'Puppets Against AIDS' is a novel educational medium being used to try to reduce the spread of HIV infection in South Africa. It involves the use of street theatre employing two-metre-high puppets who act out a story of how one person, who is infected with HIV, passes it onto a series of other people until he eventually dies. The puppet show was evaluated in two phases. The first involved a content analysis of a video recording of the show by a multidisciplinary group, according to a set of criteria for appropriate education on HIV infection. This show was found to be professional and comprehensive in terms of the educational messages provided. Some suggestions were made for improvements. The second phase was a before and after study of the impact on the audience at a series of live shows. The show made a significant contribution to knowledge and intended behaviour in the short term. Overall it was felt that the show does make a valuable contribution, but could be made more effective if incorporated into existing community-based education programmes on HIV infection.
PIP: A program of street theater has been developed in South Africa to disseminate educational messages at the community level on the prevention of HIV infection. Puppets Against AIDS employs 2-meter tall puppets to recount the story of how an HIV-positive person infects others until his eventual death. Aimed at the general community, these entertaining and educational shows include music, and are put on without advance publicity. Sex and death often being sensitive taboo issues, puppets were chosen as safe, non-threatening communicators for culturally diverse populations. The presentation was deemed professional and comprehensive. Suggestions were made for improvement. 2nd-stage evaluation questioned appropriateness and effectiveness at the community level, and consisted of a before and after audience impact study based upon a series of 21 live performances in 9 locales. Improvements and positive changes were measured for respondents' self-perceived knowledge about AIDS, expressed concern about AIDS, perceptions of who can get AIDS, perceptions of who will not get AIDS, knowledge of the healthy carrier state, knowledge of modes of transmission, perceived fatality of AIDS, and knowledge of protective behavior. Moreover, 97% of respondents stated that they had enjoyed the show. Overall, the paper urges further evaluation of the show, and incorporation of it into a multi-sectoral, ongoing campaign to effect maximum impact.