1. Presentation to the Social Development Portfolio Committee Grace Matlhape CEO: New loveLife Trust 30 August 2011

2. History of loveLife (1)  1997-1999: Consensus among some civil society partners to initiate an HIV/AIDS prevention programme targeting youth in South Africa  MOU signed between the Kaiser Family Foundation and the South African government to create a large- scale HIV-prevention programme for youth  loveLife has been promoting healthy, HIV-free living among South African teenagers since 1999.  Tri-partite relationship established 2005 with significant funding from DOH and DSD.

3. History of loveLife (2)  Since inception loveLife has combined sustained nationwide multimedia with community-level outreach and support programmes  The 2004 evaluation of loveLife resulted in the scaling up of outreach and support and the scaling down of media campaign.  Thereafter the campaign continued to focus on addressing the individual and social drivers of the epidemic, with a specific new focus on structural factors, with 2008 seeing “Make Your Move” launched.

4. Functional organogram of loveLife Board of Trustees Chief Executive Officer Finance Division Finance Procurement IT Marketing & Fundraising Division Communication Government Relations Fundraising Research & Programmes Division Design Implementation Media Research, Monitoring & Evaluation Logistics Human Resources Company Secretary Internal Auditor

5. Geographic presence

6. Sustained Media: Radio, TV, Print, Web, and Mobile loveLife Performance Summary 9,452* peer educators *2010: 1,447 groundBREAKERS, 8005 mpintshis 9,452* peer educators *2010: 1,447 groundBREAKERS, 8005 mpintshis 1,500,000 enrolments in educational programmes Schools: 6,520 Youth Friendly Clinics: 532 NGO Community Partnerships: 330 loveLife Y-Centres: 18 loveLife Games Youth Helpline goGogetters: 500 Festivals & Events 760,102 calls to call centre 1,702,621 site event participants

7. State of the epidemic: Why target youth?  Half our population is under 25

8. Main spike of infection is among youth Source: HSRC National Survey (2008)

9. It’s about more than just knowledge Source: Pettifor et al (2004). HIV and sexual behaviour among young South Africans: A national survey of 15-24 year olds 2003., Reproductive Health Research Unit, University of Witwatersrand (secondary analysis)

10. An unequal society drives new infections

11. Young people are showing the way

12. We can halve incidence... again Source: Thomas M. Rehle et al. (2010) “A Decline in New HIV Infections in South Africa: Estimating HIV Incidence from Three National HIV Surveys in 2002, 2005 and 2008”, PLoS ONE,1 June 2010, Volume 5, Issue 6, e11094.

13. 13 How does loveLife fight HIV?  Individual/Behavioural: Address attitudinal and knowledge gaps in schools through massive outreach programmes.  Social change: Sustain media and youth leadership initiatives that entrench positive social norms.  Structural: Deliver youth friendly clinical services, psychosocial support, career guidance, school sport, and so on.  Bio-medical: Create demand for bio-medical prevention technologies while reducing the burden on the primary healthcare system.

14. 14 A cluster of social & economic factors predict high risk behaviour loveLife’s Theory of Change Helplessness in the face of challenges Individual LOW SELF-ESTEEM NO SENSE OF FUTURE UNCERTAIN IDENTITY Individual LOW SELF-ESTEEM NO SENSE OF FUTURE UNCERTAIN IDENTITY Social COERCION PEER PRESSURE LACK OF PARENTAL COMMUNICATION EXPECTATIONS OF WOMANHOOD MALE SENSE OF ENTITLEMENT Social COERCION PEER PRESSURE LACK OF PARENTAL COMMUNICATION EXPECTATIONS OF WOMANHOOD MALE SENSE OF ENTITLEMENT Perception of scant opportunity Pressure to conform to negative social norms HIGH RISK TOLERANCE Structural POVERTY LOW EDUCATION MARGINALIZATION INEQUALITY Structural POVERTY LOW EDUCATION MARGINALIZATION INEQUALITY Sense of constrained choices

