New ways of combating HIV/AIDS bear fruit

As young people continue to bear the brunt of the HIV/AIDS epidemic, a pilot project in South Africa's province of KwaZulu-Natal (KZN) is working with families to teach children how to reduce risky behaviour before they reach puberty. The initiative, 'Collaborative HIV/AIDS and Adolescent Mental Health Project (CHAMP)', is being led by the Human Science Research Council (HSRC) and focuses on strengthening communication and HIV/AIDS education between parents and youth. The largest representative survey of South African youth aged between 15 and 24 - conducted by the University of Witwatersrand's Reproductive Health Research Unit (RHRU) - shows that by the age of 23, one in five young South Africans is HIV positive. Young women are hardest hit: nearly one in four aged 20 to 24 is HIV positive, compared to one in 14 men of the same age. "We need to reach children early, when they are still under parental influence, to prevent them from becoming a risk group," Prof Arvin Bhana, director of the HSRC Child, Youth and Family Development unit and one of the project leaders, told PlusNews during an interview. CHAMP, originally developed by the National Institute of Mental Health in the United States, promotes behaviour change through 'participatory education', in which participants in the programme come up with their own solutions to their problems through discussion and debate. The ten-week programme invites families and community members to actively participate, using an open-ended cartoon-based narrative developed especially for CHAMP. During each session, parents and children discuss a chapter of the cartoon narrative, which depicts the lives of two neighbouring African families, one of them affected by HIV/AIDS. Participants then have to come up with the best behaviour patterns for the characters in the story. In one of the chapters, for example, a mother discovers that her 11-year-old daughter has started menstruating, which encourages and facilitates debate around how the mother should talk to her daughter about this sensitive issue. Each session is accompanied by a workbook, which families take home to consolidate lessons learnt and involve family members - usually men - who do not participate in the programme, said Bhana. "Parents do know their kids need help, but they don't know how to help them," he explained. CHAMP was introduced into the country four years ago, as the result of a partnership between the HSRC, the School of Psychology at the University of KZN and the National Institute of Mental Health in the United States. To apply the programme to a South African context, researchers interviewed parents and children living in townships and semi-rural areas, and found that large numbers of families identified poor communication between parents and children as one of their major obstacles in dealing with HIV/AIDS. A lack of information about the disease, low levels of self-esteem and the loss of family members prompted risk-taking behaviours amongst youth. Researchers also found that family members living with HIV/AIDS experienced widespread stigma and discrimination. It was particularly important to include parental and children's rights and responsibilities, and how to deal with stigma and bereavement in the South African programme, Bhana noted. The pilot project was conducted among 124 families, each of which had at least one child aged between nine and 11, in three areas in the province: Cato Manor, an urban shack settlement on the outskirts of Durban; and Embo and Molweni, two semi-rural areas in the Valley of a Thousand Hills, about 40 kilometres north of the port city of Durban. The families were split into two groups: one group participated in the programme, while the other acted as the 'control group'. Embo resident Spongile Langa became involved with CHAMP in order to help her 11-year-old daughter, Mandisa, cope with the multitude of problems she would have to deal with as a teenager. She attributes the "success" of the project to the fact that "project leaders don't tell you what to do - they encourage you come up with your own solutions". The study found that that the CHAMP participants showed significantly greater HIV/AIDS knowledge and displayed less stigmatising attitudes than the control group. Parents and children shifted to more assertive styles of communication, engaging more openly and frequently in hard-to-talk-about subjects, such as alcohol, drugs, HIV/AIDS, and sex. Bhana said: "The stronger the family unit, the more it will be a resource a child can draw from in his or her future." Langa said she was now "ready to talk about sexuality", which was important as Mandisa entered puberty. Over the next 18 months the CHAMP project will be extended to 450 families in KZN. Community facilitators - parents who have been part of the CHAMP pilot phase and received additional training - will roll out CHAMP to more families in their villages, townships and settlements. Each of the three communities where CHAMP has been held has formed a committee of six community facilitators. The committee will approach councillors, tribal authorities, schools and churches to identify future CHAMP families. "I'm praying this programme will reach families all over South Africa, so that we can have a healthy next generation," Langa told PlusNews. HSRC and the School of Psychology of the University of KZN hope to implement the programme throughout the country.