In Southern Africa, teen abstinence is 'cool'

A program helps curb AIDS in Zambia, where 20 percent are diagnosed as HIV positive.

Here in Zambia, it's becoming hip to say no. To sex, that is.

"Abstinence. Ile che – it's cool," says Simon Lungu, a stylish young man wearing a baseball cap.

The catchphrase "ile che" is making the rounds among young people in this Southern African nation, in large part because of a program funded by the United States Agency for International Development (USAID).

The campaign, dubbed HEART – Helping Each other Act Responsibly Together – is sending out a strong abstinence message and promoting consistent condom use among youths, as part of an attempt to combat the spread of AIDS.

Though the message of condom use has roiled many in this largely Christian nation, evidence indicates that the multimedia advertising campaign designed by young Zambians is helping convince young people to delay sex and reduce the number of their partners, two key factors that experts say could lead to lower infection rates.

USAID says HEART could be a model for AIDS reduction programs elsewhere in the world.

Although 75 percent of Zambian youths are sexually active by the time they reach 19, workers with HEART say the campaign is helping young people take the decision more seriously, and encouraging them to be more responsible when they do have sex.

"Most youths here, including me, have sex for the first time because of peer pressure," says Holo Hachonda, the program's young director. "What we're trying to do is reinforce the message that it's ok to be abstinent.... The idea is to encourage youths to adopt more healthy sexual behaviors."

Message hits home

Like most of the countries in this region, this sparsely populated nation is struggling to control the spread of AIDS. An estimated 20 percent of Zambians are diagnosed as HIV-positive, and the overwhelming number of infected people are between the ages of 20 and 40.

The HEART campaign is trying reduce HIV transmission rates by targeting those most at risk of infection through television commercials, radio ads, music, and poster advertisements. Many of the ads feature local youths playing basketball or jamming to Zambian-style rap music. The phrase "ile che" comes from a popular new song of the same name released to local radio stations by HEART.

Surveys of Zambian youths reveal that the message is hitting home. More than 50 percent of youths have seen the ads, and a substantial number have discussed them with friends or family, or say it affected their decision to abstain. National statistics also show that the number of new infections are stabilizing rather than continuing to rise, as in other countries.

HEART's $95,000 campaign, half of which is paid for by the Zambian government, is a big part of the behavior changes in Zambia, according to Robert Clay, who directs health and HIV/AIDS programs for USAID.

"All the trends are in the right direction in Zambia," says Mr. Clay. "As in Uganda, indicators like the reduction in the number of partners are a positive sign. I think we're the only other African country that has been able to stabilize infection rates."

Jane Mwanza's office at the Bwafwano Community Center in Chazanga, just outside Lusaka, is decorated with posters from the HEART campaign. Ms. Mwanza runs a peer education program at local schools which targets 10- to 15-year-olds. She says the messages are educating young people about the dangers of AIDS.

"It has really helped people to talk about AIDS, and especially the abstinence issue," she says.

Down at the tip of the continent, in South Africa, the AIDS debate is quite different. Discussion has shifted largely to the question of access to expensive antiretroviral medications. There are few protests about the slick, often blunt, billboards of South Africa's youth-prevention campaign called LoveLife.

Controversy rages

In Zambia, however, which is largely Christian, debate rages about how frank public discussion about AIDS and sex should be.

While HEART's abstinence messages have been lauded by church leaders and politicians, some of their condom-oriented messages have set off a storm of controversy. One television ad, which featured two teenage girls encouraging their friend to tell her boyfriend, "no condom, no sex," was denounced by church leaders and then-president Frederick Chiluba, who declared Zambia a Christian nation. They said it was indecent for young Zambian women to talk about sex on television. The ad was pulled from the air.

"What we discovered is that it's still a bit too sensitive for us to have girls talking publicly about condom use," says Mr. Hachonda.

The unwillingness of Zambians to talk publicly about sexuality, and particularly the sexuality of women, has frustrated the young people at the HEART campaign, as well as leaders of women's groups.

"We talk about sexuality behind closed doors," says Emily Sikazwe, director of Women for Change, one of Zambia's most prominent women's groups. "But we don't talk about sexuality on television or with our children."

Teenage girls at the Kabulonga Girls Secondary School in Lusaka, however, have no trouble talking about sex. They say they know boys want it, but that for now, they're not ready to give it.

"Sometimes the boys want to have sex, but you just tell them no," says 19-year-old Chilala Sitali, who was on her way home from school with friends all dressed in their identical red-gingham school uniforms.

"You have to be strong. But it's good to be a virgin."

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