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Presentation to the Social Development Portfolio Committee. Grace Matlhape. CEO: New loveLife Trust 30 August 2011. History of loveLife (1). 1997-1999: Consensus among some civil society partners to initiate an HIV/AIDS prevention programme targeting youth in South Africa
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Presentation to the Social Development Portfolio Committee Grace Matlhape CEO: New loveLife Trust 30 August 2011
History of loveLife (1) • 1997-1999: Consensus among some civil society partners to initiate an HIV/AIDS prevention programme targeting youth in South Africa • MOU signed between the Kaiser Family Foundation and the South African government to create a large-scale HIV-prevention programme for youth • loveLife has been promoting healthy, HIV-free living among South African teenagers since 1999. • Tri-partite relationship established 2005 with significant funding from DOH and DSD.
History of loveLife (2) • Since inception loveLife has combined sustained nationwide multimedia withcommunity-level outreach and support programmes • The 2004 evaluation of loveLife resulted in the scaling up of outreach and support and the scaling down of media campaign. • Thereafter the campaign continued to focus on addressing the individual and social drivers of the epidemic, with a specific new focus on structural factors, with 2008 seeing “Make Your Move” launched.
loveLife Performance Summary Youth Friendly Clinics: 532 1,500,000enrolments in educational programmes Schools: 6,520 9,452* peer educators *2010: 1,447 groundBREAKERS, 8005 mpintshis goGogetters: 500 NGO Community Partnerships: 330 760,102 calls to call centre loveLife Y-Centres: 18 1,702,621site event participants loveLife Games Youth Helpline Festivals & Events Sustained Media: Radio, TV, Print, Web, and Mobile
State of the epidemic: Why target youth? • Half our population is under 25
Main spike of infection is among youth Source: HSRC National Survey (2008)
It’s about more than just knowledge Source: Pettifor et al (2004). HIV and sexual behaviour among young South Africans: A national survey of 15-24 year olds 2003., Reproductive Health Research Unit, University of Witwatersrand (secondary analysis)
We can halve incidence... again Source: Thomas M. Rehle et al. (2010) “A Decline in New HIV Infections in South Africa: Estimating HIV Incidence from Three National HIV Surveys in 2002, 2005 and 2008”, PLoS ONE,1 June 2010, Volume 5, Issue 6, e11094.
How does loveLife fight HIV? • Individual/Behavioural: Address attitudinal and knowledge gaps in schools through massive outreach programmes. • Social change: Sustain media and youth leadership initiatives that entrench positive social norms. • Structural: Deliver youth friendly clinical services, psychosocial support, career guidance, school sport, and so on. • Bio-medical: Create demand for bio-medical prevention technologies while reducing the burden on the primary healthcare system. 13
loveLife’s Theory of Change A cluster of social & economic factors predict high risk behaviour • Social • COERCION • PEER PRESSURE • LACK OF PARENTAL COMMUNICATION • EXPECTATIONS OF WOMANHOOD • MALE SENSE OF ENTITLEMENT • Structural • POVERTY • LOW EDUCATION • MARGINALIZATION • INEQUALITY • Individual • LOW SELF-ESTEEM • NO SENSE OF FUTURE • UNCERTAIN IDENTITY Helplessness in the face of challenges Pressure to conform to negative social norms Sense of constrained choices Perception of scant opportunity HIGH RISK TOLERANCE 14
loveLife Annual Report 2010: All Sites Total = 880 Figure 1: Sites by site type Source: 2010 loveLife Monitoring Report 16
loveLife Annual Report 2010: All Sites Table 1: Sites table by province and type Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: DSD Sites Figure 2: DSD sites by region and type Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: DSD Sites Figure 3: DSD sites by type Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: DSD groundBREAKERS Male to Female Ratio of all groundBREAKERS (n=1476) Total = 519 Figure 4: DSD groundBREAKERS by region showing M:F ratio Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: mpintshis Total = 8,005 Figure 5: mpintshis by province showing M:F ratio Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: mpintshis at DSD sites Figure 6: DSD mpintshis by region Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Schools Total = 6,520 Figure 7: Schools by province and type Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Schools linked to DSD sites Total number of schools linked to DSD sites Figure 8: Schools by loveLife Region Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: In-school programmes Young people registered = 1,509,555 Figure 9: Total participants in loveLife programmes by province Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Participant age distribution Figure 10: Total participants in loveLife programmes by province Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Participants (DSD) Figure 11: Registrations by region, DSD-funded sites Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Site-based events (all) Total participants = 1,702,621 Figure 12: Site events by type and participants Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Site-based events (DSD) Figure 13: Site events by type and participants Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Born Free Dialogues Total participants = 49,226 Parents Children Figure 14: Participants in Born Free Dialogues: Parents vs. Children Source: 2010 loveLife Monitoring Report 31
