Survey of Nonformal Life Skills and HIV Prevention Literature Aimed at Young People in Africa

According to this report, a potentially important component of effective HIV/AIDS prevention strategies for young people is non-formal literature, such as comic books, magazines, and videos. This document aims to pull together what is known about existing non-formal literature for HIV/AIDS prevention, providing in-depth content analysis of a wide variety of comic books and photo novels and also offering some collective lessons learned and recommendations.

In the absence of formal evaluations, the researchers chose potentially effective documents based on the presence of a balance of elements likely, in their opinion, to effect behaviour change. These included:

• knowledge (information on HIV transmission, HIV non-transmission, sexually transmitted infections (STIs), protective methods, information sources, etc.);
• personal or group risk perception (situations, behaviours, and stereotypes);
• values or attitudes (toward sexuality, condoms, people living with HIV/AIDS (PLWHA), and gender roles);
• social influence (parents, peers, and help-seeking behaviour);
• self-efficacy (negotiation with partners and parents, assertiveness, self-esteem, help-seeking behaviours, and self-confidence for condom use or abstinence); and
• skills (thinking and critical reasoning; decision-making; communication and social skills; emotion management, including coping with emotion and stress; resisting peer pressure; practical motor skills, including condom use; and self-defense).

Following is an overview of the main characteristics found in the life skills and non-formal reproductive health and HIV/AIDS prevention literature designed for young people in sub-Saharan Africa.

• Most include knowledge and address risk perception, attitudes, and values, but only one-quarter of the documents identified actually have significant life skills content.
• When life skills content is present, one of the most commonly developed themes is promoting help-seeking behaviour linked with STIs, unwanted pregnancy, and HIV/AIDS.
• Most of the comic books and magazines include knowledge about HIV transmission and non-transmission, HIV symptoms, protective methods, and the HIV test. They also show that having multiple sex partners and unprotected sex is risky behaviour. Some provide good examples of peer support, knowledge, attitudes, and help-seeking behaviour regarding sexual violence or abuse.
• Many moralise, try to scare their audience, and/or project negative attitudes toward sexuality and condom use in a way that may discourage or repel many young people that the materials are trying to reach.
• Many documents include community concerns about HIV/AIDS and the search for responses, including positive attitudes toward PLWHA.
• Few documents effectively portray the vulnerability of young women. Subjects such as non-formal sex work, physical violence against women, and sex with older men are not covered sufficiently.
• Few deal substantially with child sexual abuse or sexual harassment.
• Communication between parents and their adolescent children is not sufficiently explored.
• Few materials are designed for pre-adolescents. Many young people only begin receiving information after they have become sexually active.
• One finds almost no mention of sexual orientation in any of the publications or videos.

The authors state that the following recommendations will be useful for those thinking about creating or supporting new non-formal literature to reach young Africans:

• Non-formal literature should pay particular attention to helping girls and young women understand the factors that place them at risk.
• Because of the role older men play in infecting younger women in Africa, the character of the "sugar daddy" should receive more attention.
• Violence against women both in and out of marriage also requires more attention to foster public debate and help create new norms.
• Protection of children in the face of the AIDS epidemic and its consequences for increased child abuse make coverage of this theme a priority.
• The HIV/AIDS epidemic has made it even more crucial today to find ways parents or adults can discuss sexuality with their children in truthful, frank, and nonjudgmental ways.
• It is imperative to talk realistically about sexuality and reproductive health issues related to STI/HIV/AIDS in a way that gives young people the chance to make informed, age-appropriate choices while ensuring that they will be protected.
• Prevention should start with pre-adolescents, before they become sexually active.
• Culturally appropriate ways to broach sexual orientations and protect this vulnerable subgroup need to be explored.
• It is essential that teachers, group leaders, and peer educators organise participatory, experiential activities for young learners so they have a chance to practice and internalise these new, lifesaving skills.
• The importance of materials in local languages is a recurring theme.
• Thought and attention need to be given to preparing effective, appropriate systems to ensure wide distribution and monitoring.
• It is crucial that the impact of non-formal literature on youth behaviour change be evaluated to identify what is effective and what is not.