from United States      44.77%       48.57%        38.1%

      Visitors     Unique Visitors                            1,984        2,762        4,262

                   Visitors Who Visited Once                  1,509        2,218        3,574

                   Visitors Who Visited More Than Once         475          544          688




                                                                                                44
                                                                                   loveLife 2002



Promoting improved accessibility and acceptability of reproductive
health services for youth

loveLife works in partnership with the national and provincial Departments of Health to
increase the quality of reproductive health services for youth. It is well established that one
of the major disincentives for young people in seeking counselling and care for sexual health
problems in government clinics is the perceived poor quality of care and the inappropriate
approach to young people in these facilities. Counselling and testing for HIV and early
treatment of STIs are a critical part of the effort to combat HIV/AIDS.

The National Adolescent Friendly Clinic Initiative (NAFCI)
NAFCI is a comprehensive service performance and quality improvement accreditation
programme designed for public sector primary health care clinics. It has three main
objectives within the loveLife campaign, namely to
    • Catalyse an adolescent friendly ethos in all government clinics
    • Provide a bridge between prevention and treatment through improved management
        systems, infrastructure and clinical capacity
    • Institutionalise elements of loveLife that need to be sustained.

Typically, barriers to adolescents using public sector services include feelings of
embarrassment and discomfort, fear of chastisement and lack of confidentiality, fear of
medical procedures, lack of information and operational barriers such as operating hours that
are inconvenient for young people.

In response to these realities, and drawing on best practice in youth friendly services, during
2000, NAFCI developed quality improvement tools and standards and criteria of “adolescent
friendliness”. Through a process of self-assessment and external review, clinics are awarded
achievement recognition. Under the initiative, for each public sector primary health care
clinic seeking accreditation, baseline assessments are conducted, following which there is a
phase of service improvement and a follow-up assessment.

The first ten clinics were identified and piloted in 2000. During 2001, provincial buy-in and
support from provincial health departments was sought, provincial co-ordinators and other
facilitators were trained and IEC materials were developed and distributed. Implementation
and roll out began in 2002.

By the end of 2002 around 70 clinics across the country were introduced to NAFCI. Of
these, 51 clinics were active NAFCI clinics and a further 6 were assessed during 2002 (Table
7). The planned roll-out of the NAFCI programme to a further 200 clinics in 2002 did not
happen due to delays in funding for the planned scale up of NAFCI activities from the Global
Fund for HIV/AIDS, TB and Malaria.




                                                                                             45
                                                                                    loveLife 2002


                      Table 7: NAFCI clinic status by province in 2002


         Provinces            Active          Introduced          Assessed             Total

 Eastern Cape                          11                  4                  0                15
 Free State                             0                  3                  0                 3
 Gauteng                                7                  1                  1                 9
 KwaZulu-Natal                          5                  0                  1                 6
 Mpumalanga                             4                  0                  0                 4
 Northern Cape                          3                   3                 0                 6
 Limpopo                                3                  1                  2                 6
 North West                             5                  0                  0                 5
 Western Cape                          13                  0                  2                15
 TOTAL                                 51                  12                 6                69


The Eastern Cape and the Western Cape had the highest number of active clinics, followed
by Gauteng. There were a further four clinics in the Eastern Cape which had been introduced
to the initiative, once active, this province will have the highest number of accredited clinics.

A large quantity of data is collected under NAFCI for a variety of purposes. Some of these
data are summarized below.

System-level indicators
As of the end of 2002 there is little routinely collected information on the process and quality
indicators at a system-level. For example, the inputs and processes followed to advertise
NAFCI and the main barriers to application and accreditation. Some monitoring of quality
and perceived usefulness of the system by accredited clinics would be important to obtain in
the future in order to ensure that the initiative is optimally efficient and effective and to
address any remaining barriers to implementation.

Clinic-level indicators
As NAFCI occurs within public sector services, data collection and monitoring pose a
particular challenge due to other, possibly competing, data collection requirements of the
public health care system. Of the 51 clinics registered as active in 2002, only 33 supplied
data on clients for 2002 and even where data were supplied, there were considerable missing
data for months, quarters and particular services rendered.

Figure 21 shows the average number of monthly youth visits per clinic over the year for
2002. Some clinics (notably KwaMakutha, Khutsong West and Pankop) showed steadily
increasing utilization by youth over the course of the year.