15. Alignment to DSD Strategic priorities Programme 3 “To invest in and ensure the provision of sound social welfare services to children, including those in need of care and protection” goGogetters (MP, NC) “To support and strengthen family and community through interventions that foster social cohesion” Born Free Dialogues Community Dialogues Programme 4 “To reduce the incidence of and minimise the psychosocial impact of HIV/AIDS in order to achieve the goals and targets of the National Strategic Plan for HIV/AIDS, TB and Malaria, and to expand the HIV & AIDS programmes an M&E using relevant indicators.” groundBREAKERS, mpintshis, sites, schools, loveLifestyle programmes. “To implement youth programmes that assist youth to access work and participate in the mainstream economy“ groundBREAKERS, mpintshis, alumni, MYMsta

16. Total = 880 16 loveLife Annual Report 2010: All Sites Figure 1: Sites by site type Source: 2010 loveLife Monitoring Report

17. loveLife Annual Report 2010: All Sites ECFSGPKZNLPMPNWNCWCTOTAL Franchise2215729162821289175 loveLife Outlet31332625 2255155 Y-Centre32132221218 Youth Friendly Clinic984474559749413143532 GRAND TOTAL1267485113117849082109880 Table 1: Sites table by province and type Source:2010 loveLife Monitoring Report

18. loveLife Annual Report 2010: DSD Sites Figure 2: DSD sites by region and type Source:2010 loveLife Monitoring Report

19. loveLife Annual Report 2010: DSD Sites Figure 3: DSD sites by type Source:2010 loveLife Monitoring Report

20. loveLife Annual Report 2010: DSD sites by geo-type

21. loveLife Annual Report 2010: DSD groundBREAKERS Figure 4: DSD groundBREAKERS by region showing M:F ratio Source:2010 loveLife Monitoring Report Total = 519 Male to Female Ratio of all groundBREAKERS (n=1476)

22. loveLife Annual Report 2010: mpintshis Figure 5: mpintshis by province showing M:F ratio Source:2010 loveLife Monitoring Report Total = 8,005

23. loveLife Annual Report 2010: mpintshis at DSD sites Figure 6: DSD mpintshis by region Source:2010 loveLife Monitoring Report

24. loveLife Annual Report 2010: Schools Figure 7: Schools by province and type Source:2010 loveLife Monitoring Report Total = 6,520

25. loveLife Annual Report 2010: Schools linked to DSD sites Figure 8: Schools by loveLife Region Source:2010 loveLife Monitoring Report Total number of schools linked to DSD sites

26. loveLife Annual Report 2010: In-school programmes Figure 9: Total participants in loveLife programmes by province Source:2010 loveLife Monitoring Report Young people registered = 1,509,555

27. loveLife Annual Report 2010: Participant age distribution Figure 10: Total participants in loveLife programmes by province Source:2010 loveLife Monitoring Report

28. loveLife Annual Report 2010: Participants (DSD) Figure 11: Registrations by region, DSD-funded sites Source:2010 loveLife Monitoring Report

29. loveLife Annual Report 2010: Site-based events (all) Figure 12: Site events by type and participants Source:2010 loveLife Monitoring Report Total participants = 1,702,621

30. loveLife Annual Report 2010: Site-based events (DSD) Figure 13: Site events by type and participants Source:2010 loveLife Monitoring Report

31. loveLife Annual Report 2010: Born Free Dialogues 31 Total participants = 49,226 Figure 14: Participants in Born Free Dialogues: Parents vs. Children Source:2010 loveLife Monitoring Report Parents Children

32. loveLife Annual Report 2010: goGogetters and OVC Total goGogetters = 465Total OVC supported = 2,247 Figure 15: goGogetters and the children they support by province Source:2010 loveLife Monitoring Report

33. loveLife Annual Report 2010: Call Centre Youth Line: 760,102 calls in 2010Parent Line: 29,788 calls in 2010 Figure 16: Calls to loveLife Youth Line and Parent Line Source:2010 loveLife Monitoring Report

34. loveLife Annual Report 2010: Call Centre Callers by ProvinceCallers by reason for calling Figure 17: Callers by province and reason for calling Source:2010 loveLife Monitoring Report

