New report shows impact of South African HIV/AIDS television serial drama

A new report from the Health Communication Partnership (HCP) demonstrates how a powerful television serial drama about young adults living in a rural South African town impacted by HIV/AIDS led to improved attitudes about HIV/AIDS, stigma, living openly and positively with HIV and faithfulness among its viewers. The latest issue of HCP’s Communication Impact profiles Tsha Tsha, a gritty Nguni language drama (with English subtitles) set in the Eastern Cape that focuses on the lives of several young people exploring love, sex, and relationships in a world affected by the realities of the AIDS pandemic. Based at Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (CCP), HCP is a global communication initiative supported by the U.S. Agency for International Development (USAID). According to national audience rating data provided by the South African Broadcasting Corporation Limited, Education Division (SABC), Tsha Tsha reaches an average of 1.8 million viewers each week, for an estimated cost of $.55 per person reached. SABC Education and SABC One, Curious Pictures, the Centre for AIDS Development Research and Evaluation (CADRE), and HCP collaborated to develop this entertainment-education drama series. By depicting the challenges facing young South Africans, the series aims to enhance its young adult viewers’ capacity to reflect on their own problems, engage in developing solutions, and become active agents in shaping their future. The U.S. President’s Emergency Plan for AIDS Relief supports the research, development, and production of Tsha Tsha through the USAID. SABC Education produces, markets, and SABC One broadcasts the series, which premiered in April 2003. HCP provides technical assistance in all aspects of the show's design, scripts, production, research and evaluation, and funds all elements of production. HCP also works with SABC Education, CADRE and other South African partner organizations to set up community viewing clubs for the series. CADRE and HCP researchers evaluated audience responses to the first 26 episodes based on data collected between April 2003 and May 2004. Researchers used propensity score matching — a relatively new statistical procedure — to analyze the responses by creating a matched control group to compare against a group that watched the drama. This fulfilled one of the aims of the research – to develop more precise research tools for evaluating the effects of mass-media education programs. This method effectively overcomes the problem of confounding variables that influence exposure being associated with outcome variables – an issue that has been one of the most vexing challenges in establishing equivalent exposed and unexposed groups for evaluation of mass media interventions. Recall of the drama content served to measure exposure. The percent of respondents that recalled the program increased from 57.6% after 13 episodes to 67.6% after 26 episodes. Viewers and non-viewers differed significantly on the following variables after controlling for the effects of propensity to view the series: Compared to the statistically created control group, viewers were more likely to have positive attitudes about HIV issues addressed in Tsha Tsha, including stigma towards people living with HIV/AIDS. Viewers were more likely to practice HIV preventive behaviors, such as abstaining from sex, being faithful to one partner, having sex less often, using a condom to prevent HIV, or using a condom at last sex. (Figure 1 and 2) Viewers were more likely to undergo Voluntary Counseling and Testing (VCT) to determine their HIV status. (Figure 2) The qualitative data reflected a high level of visual literacy amongst viewers, and an interest in engaging with the series and its characters. Viewers saw the series as realistic, captivating, entertaining, and educational. They considered the rural setting novel and the show appealed to both rural and urban residents. Knowledge and general awareness about HIV/AIDS increased, and various self-reported shifts in HIV attitudes, beliefs, practices, and behaviors occurred. Viewers also reported an increased sense of responsibility for the well-being of others as Tsha Tsha portrayed the dynamics of living openly with HIV and the problems and challenges involved in sharing one’s status with others. It provided strong, positive images of young people confronting their HIV positive. HCP is a global communication initiative based at CCP in partnership with the Academy for Educational Development, Save the Children, the International HIV/AIDS Alliance, and Tulane University's School of Public Health and Tropical Medicine. In addition to the five core partners, HCP works with leading Southern-based health communication organizations as well as global programming partners from the corporate sector, international media, academic institutions, and faith-based organizations. For more information, visit the HCP web site. To order this issue of Communication Impact, contact orders@jhuccp.orgor for an electronic copy, visit http://www.jhuccp.org/pubs/ci/20/20.pdf. Source: HCP web site.

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