                                                                                               46
                                                                                                                      loveLife 2002


Figure 21: Average number of monthly youth clients per quarter for NAFCI clinics in
                                     2002
           1800



           1600



           1400



           1200



           1000



            800



            600



            400



            200



               0
                             Q1                        Q2                        Q3                           Q4

                               Bophelong                       Sharpville                      Empilisw eni
                               Levai Mbatha                    Bakubung                        Kekanastad
                               Maboloka                        Makapanstad                     Tigane
                               Gamalakhe                       Kw aMakhutha                    Commercial City
                               Ekuphileni                      Esdumbini                       Kw aMbonambi
                               Unit R                          Nkow ankow a                    Mofolo
                               Daveyton Main                   Stanza Bopape                   Khutsong West
                               Vlaklaagte # 2                  Dipaleseng                      Pankop
                               Driefontein New Stand




      Data from the following clinics were not included because of a lack of trend data (i.e. data were available for only one quarter
          or not at all): Ethembeni; Kwanomzamo; Lillydale; Bungeni; Parkwood Clinic; Masiphumelele; Site B and Hout Bay.




Whether or not NAFCI clinics are resulting in greater general accessibility and acceptability
of the services to youth cannot be answered by the available data. Nonetheless, it is clear that
NAFCI clinics have been successful in attracting a greater proportion of young men to the
services compared to 2001. In 2001, it was reported that 2% of visits were by young men.
This has to do with the way in which family planning services are marketed in South Africa.
However, during 2002, the proportion of male clients increased to 11% of all visits. This was
a consistent pattern across most of the clinics.




                                                                                                                                     47
                                                                                   loveLife 2002


Voluntary Counselling and Testing
A further way in which loveLife has sought to improve reproductive health services for youth
has been through the development of the Voluntary Counselling and Testing (VCT) Site
Instrument. This came about when loveLife recognized the need for expansion of VCT
services for young people and a number of Y-Centres identified barriers to offering these
services. The readiness of a centre to offer VCT was formalized through the development of
the site-testing tool.

This is a simple tool designed to assess readiness of a centre or clinic to provide VCT and to
identify critical action points for a service to prepare itself for VCT provision. Those Y-
Centres that are assessed as meeting the criteria necessary to provide a quality service have
been incorporated into the Department of Health’s network of VCT sites.

This network of sites have institutionalised sources of supply through the Department of
Health, and it is a further way in which loveLife seeks to embed action within existing
institutions to enhance cost-effectiveness and sustainability. The VCT site instrument is also
available generally within the public service to assist public sector clinics in preparation for
offering VCT.

Objectives of loveLife’s VCT site testing instrument:
1. Assess availability of staffing levels
2. Assess adherence to protocols
3. Assess availability of health education materials and condoms
4. Assess availability and use of record keeping formats
5. Assess availability of test kits and medical consumables
6. Assess adherence to staff roles and responsibilities
7. Assess general aspects of site operations

The development of this tool demonstrates the commitment by loveLife to link with partners
with similar interests, in this case the Department of Health, and to work together to improve
youth services.




                                                                                              48
                                                                                 loveLife 2002




Key challenges for loveLife

loveLife’s greatest challenge is to sustain engagement among young people with the
campaign in a media saturated environment with many competing attractions, and in an
atmosphere of general cynicism among youth about conventional AIDS campaigns. The
level of positive association by young people is encouraging, and loveLife’s challenge is to
reach young people not yet exposed to the campaign, and to intensify engagement with those
who are.

Behaviour change is complex and generally incremental. The true measure of loveLife’s
effectiveness will be in declining HIV infection rates in South Africans under 20 years. This
evidence will be measured through a large scale bi-annual national surveillance study
combined with a 33 sentinel site survey tracking behavioural trends and HIV prevalence
among the target group. Baseline data from the first in this series of studies is expected at
end of 2003.




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                                                                                               loveLife 2002



ANNEXES
    Annex 1: Communication Strategy 2002. Informing loveLife's multi-media campaign

Source: loveLife 2002. Communication Strategy 2002 - Informing loveLife's multi-media campaign
The Crisis
-     Already more than 5 million South Africans (12 per cent of the population) are HIV positive.
      Conservative estimates are that in excess of 10 million South Africans could be infected with HIV
      in the next five to 10 years. At the current rate of infection among 15-20 year olds, half of all South
      Africans currently 15 years or younger could die of HIV/AIDS.


AIDS is not the only problem
-     One in three women in South Africa has given birth before the age of 18;
-     STIs are endemic among young people in large parts of South Africa;
-     Violence, coercion and abuse are common features of adolescent sexual behaviour.


Cause for hope
-     Despite the gloomy prognosis, there is hope that the progress of the HIV epidemic can still be
      curtailed. About 40 percent of the South Africa's population is under 15 years of age. This is the
      age group that is most at risk of HIV, but where there is also the best chance of positively affecting
      behaviour change. Conversely, failure to influence the sexual behaviour of this age group will have
      catastrophic consequences for the scale of the HIV epidemic in South Africa.


So what's the problem?
-     Existing HIV education programmes have had limited impact on sexual behaviour. Survey's show
      that about 98 percent of South Africans are aware of HIV/AIDS and how it is spread, but condom
      use among South African males has remained almost unchanged at about 10 percent over the past
      five years.