35. What do we know prevents HIV? METHODEFFICACYCOMPLEXITIES Male Condoms 95 % when used consistently; (No RCT can be conducted for ethical reasons). May not be used consistently & correctly; gender dynamics Female condoms Estimated 95 % when used consistently & correctly; currently the only female- controlled method of prevention Low uptake; costly; conspicuous; unpopular; must be used correctly and consistently. Medical Male Circumcision Shown to reduce female-male HIV transmission by approx. 60 %; 3 RCTs confirm this; one-time procedure = cost effective. Cultural issues; requires demand and uptake; concerns about behavioural disinhibition. STI treatment Mixed evidence for efficacy in reducing HIV transmission; longitudinal studies support syndromic management though RCTs show little evidence of efficacy. Mixed evidence Post-exposure prophylaxis Observational studies & animal studies suggest efficacy in preventing infection after exposure to HIV Access; requires adherence and awareness of protective effect of PEP.

36. Behavioural interventions have been shown to work  Participated in face-to-face HIV prevention programme 1 (AOR: women 0.61 95% CI 0.43-0.85 & men 0.60 95% CI 0.40-0.89). Pettifor et al., “Young people’s sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey”. AIDS 19:1525-1534. less risky sexual behaviour lower rates of HIV  In-school learners report less risky sexual behaviour and have lower rates of HIV than same-aged out of school peers. Hargreaves et al., “The association between school attendance, HIV infection and sexual behaviour in rural South Africa”. Journal of Epidemiological Community Health; 000;18;doi.10.1136/jech.2006.053827 (2007). 1 The programme under evaluation was loveLife.

37. Combination prevention is necessary  Multi-pronged interventions, none of which is 100% effective.  All require the adoption of certain behaviours (adherence, correct and consistent condom use, etc.)  Growing consensus (cf. Lancet Series 2008) that we need to combine our interventions: “...to avoid risk compensation and to increase adherence, biomedical methods should be inextricably implemented together with behavioural interventions. Likewise, biomedical interventions, such as male circumcision, offer a unique opportunity for risk reduction counselling.” Padian et al., Lancet 2008

38. Significant inroads have already been made

40. Preliminary findings of HSRC impact assessment Study conducted by the Human Sciences Research Council; Funded by Kaiser Family Foundation 1.Most reported improved skills development and increased access to opportunity as a result of loveLife participation 2.Increased motivation and capacity to perceive and take opportunities after loveLife participation 3.Increased likelihood of safe sex 4.Youth reported (1) learning healthy sexual behaviour (2) practicing safe sex after participating in loveLife 5.Youth reported positive thinking and ‘hope’

41. Upcoming evaluations of loveLife 2012: National Communication Survey (NCS) in partnership with Soul City and JHHESA: To examine whether public health communications programmes and messages have an impact in changing knowledge, attitudes, norms and behaviour with regard to HIV/AIDS and TB To be conducted across South Africa, sample of 10000 households To be conducted in 2012 2012: Internal evaluation of loveLife groundBREAKER programme 2011-12: Plans for baseline study and follow up evaluations of new Y- Centre; and plans for assessment of impact of existing Y-Centres

42. What does SA get for investing in loveLife?  A study of South African youth (15-24 years old) found that interaction with loveLife face-to-face was had a 0.61 AOR “protective effect” (Pettifor et al. A national survey of 15-24 year-olds, AIDS 2005)  This means that participating in loveLife programmes makes young men and women around 40% less likely to contract HIV – a remarkable efficacy rate that is exceptionally cost effective.  2,500 temporary employment opportunities 1 Cash transfers to marginalized communities Skills transfers affect long-term employability 1 goGogetters, groundBREAKERS, IDT Mpintshis, HWSETA learnerships – Monitoring2009 and 2010 2 VOSESA groundBREAKER Survey, 2007. SA Youth Average groundBREAKERS before programme groundBREAKERS after programme 2 POST-MATRIC QUALIFICATION 6.1%8%47% EMPLOYMENT34%12%60%

43. loveLife has implemented at ever increasing scale Participants: 450% increase over 5 yearsSchools: 127% increase over 5 years Community Sites: 29% increase over 5 years Source: loveLife Monitoring Reports 2006-2010

44. loveLife has increased efficiency levels dramatically Source: loveLife Annual Reports 2006-2010

