OneLove Regional HIV Prevention Campaign: Evaluation Summary 2013

This report offers a summary of an evaluation of the OneLove Campaign, a Southern African regional HIV prevention campaign that was designed to address multiple concurrent sexual partners (MCP). Across the region, the campaign reached 27 million people and was associated with increases in condom use, HIV testing, and knowledge levels, however less consistent impact was shown on multiple partner reduction in most countries.

The OneLove campaign was implemented in Lesotho, Malawi, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe by Soul City Institute for Health and Development Communication (SCI) and its country partners in each country. In other SCI regional programme partner countries (Botswana, Namibia and Mozambique) key messages were incorporated in local multi-media productions under different brand names. OneLove campaign messages were carried by a mix of materials, media and community action, uniquely researched and developed by each country partner. The programme includes television, films and radio drama series, talk shows and public service announcements broadcast by national broadcasters and community broadcasters; billboards; social mobilisation and community dialogues as well as community capacity building through training. A regional component that crosses borders aimed to reach migrant populations.

The Onelove campaign was evaluated by a set of complementary studies. This included large scale, quantitative household surveys in eight countries, mid-term qualitative audience studies, an in-depth qualitative study in Zambia and a process evaluation that explored regional value add and capacity strengthening.

The primary purpose of the external evaluation of the regional OneLove Campaign was to understand and quantify what worked, how and why; as well as to inform subsequent interventions. The main objectives were: to measure campaign reach and outcomes (in the general population and high risk populations); and to investigate the extent to which the intervention built the skills and resources of communities to respond to the HIV epidemic.

Summary of key findings:

Reach

• The OneLove regional campaign reached an estimated 27 million people across the Southern African region.
• Over 50% of the adult population recognised the campaign logo in Lesotho, Malawi, Swaziland and Zambia.
• Overall, radio had the highest reach, followed by print and then TV. Some 74% of the population were reached by radio in Malawi, while over 60% of the Swazi and Zambian target audiences were reached by this medium.

Impact

• Across the region the campaign was associated with increases in condom use, HIV testing, knowledge levels; shifts in attitudes/norms and greater interpersonal communication (all of these were statistically significant). For example, in Lesotho multimedia exposure was associated with increased HIV testing in the preceding year and a dose response relationship was demonstrated (46.% unexposed, 52.8% exposed to 1 medium, 59% exposed to 2 media). In Malawi, there was a 7% increase in condom use at last sex for men who had multiple partners, for those who were exposed to OneLove radio and a 22% increase amongst the general population for those exposed to OneLove TV. In Zambia, those who read the OneLove booklet had a 10% increase in discussing HIV compared to those who hadn’t read the book.
• The campaign had less consistent impact on multiple partner reduction, though impacts were measured in some countries.
• The regional nature of the campaign, including consistent messaging, was recognised and well received by target populations, there is evidence of greater impact of cross-border exposure on condom use.
• Simultaneous to campaign planning and implementation, a range of SBCC skills and capacities were built within partner organisations.
• Continued implementation of SBCC campaigns will contribute to sustaining safer behaviours such as condom use and HIV testing.

According to the report, multiple sexual partner behaviour appears to be more difficult to change in the short/medium term than other behaviours. This is likely to be due to a combination of factors including deeply entrenched cultural and gender norms as well as structural factors such as poverty and migrancy. In the context of continued multiple and concurrent sexual partners, it is encouraging to note that the OneLove campaign has had a desirable impact on increased condom use, which will likely contribute to decreases in new HIV infections. It is therefore crucial that social and behaviour change campaigns for HIV prevention be continued both to build on gains and to sustain changes achieved.

In addition, as stated in the report, the OneLove regional campaign was arguably the largest regional HIV prevention effort in Southern Africa to date. Evidence suggests that a regional approach with consistent branding and messaging across borders had several benefits including greater health impacts, a strong public perception of regional integration, and cost-efficiencies.

Click here for a related poster presentation which was presented at the 6th South African AIDS Conference.