Jo-Anne Collinge
Maria-Elena Figueroa
D. Lawrence Kincaid
Bronwyn Pearce
Lusanda Mahlasela
Publication Date

"4Play: Sex Tips for Girls was a television drama that brought a rare touch of glamour and a distinctly feminine sensibility to the HIV communication genre in South Africa. 4Play also confronted the fact that – in the absence of a widely available female-initiated and controlled HIV prevention method – the key to protection for women lies in their ability to manage their intimate relationships."

This 42-page report reflects on the television drama 4Play: Sex Tips for Girls, which explored the complexities of women's intimate relationships to show how this affects their HIV risk. The drama focuses on the lives of four female friends in their early 30s as they contend with personal and relationship issues. "The dominant educational mode of the series was social modelling of positive and destructive behaviours in the areas of love, sex, relationships and health through strong story telling." The 4Play series was produced by Quizzical pictures, under the leadership of Johns Hopkins Health and Education in South Africa (JHHESA) as part of a five-year agreement between the United States Agency for International Development and the Center for Communication Programs at Johns Hopkins University’s Bloomberg School of Public Health.

The report starts off by providing a summary of the epidemiological and behavioural evidence that underpinned the drama and its approach. For example, research points to women's relationships as a key aspect of HIV prevention and treatment. Data suggests that while women have lower risk taking behaviours, they have higher HIV prevalence than men in their reproductive years. One contributing factors is that women tend to choose older partners and condom use among men declines steadily with advancing age. Women also face widespread gender violence and inequality in relationships, which are positively associated with increased risk of HIV. "The figures constitute a clear argument for placing an examination of sexual relationships right at the heart of any HIV prevention programme for women."

The report then goes on to look at the aims and objectives of the show, followed by an outline of the communication model, which was based on the social ecology model of transformational communication. The report explains how the entertainment-education communication model enabled viewers to learn through the characters’ experiences with "complex story lines that speak not only to behaviours but the underlying causes of behaviours."

Section 5 of the report looks at the development process of the series, focusing on how the characters, health themes, and storylines were integrated and developed. Section 6 of the report focuses on the development of the discussion guide, which was created (together with DVD versions of the series) in order to expand the reach of the programme into non-broadcast environments and to extend dialogue of the health themes.

The final section looks at the evaluation of the series. Qualitative research conducted by the Centre for AIDS Development, Research and Evaluation (CADRE) following the broadcast of the first two series found that the drama prompted critical reflection and debate around the main characters behaviours and relationships. During nine focus groups held with 60 male and female viewers, participants described the drama as "true to life", "realistic" and "rich". In some cases the drama prompted people to think about their own attitudes and behaviours. For example, the story of how Nox discloses her HIV status to her family resonated with the participants who "conceptualised forms of action, including disclosing to a friend, communicating with children and one’s sexual partner, and having an HIV test." Some of the feedback from this first assessment was considered in the development of season 3.

The report also discusses findings related to 4Play in the third National HIV Communication Survey (NCS 2012), which sampled 10,034 males and females in the first half of 2012 (approximately two years after the initial broadcast of 4Play). The survey data show that nearly a quarter of the sample (22%) watched 4Play and viewership was higher among the younger groups. Since the drama featured only four main characters, viewers were able to develop an emotional attachment to these characters. "Identification with the drama characters had the expected positive impact on HIV discussion. Among respondents who were exposed in the last 12 months but did not care about any of the characters, 51% reported discussing HIV testing with their sex partners. This figure climbs to 57% among those who were exposed and cared about at least one of the drama characters." As well, "overall, the 4Play television drama had an indirect effect on HIV testing behaviour on men and women through increased discussion of HIV testing with their sex partners, and on condom use at last sex on women through increased self-efficacy for condom use."