Smart Science: An HIV/AIDS Education Initiative Aiming to Prevent New Infections in School Going Children by Encouraging a Correct Understanding of Current Health Research through a Scientific Approach

This entertainment-education project involved an interactive, multimedia show focused on delivering scientifically-based HIV/AIDS education aiming to:

• Dispel myths about HIV/AIDS;
• Promote a scientific understanding of processes;
• Provide clarity on infection, role of antiretrovirals (ARVs), etc.
• Involve pupils as "science ambassadors" to disseminate research findings;
• Give clear, scientific understanding of ways one can contract HIV, with the aim of reducing infection/transmission rates; and
• Reduce stigma associated with AIDS to allow more open dialogue on the issue - both with schools and more generally in the community (local research has identified this as a major issue).

The programme presented was a 4-hour Science Centre visit, encompassing:

• The Alarming Aids Adventure: Multi-media Science Show - included a journey through the body and  done so that learners actually feel like they are in the body. The goal of this was to highlight the replication process of the virus.
• HIV Comes to the Party: Interactive Fluid Mixing Demo - involved all learners in a demonstration designed to communicate the rapid spread of HIV. Twenty glasses of water were handed to 20 pupils who were encouraged to "share fluids" by mixing them. Two of the glasses had a small amount of alkali in them. After a few minutes of this, an "aids test" was performed by adding a little indicator to the glasses, which picked up even small amounts of alkali. According to organisers, pupils were shocked to find how quickly the "aids" (alkali) spread after just a short time, as almost all the glasses tested "positive".
• AIDS and Ladders: Board Game - designed similarly to the popular snakes and ladders board game. Organisers also used other games (although they did not design them): Stepping Stones for primary schools and Choices and Consequences for High school learners.
• HIV/AIDS Decisions Maze - designed in a way that took learners on a journey. At every intersection, they were faced with a situation. The choice they make will determine if they enter the maze HIV "positive" or "negative."
• Science Show ("Collisions" or "Waves" or "Electricity"), which was also performed to staff in a local industry.
• Exploration of 200 interactive exhibits
• Careers Centre Visit

A conscious decision was made to make only half of the session an AIDS programme and to stress positive choices (i.e., careers in science and math) in the other half. It was felt that 4 hours of AIDS information would possibly have a negative effect on the pupils.

There were also events held for adults such as a discussion event called "Winning the Game - Winning the Fight", which engaged participants to explore - with science experts - how to fight denial, taboos, and discrimination around HIV/AIDS. Information was provided on: preventing infection, having healthy children even if the mother is infected, and dealing with side effects and living a long life with HIV.

The project engaged policymakers and science communicators as well. Smart Science was covered in science conference proceedings, such as at the 6th Science Centre World Congress (Cape Town, South Africa, September 2011) and news broadcasts surrounding the various conferences, such as a radio interview (Vienna, Austria, June 2010).

HIV/AIDS, Youth

Organisers reflect on the fact that, while HIV/AIDS is a sensitive topic, "we should never make the mistake of avoiding it altogether because it is difficult. Pupils in particular are extremely open to talk about it if it is approached in the right way. South Africa often presents a moral and scientific vacuum to these pupils, who are confused by the contradictory messages they hear (and more importantly observe) from their elders and from government. In the light of this it is more essential than ever for us to present a message which is both scientifically sound (to our best current knowledge) and morally defensible. Pupils are tired of hearing the 'doom and gloom' messages, and focussing rather on prospects and consequences of certain behaviours seems to be more effective."

According to organisers: "We had the great advantage of our programme being the subject of study for the PhD of Graham Walker (Australian National University) which gave us very useful international feedback. It showed that the programme was helping pupils to be clearer on subjects like infection, ARV's, ways of catching or transmitting HIV etc. It also showed a strong intention to transmit this new understanding to siblings and even to parents (very unusual in patriarchal rural communities), thus fulfilling our aim for pupils to be 'science ambassadors'. The fact that pupils and even teachers spoke so freely about a taboo subject both after the shows and in their surveys gives us hope that this process will help to reduce stigma associated with AIDS and bring it more into the open for discussion."

As part of his graduate work, Walker carried out an evaluation, including: pre- and post-tests studying the (mis)understanding of concepts; informal observation of the show; feedback by way of questionnaires and interviews; and evaluation of change in intentions to behave in certain ways. He found highly statistically significant (P<.01) differences in pre/post measures of:

• Abstinence intention (2 measures)
• Faithfulness to one partner intention
• Confidence to stay HIV free
• Self-reported knowledge of transmission methods
• Talking to family about HIV intention (family is not a common group to discuss HIV with)
• Confidence in carrying out positive behaviours
• Intention to follow ABC - abstinence, be faithful, use a condom - when other students do not follow ABC (peer pressure)

He found significant (P<.05) differences in pre/post measure of intention to have an HIV test following unsafe behaviour. Differences in two other intention measures for were not statistically significant, but were very close, however both showed positive changes: intention to follow ABC (P=.057) and intention to use condoms use (P=.06).

Although the questionnaires only indicated the way students intended to behave, reassuring results were found about actual behaviour at follow-up interviews about a month after visiting the science centre. Amongst the small sample interviewed, students reported substantial behavioural changes following the programme, including refusing to have unprotected sex and moving to single-partner relationships. The results demonstrate that the programme affected not only intentions and attitudes, but - crucially - the way young people actually acted.