Award-Winning Mass Media Campaign Hits Home with Dominican Youth

It could be an ad for clothing, shampoo, musical recordings or almost any other product that appeals to adolescents. In quick succession, four attractive young couples -- sometimes the same person but with a different partner -- are each shown embracing on a couch in a dimly lit living room. In the background a singer croons the opening lyrics of a well-known romantic ballad, "Solamente Una Vez": "Just one time I loved in my life, just one time and never again."

But the mood turns starkly somber as the last of the young women looks up with a grim expression and stares directly at the camera. The word "SIDA" (AIDS) in bold red letters covers her face, and a narrator takes the sweet love song and turns its meaning on its head. "AIDS. Just one time, and never again," he warns. "Protect yourself. Don't change partners. Use condoms. Because just one time is enough, and never again."

This forceful TV ad is one of four produced for a campaign by the AIDS Control and Prevention (AIDSCAP) Project in the Dominican Republic targeting adolescents and their parents. Created by a leading Dominican advertising agency, the ads used high-quality production techniques and attractive young actors to convey well-researched public health messages.

Other equally polished materials developed for the campaign -- including radio announcements, brochures, posters and roadside billboards -- presented the same hard-hitting themes, designed to pierce young people's sense of invulnerability.

As attention-grabbing and persuasive as the mass media pieces may have been, they were just part of a comprehensive, well-coordinated national campaign, explained Oscar Vigano, a communication officer in the AIDSCAP Latin America and Caribbean Regional Office. "The mass media is a tool," said Vigano, who helped the AIDSCAP staff in the Dominican Republic create the campaign. "If you use it within an integrated plan, you can have an impact."

A National Strategy

The campaign grew out of research showing that large numbers of Dominicans with HIV/AIDS were between the ages of 25 and 34 and had probably become infected during their adolescence. Studies conducted by AIDSCAP and other HIV/AIDS prevention groups also showed that many individuals knew how to protect themselves from HIV and other sexually transmitted infections (STIs), but they hadn't moved beyond that awareness stage and changed their behavior.

After the AIDSCAP program in the Dominican Republic was launched in September 1993, one of its priorities was to work with government agencies and nongovernmental organizations (NGOs) to create communication strategies for HIV/AIDS prevention. As part of that effort, AIDSCAP and more than a dozen organizations involved with young people set up a special working group to develop a national plan for preventing HIV transmission among 13- to 19-year-olds. Many of those organizations have continued to provide suggestions and feedback on the mass media campaign through a special advisory committee that meets regularly.

Interactive Advertising

In June 1995 AIDSCAP chose Cumbre, a well-known Dominican advertising agency, to produce mass media materials for the first phase of a three-part campaign that would ultimately span nearly two years.

The first TV spot created by Cumbre began airing in September 1995. In this "interactive" ad, young actors looked directly at the camera and posed questions for youthful audiences to consider, including: Are you sexually active? Do you know what STIs are? Do you know AIDS can't be cured?

The TV ad and its companion radio piece concluded with a campaign slogan, "¿Sabes que si te da, no llegas?" (Do you know, if you get it, that's it, that's the end?) The first part of that question -- si te da -- is a word play on SIDA, the Spanish acronym for AIDS, that was further emphasized in printed materials through the use of contrasting colors.

With the "interactive" format of the first broadcast ads, the Cumbre agency intended to confront the attitudes and misconceptions revealed in research among Dominican youth. "Young people live in their own world," said Cumbre President Freddy Ginebra. "They don't have fear, they take more risks, they're adventurous and rebellious. They don't think death exists, so we looked for a 'code' to challenge them and to make them think."

The campaign's second ad, which began airing in December 1995, was also intended to raise young Dominicans' awareness of HIV/AIDS and their personal risk. Entitled "Party," it showed a crowd of attractive, well-dressed young people dancing, talking and looking for potential partners. It ended with a warning: "You can't know who to be with and who not. You can't guess who has AIDS."

Posters, bumper stickers, brochures and other printed pieces featured photos of the actors in the TV ads and reinforced the broadcast spots' key messages. These materials were distributed to government agencies, NGOs working with adolescents, radio stations, record and video stores, and movie theaters.

AIDSCAP persuaded dozens of radio and TV broadcasters and cable-TV system operators to carry those first two ads for free, as well as two more produced the following year. While some media ran the announcements only once a day, other outlets carried them more than 30 times daily. In just the first five weeks of the campaign, broadcasters contributed air time worth over U.S.$350,000; in a year, that total reached more than $2.6 million.

The AIDSCAP campaign received additional free exposure from news media reports. For example, Listín 2000, the Sunday youth magazine of the Dominican Republic's largest-circulation newspaper, carried a front-page article on the campaign and included basic information on HIV transmission and prevention.