What to do about it?
-     International research shows that to be effective, prevention efforts must target the highest risk
      groups;
-     Education must deal with the broader context of sexual behaviour;
-     Condom use must become a normal part of youth culture;
-     Education and prevention must be sustained over many years at a sufficient level of intensity to
      hold public attention.




                                                                                                           51
                                                                                             loveLife 2002


The Basic Premises of the loveLife Strategy
-   loveLife is a campaign designed to bring about adolescent sexual behaviour change in order to
    effect reductions in HIV/AIDS, STIs and teen pregnancy. loveLife's strategy is the product of
    nearly three years of research into public health education programmes internationally, and
    extensive research among young South Africans.

-   The basic premise of the loveLife strategy is that more open communication about sex, sexuality
    and gender relations is a necessary precondition for adolescent sexual behaviour change. And
    since sexual behaviour drives the HIV epidemic, change in established sexual behaviour patterns is
    an essential precondition to reductions in HIV infection. loveLife specifically targets 12-17 year
    olds because that is the age group where there is greatest opportunity to positively affect sexual
    behaviour, and that is the age group most at risk from HIV infection (most HIV infections occur
    before age 20).

-   Behaviour change requires internalisation of the desired changes by the target group. To be
    successful, loveLife has to change the pervasive values and attitudes among adolescents to sex,
    sexuality and gender relations. Behaviour is also substantially influenced by personal motivation,
    peer pressure, family and broader cultural and societal influences. Behaviour change is incremental
    requiring sustained and consistent effort over many years. One of loveLife's greatest challenges is
    to keep young people sufficiently engaged for long enough to make a difference.

-   While the bedrock of loveLife's communication strategy will always be the imperative of open
    communication about sex ("Talk About It"), through its communications strategy loveLife also
    must inform WHAT is being talked about, HOW it is talked about, and among WHOM.

-   The fundamental behavioural values that should shape the "Talk About It" are: informed choice,
    shared responsibility and positive sexuality. These are the key tenets (value underpinning) of the
    loveLife campaign AND, together with "Talk About It" are the constant core of the communication
    strategy and the essence of the loveLife campaign.

Informed Choice

-   One of the underlying value propositions that make up the loveLife brand, informed choice is
    geared at highlighting the importance of (young South Africans 12-17year olds in particular) being
    in control of ones individual behaviour - "know who you are/what you want". Risks opportunities
    of youth-----assertiveness------self-realization. This value is about encouraging young people to
    seek accurate knowledge that guides decision making that should see positive outcomes in the long
    term.

Shared Responsibility

-   Another of loveLife's core values, shared responsibility refers to the extent to which individuals,
    couples, families, communities and so on, interact with one another, collectively problem solve and
    share in the responsibility of life's challenges. This value highlights the benefits of (achieve
    positive results) people treating themselves and others with respect (respecting other peoples
    choices/decisions, acknowledging people have different opinions/beliefs etc), dignity and love.

Positive sexuality

-   The third value proposition loveLife posits, Positive sexuality is, an expression/function of lifestyle
    informed values of informed choice and shared responsibility. Positive sexuality is the value that
    encourages better understanding of ones sexuality and where and when 'sex' might fit into the
    picture (anatomy, gender relations, visiting a clinic regularly etc). It is about an expression of 'the
    self'/self confidence/good self esteem which translates to a positive understanding/affirmation of
    'ones' place in the world.




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                                                                                           loveLife 2002


A Lifestyle Approach
-   loveLife's communication strategy is driven by a non-didactic lifestyle approach that builds on the
    fundamental aspirational optimism among South African youth. This approach is based on the
    premise that individuals are more likely to be positively motivated to adapt their behaviour if they
    can imagine demonstrable benefits (i.e. a chance to fulfil their dreams, hope of a better life etc.)
    loveLife's lifestyle approach also recognises the spectrum of motivational influences that are likely
    to impact on young people's behaviour from self, to peers, family, community, society and broader
    cultural influences, and loveLife encourages young people to "take control" of their lives.

-   The loveLife brand is positioned as part of popular youth culture and loveLife's media reflects that
    genre. The premise is that the desired behaviour changes have to be accepted as part of popular
    culture if they are to become the behavioural norm among young people.

-   loveLife is competing for the sustained attention of young South Africans with a plethora of
    popular, highly sophisticated media. The loveLife brand is therefore promoted with the same
    intensity and imbued with similar attributes as other popular youth brands. But unlike other brands
    that sell a defined product (e.g. Nike), loveLife is promoting a new lifestyle for young South
    Africans. The primary communications challenge is to get young South Africans hooked (and to
    keep them hooked) on the 'idea' of the loveLife lifestyle as the new popular culture, and to shape
    that lifestyle according to the basic premises of the loveLife campaign.