loveLife Annual Report 2010: goGogetters and OVC Total goGogetters = 465 Total OVC supported = 2,247 Figure 15: goGogetters and the children they support by province Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Call Centre Youth Line: 760,102 calls in 2010 Parent Line: 29,788 calls in 2010 Figure 16: Calls to loveLife Youth Line and Parent Line Source: 2010 loveLife Monitoring Report
loveLife Annual Report 2010: Call Centre Callers by Province Callers by reason for calling Figure 17: Callers by province and reason for calling Source: 2010 loveLife Monitoring Report
Behavioural interventions have been shown to work • Participated in face-to-face HIV prevention programme1(AOR: women 0.61 95% CI 0.43-0.85 & men 0.60 95% CI 0.40-0.89).Pettifor et al., “Young people’s sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey”. AIDS 19:1525-1534. • In-school learners report less risky sexual behaviour and have lower rates of HIV than same-aged out of school peers. Hargreaves et al., “The association between school attendance, HIV infection and sexual behaviour in rural South Africa”. Journal of Epidemiological Community Health; 000;18;doi.10.1136/jech.2006.053827 (2007). 1 The programme under evaluation was loveLife.
Combination prevention is necessary • Multi-pronged interventions, none of which is 100% effective. • All require the adoption of certain behaviours (adherence, correct and consistent condom use, etc.) • Growing consensus (cf. Lancet Series 2008) that we need to combine our interventions: “...to avoid risk compensation and to increase adherence, biomedical methods should be inextricably implemented together with behavioural interventions. Likewise, biomedical interventions, such as male circumcision, offer a unique opportunity for risk reduction counselling.” Padian et al., Lancet 2008
Preliminary findings of HSRC impact assessment • Most reported improved skills development and increased access to opportunity as a result of loveLife participation • Increased motivation and capacity to perceive and take opportunities after loveLife participation • Increased likelihood of safe sex • Youth reported (1) learning healthy sexual behaviour (2) practicing safe sex after participating in loveLife • Youth reported positive thinking and ‘hope’ Study conducted by the Human Sciences Research Council; Funded by Kaiser Family Foundation
Upcoming evaluations of loveLife • 2012: National Communication Survey (NCS) in partnership with Soul City and JHHESA: • To examine whether public health communications programmes and messages have an impact in changing knowledge, attitudes, norms and behaviour with regard to HIV/AIDS and TB • To be conducted across South Africa, sample of 10000 households • To be conducted in 2012 • 2012: Internal evaluation of loveLife groundBREAKER programme • 2011-12: Plans for baseline study and follow up evaluations of new Y-Centre; and plans for assessment of impact of existing Y-Centres
What does SA get for investing in loveLife? • A study of South African youth (15-24 years old) found that interaction with loveLife face-to-face was had a 0.61 AOR “protective effect” (Pettifor et al. A national survey of 15-24 year-olds, AIDS 2005) • This means that participating in loveLife programmes makes young men and women around 40% less likely to contract HIV – a remarkable efficacy rate that is exceptionally cost effective. • 2,500 temporary employment opportunities1 • Cash transfers to marginalized communities • Skills transfers affect long-term employability 1goGogetters, groundBREAKERS, IDT Mpintshis, HWSETA learnerships – Monitoring2009 and 2010 2 VOSESA groundBREAKER Survey, 2007.
loveLife has implemented at ever increasing scale Participants: 450% increase over 5 years Schools: 127% increase over 5 years Community Sites: 29% increase over 5 years Source: loveLife Monitoring Reports 2006-2010
loveLife has increased efficiency levels dramatically Source: loveLife Annual Reports 2006-2010
Thank youloveLife Tel +27 (0)11 523 1000 Fax +27 (0)11 523 1001 48 wierda rd west wierda valley sandton 2196 P O Box 45 parklands 2121 south africa firstname.lastname@example.org www.mymsta.mobi www.lovelife.org.za