The Dominican news media also gave wide coverage to a September 1995 rally AIDSCAP organized to announce the launch of the campaign. Some 1,000 young volunteers from NGOs working in HIV/AIDS prevention marched through the streets of Santo Domingo wearing campaign hats and T-shirts and carrying colorful balloons and banners with campaign slogans. At the launch ceremony, representatives from the government, church and other influential sectors of Dominican society endorsed the campaign.

A Coordinated Approach

In the fall of 1995, AIDSCAP began the campaign's second phase, synchronizing the activities of many of the groups working with young people and establishing a referral network for adolescents' questions about HIV/AIDS.

A two-day workshop brought together representatives from government agencies, NGOs and international organizations in June 1996 to discuss what they had learned from their work with young people and suggest models for effective STI and HIV/AIDS education and counseling services. Using that information, AIDSCAP produced a manual and held training sessions for some 50 groups in four cities during the spring of 1996.

Both the manual and workshops, said Ceneyda Brito, AIDSCAP's communication coordinator in the Dominican Republic, "dealt with how to work with young people on any problem, not just HIV and AIDS." The materials emphasized the need to view HIV/AIDS prevention within the context of all the challenges adolescents face and the physical and emotional changes they undergo.

Collaborating with other groups on the manual and encouraging them to convey consistent messages to young people had another benefit, according to Brito. "Working to reach a consensus," she said, "gave them a sense of participation and made them feel like 'owners' of the process. All of the groups that came together have continued participating in the campaign."

AIDSCAP also hired a research firm to conduct focus group discussions with adolescents to assess their reactions to the campaign's first phase. The majority of the participants remembered seeing or hearing the ads on television or radio at many different times of the day. When asked about the campaign's messages, the young people cited the need to protect themselves against HIV/AIDS, the need to have fewer sexual partners and the fact that HIV infection could ruin a person's future.

The focus groups also identified misconceptions about HIV/AIDS for the campaign to address, as well themes for future advertisements. Many of the participants suggested the campaign encourage better communication between adolescents and their parents about HIV, AIDS and sexuality.

As AIDSCAP and the Cumbre agency began working on the materials for the campaign's third phase, they included a step they hadn't anticipated with the first TV spots. The new actors in the third and fourth ads received "sensitization" training to prepare them for the attention they were likely to receive and "to turn them into peer educators," Brito said. The novice actors in the first two ads had become so well known that members of the public and media frequently asked them questions about HIV/AIDS.

The third advertisement, with the "Solamente Una Vez" theme, was launched in September 1996 with another large rally affirming public support for the campaign. While the ad reinforced the campaign's message of risk awareness, it also listed a telephone hot line number audience members could call for additional information and referrals. The ad was especially effective at generating calls during the after-school hours when young people usually watch television, according to Brito.

Involving Parents and the Media

The last of the TV and radio ads was another interactive spot. But this one was aimed at adults, encouraging them to talk to their adolescent children. Through a series of questions, parents were challenged: Have you noticed your children are taller than you? Have you talked to them about sexually transmitted infections and AIDS? Do you realize that if you don't talk to them, you'll be responsible if they become infected? And if you haven't talked to them, what are you doing?

As with the first phase of the campaign, printed materials reinforced the radio and TV ads. Dominican broadcasters again aired the new announcements thousands of time without charge, according to data compiled by a media monitoring firm. During the last three months of 1996, the value of the contributed air time was about U.S.$1.6 million.

Persuading media executives to break with tradition and carry the ads for free was one of the campaign's greatest challenges, according to Brito. "I tried to convince them it's a responsibility we all have," she said. "With new stations, I also pointed to other broadcasters that were already running the advertisements. In many cases, they ended up broadcasting the advertisements more often than they promised us."

Brito, who has worked on other public health media campaigns in the Dominican Republic, believes one reason the broadcasters responded so favorably was the high quality of the advertisements. That, she said, could be an important lesson for other organizations considering a mass media campaign.

The Dominican campaign has drawn praise from other countries in Latin America. At meetings in Mexico, Venezuela, Colombia and Costa Rica, advertising and public relations colleagues gave Cumbre's Ginebra standing ovations when he showed them the ads and other campaign materials.

The television and radio spots received the top prize at another meeting in Mexico, awarded by communication experts from 20 countries who gathered in the city of Zacatecas last November for a seminar on adolescent sexual health. Along with the recognition came a grant of U.S.$3,000, to go toward duplicating the Dominican materials and distributing them to organizations elsewhere in Latin America and the Caribbean.

"The groups in Zacatecas," Brito reported, "were impressed with the campaign's coordination of materials and work being done by the various HIV/AIDS prevention agencies."

That careful structuring of numerous communication channels is vital to a successful campaign, as is cooperation among those who work with the target audience, emphasized Brito. "Having all the groups harmonize their approach," she said, "guaranteed their support, as well as the support of others who saw the example of a product produced jointly to solve a problem."

And, said Brito, that close collaboration and use of multiple dissemination paths ensured that Dominican youth received a consistent message from NGOs, the media, their parents and their peers -- much more often than "just one time."

-- Bill Black