-   In summary therefore, the loveLife lifestyle is characterised by open communication about sex,
    sexuality and gender relations shaped by the basic tenets of informed choice, shared responsibility
    and positive sexuality.

-   But we also know from international experience that in order to reduce HIV infection, loveLife has
    to impact on three key sexual denominators: the age of sexual initiation, number of sex partners,
    and condom usage. The imperatives of DELAY, REDUCE, PROTECT are specific behaviours
    (as opposed to values) that intertwine loveLife's communication strategy.

-   The components of loveLife's communication strategy build on each other in an integrated and
    complementary fashion.

The Evolution of the Communications Strategy

-   In its' first year, the loveLife communication strategy concentrated on brand awareness and
    promotion of the concept of "talk about it" evolving through an initial teaser campaign designed to
    create intrigue and enquiry to a more pointed focus on sex and HIV.

-   Once loveLife was successful in engaging the target group (nearly 70% brand recognition in year
    one), the concept of "talk about it" was expanded to focus on the values of informed choice, shared
    responsibility and positive sexuality.

-   The next phase of the loveLife communication strategy is designed to sustain and further inform
    loveLife's engagement with the target group by further evolving and expanding on the "bedrock
    communication premises" (as described above). While continuing to promote "talk about it" and
    driving the key tenets of informed choice, shared responsibility and positive sexuality, loveLife
    now is introducing into this context three specific (crosscutting) behaviours: DELAY, REDUCE,
    PROTECT.

-   Although similar to the more traditional ABC (Abstain, Be Faithful, Condomise) strategy,
    loveLife's lifestyle approach is fundamentally different. Specifically it is recognised that such
    behaviour choices are likely to be driven by the basic values shaping adolescent sexual behaviour.
    Therefore, to the extent that loveLife promotes 'delay', 'reduce', 'protect' it does so within the
    holistic/lifestyle context of its fundamental communication values: informed choice, shared
    responsibility and positive sexuality.

Delay


                                                                                                       53
                                                                                            loveLife 2002



-   The average age of sexual debut in South Africa has declined three years in the last 15 years and
    research indicates that 10% of youth who are sexually active started having sex before age 11.
    Furthermore, 60% of sexually experienced youth believe that having sex is a way of proving that
    you love the other person (Hot Prospects Cold Facts, 2000:14). It is against this backdrop of
    research findings that loveLife embarks on its next communication strategy in 2002 with, the
    behaviour driven principle - 'delay'. Mediums of media like, print, television, radio, billboards etc
    will communicate the principle delay using an array of creative executions. As such, one would
    never see the words 'delay' being used in any loveLife media product rather, media products will
    communicate the principle 'delay' in fun interesting ways that resonate with young people (12-
    17yrs). As informed by research, the issues to be communicated around 'delay' are principally
    delaying age of sexual debut, delaying causal unprotected sex, delaying experimenting with drugs
    alcohol and risky behaviour.

Reduce

-   loveLife research (Hot Prospects Cold Facts 2000) indicates that having multiple sexual partners is
    a common and widely accepted behaviour traits among young people in South Africa. About one in
    five sexually experienced young people report having multiple sexual partners "at the moment".
    Result of this nature have, influenced the development of loveLife's 2002 communication strategy.
    Communicating the principle 'reduce' will involve presenting creative material that positively
    influences young people's behaviour addressing the issues of multiple partners, casual unprotected
    sex, transactional sex, non-consensual sex, non-informed decision making and risky behaviour -
    drug and alcohol abuse. Similarly, the behaviour principle 'reduce' will be presented in interesting,
    engaging and exciting ways across all mediums of media.

Protect

-   Constantly surveying the country's landscape, it is difficult to find a young person who has not
    heard about HIV/AIDS and the risks of unprotected sex. Research indicates that forty one percent
    of sexually experienced young people say they do not always use a condom when they have sex
    (Hot Prospects Cold Facts, 2000:15). Some youth go on to explain why - seventy percent actually
    admit that they find buying condoms very embarrassing. The principle 'protect' will be driven
    primarily from the point of view that young South Africans continue to have unprotected sex
    despite high levels of awareness of the risks involved. 'Protect', which forms part of the
    communication strategy for 2002 will be creatively executed to address such issues including
    others like, encouraging youth to take action to protect the future, protecting friends, family,
    community (shared responsibility), protecting people living with HIV/AIDS and so on. Taken
    together, 'delay', 'reduce' and 'protect' will be positioned holistically in order that young people
    across the country easily internalise the messaging. Over time loveLife hopes to achieve its goals of
    changing behaviour that puts young people at risk making them less vulnerable to the scourge of
    HIV/AIDS.




                                                                                                        54
Annex 2: Examples of outdoor media displayed and developed in 2002

     Figure A1: Billboard messages targeting youth displayed in 2002




           Figure A2: Messages displayed on taxis during 2002
56

				
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