45. Who pays for lovelife? FUNDERDESCRIPTION OF PROJECTFOCUS AREA BUDGET Bill and Melinda Gates Foundation goGogetter programmeNationalR4,716,731 Department of Health -National National Call Centre, groundBREAKERS (n=622), National Youth Friendly Services, goGogetters (n=470), 523 clinical Sites, 18 Y-Centres, events and outreach into schools. Primary Healthcare for HIV prevention R76,285 000 Department of Social Development - National groundBREAKERS (n=525), national Outlet and Franchise programmes, national "mpintshi" initiative, events and outreach into schools. Reach marginalized urban informal and deep rural communities R42 595 000 BarloworldYouth leadership developmentNationalR333 333 Henry Kaiser Family Foundation National evaluation of loveLifeEvaluationR650,159 Ilembe Consortuim groundBREAKERS around ACSA – Durban AirportgroundBREAKERS - KZNR209,099 Department of Social Development – North West Additional mpintshis, groundBREAKERS, and goGogetters in selected areas in Northwest Province. Extend loveLife's reachR3,150,000

46. FUNDERDESCRIPTION OF PROJECTFOCUS AREABudget National Lottery Distribution Trust Fund "Cultcha Factories" in 18 marginalized communities; national "loveTrain" tour to railway stations across the country; Enviro Ys green economy programme; film-making for SABC including "I AM Mzansi" Arts & Culture and Environment R17,339,660 Murray & Roberts Repairs, maintenance, and programme activity at loveLife Y-Centres Youth CentresR3,400,000 Royal Bafokeng State-of-the-art loveLife Y-Centre in Luka Village and outreach into surrounding Bafokeng areas. Youth CentreR1,561,216 Department of Sports & Recreation- National loveLIfe Games: events and outreach, coaches training, league formation, partnership model. Sports & RecreationR27,390,420 Deutscher Entwicklungsdiens t Youth leadership development Youth Leadership Development R695,804 United Nations Population Fund HCT Campaign roll-out and World Aids DayHCTR644,608 Other Funders Once-Off Donations, AdvertisementsNationalR1,545,196 Who pays for loveLife?

47. Expenditure breakdown EXPENDITURE FOR PERIOD JANUARY TO DECEMBER 2010 DOHDSRDSD Support Costs 13,263,99618% 4,157,71614% 9,877,56924% Audit/Bank Charges/Insurance 600,328 236,385 369,650 Municipal/Rates/Licenses 399,605 68,643 314,163 Office Maintenance/Security/Cleaning/Repairs 1,010,813 302,540 589,370 Postage/Courier/Distribution 277,206 155,238 106,123 Rental-Premises/Equipment 915,263 129,366 643,073 Research/Consultancy/Project Management 792,728 225,237 421,274 Staff Costs 6,718,152 2,530,746 4,842,230 Stationery/Printing/Office Supplies 157,737 26,025 608,006 Telecommunications & IT 1,940,828 279,224 1,542,072 Trainings/Workshops/Events/Meetings 169,295 53,394 50,507 Travel/Accomodation/Transport 282,041 150,918 391,101 Programme Costs 58,466,38381% 25,007,42685% 30,469,31976% Media/Advertising/Merchandise 10,996,952 2,543,599 1,952,523 Postage/Courier/Distribution 780,351 479,928 539,686 Research/Consultancy/Project Management 1,646,083 475,583 70,654 Staff Costs 25,449,235 6,528,465 15,120,454 Stationery/Printing/Office Supplies 6,097,024 1,928,270 3,768,005 Telecommunications & IT 420,446 114,194 65,758 Trainings/Workshops/Events/Meetings 5,726,916 5,041,263 4,566,637 Travel/Accomodation/Transport 7,349,376 7,896,126 4,385,602 Capital Expenses 861,5311% 245,000 1% - Total Cost 72,591,910100% 29,410,142100% 40,346,888100%

48. Thank you loveLife Tel +27 (0)11 523 1000 Fax +27 (0)11 523 1001 48 wierda rd west wierda valley sandton 2196 P O Box 45 parklands 2121 south africa talk@lovelife.org.za www.mymsta.mobi www.lovelife.org.za