Community Media Trust Evaluation Report: A Report on the Impact of Siyayinqoba Beat It! on HIV and AIDS

This evaluation report outlines key findings related to Community Media Trust’s (CMT) Siyayinqoba Beat It! programme in South Africa based on The Third National HIV Communication Survey 2012. The objective of this analysis of the survey was to examine and measure awareness, knowledge, and exposure to Siyayinqoba Beat It! and to estimate impact on health knowledge, attitudes, and perceptions, which would in turn contribute to behaviour change in HIV prevention, care, support, and treatment. This in turn would be used to help guide CMT programming in moving forward. The Siyayinqoba Beat It! television magazine programme was first launched in 1998 and is now accompanied by activities such as outreach, health literacy print materials, training, and the Siyayinqoba Beat It! archive of audio visual resources.

In the National HIV Communication Survey 2012, "respondents were asked about their values and behaviours, regardless of whether they had been exposed to Siyayinqoba Beat It! programme. The evaluation used quantitative methods for analysis, which allow for the measurement of the impact of the Siyayinqoba Beat It! programme on the South African population. By comparing the knowledge, attitudes, and behaviours of those respondents who had interacted with Siyayinqoba Beat It! with those who had not, changes attributable to Siyayinqoba Beat It! could be measured."

A number of key findings are discussed:

• Structural Drivers: The report discusses structural drivers of the HIV epidemic and how these contribute to and hinder behaviour change related to HIV/AIDS. For example, the survey data shows that knowledge around partner reduction (MSP) remains low, particularly among individuals with low levels of education. People with higher levels of education are more likely to have a positive outlook on the future, while those with higher socio-economic status and those employed are more likely to demonstrate better knowledge and less risky behaviours. This could indicate that radio and interpersonal communication options need to be explored in greater depth to reach people who are living in poverty and are not employed.
• Behavioural Drivers: Across areas such as multiple sexual partnership, consistent condom use, and condom use at first sex, there are positive associations between Siyayinqoba Beat It! and knowledge, but little significant impact on behaviours. Likewise, there was no association between transactional sex and exposure to Siyayinqoba Beat It! However, the report notes that increased knowledge is moving people in the right direction towards behaviour change.
• Biomedical HIV Prevention Interventions: One of Siyayinqoba Beat It!'s main objectives is increasing treatment literacy, including around biomedical prevention interventions such as prevention of mother to child transmission, medical male circumcision, and HIV counselling and testing. In these areas, there is improved knowledge, as well as mixed understanding. For example, 92% of respondents knew that all pregnant women should be tested for HIV, and 85% knew that a woman with HIV can give birth to a child who is HIV negative, but only 45% of respondents knew that a baby should be exclusively breastfed for 6 months. "Though knowledge on PMTCT was high, there remains considerable room for improvement on the knowledge about safer feeding of babies born to HIV infected women."
• Treatment Literacy: Siyayinqoba Beat It! was associated with significant positive impact on knowledge of antiretroviral therapy, as well as tuberculosis co-infection. Unfortunately, there still appears to be little community-level support for people living with HIV (PLWHV), and it is suggested that "this may be a platform for Siyayinqoba Beat It! to increase its programme reach towards greater community engagement with the HIV epidemic." Likewise, while stigma has decreased, "it is still essential to have sustained messaging to address stigma so as to maintain acceptance and support of PLWHA. Continued positive messaging around stigma is needed as this may result in an increased community engagement surrounding HIV related issues."

Based on the findings, the report outlines the following conclusions and recommendations:

Reach of Siyayinqoba Beat It!
Data suggests that 52% of the population has had some exposure to Siyayinqoba Beat It!, mostly through the television programme - with somewhat more exposure in urban areas. As a result, Siyayinqoba Beat It! has had positive results in areas such as "building knowledge, developing appropriate attitudes and beliefs, and - as a consequence - changing behaviour patterns." For example, knowledge of male circumcision benefits has improved since 2009; in 2012, 48% of respondents were aware that male circumcision reduced the risk of getting HIV, compared to 8% in 2009. As the HIV epidemic evolves, impact from communication interventions can be sustained through modifications to future programming and messaging.

Areas of Siyayinqoba Beat It! Impact
According to the analysis, "people exposed to Siyayinqoba Beat It! had significantly higher knowledge of partner reduction as a way to reduce the risk of getting HIV," though exposure was not significantly associated with behaviour change. Changing behaviours around MSP continues to be a challenge, and there is a need to design messages, especially for men and young people, and to better understand socio-cultural factors that hinder behaviour change. In order to not promote condom use over partner reduction, "[i]t is important to continue to promote partner reduction and faithfulness in the future, and to present this messaging within the framework of a combined or multi-method approach to HIV prevention."

Areas of Siyayinqoba Beat It! Low and Unmeasured Impact
Data suggests that Siyayinqoba Beat It! has had little impact in some areas, such as male circumcision to reduce risk of HIV infection, correct and consistent condom use, and intergenerational and transactional sex. In these areas, there is a need for sustained and contextualised messages.