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Improving HIV/AIDS education and support through comics writing

Workshops in comics drawing at the Whizzkids United academy in KwaZulu-Natal, South Africa helped teenagers to express their feelings.

Whizz kids Lola's story
Comic strip drawn by a teenager at a Whizzkids United youth development workshop.

Over 5.6m people in South Africa have HIV/AIDS, with the highest prevalence recorded in KwaZulu-Natal (39.5% of the adult population, according to UNAIDS in 2009). 

Many teenagers with HIV were born with it. Due to taboos that prevent open discussion, children are deprived of clear information about both risks and prevention, even though many are sexually active from a young age.

Whizzkids United founder Marcus McGilvray contacted Cardiff University for assistance with communicating health messages and encouraging teenagers to visit their Health Academy.

One of the most amazing things ... was when they opened up and realised they all had the same problem. There was a surge of emotion and relief when they found out they were all HIV positive.

Marcus McGilvray Whizzkids United founder

Using visual storytelling

Whizzkids United is the youth outreach programme of the UK charity Africaid. Using football as a metaphor for life, its six week course On the Ball teaches life skills and HIV prevention to teenagers.

The Cardiff team found that some of the images used in teaching materials were not well-targeted to the teenagers. This raised the question of how comics (Dr Elisabeth El Refaie’s research specialism) might be used instead.

Dr El Refaie proposed to McGilvray that the teenagers might draw their own illustrations for On the Ball. A comic drawing competition was arranged and from this the idea of a comic drawing workshop as an alternative to football was developed. Dedicated workshops would teach participants to create original stories in the comics format. 

The first aim was to empower the young people to express their feelings and concerns. The second aim was to produce comics for distribution, reflecting the teenagers’ own perspectives on HIV/AIDS and thus appealing to other local youngsters, as well as providing a way of promoting the services of the Health Academy.

A new way of 'writing'

El Refaie's research shows how autobiographical comics can give disadvantaged teenagers a means of expressing emotions and ideas that would be difficult to express in written prose or in speech.

Improving health and quality of life

Workshops were initially held at the Health Academy but were so popular that schools asked them to run them in their Life Orientations classes, increasing the reach by 75%. 

The workshops have made an impact on the health and quality of life of teenagers with, or at grave risk of, HIV. The activities have affected their attitude, awareness and behaviour, and make a major contribution to Whizzkid United’s work in creating new opportunities for empowerment and a positive future.

There was a clear impact on the teenagers. The teams composed of only HIV+ participants were soon sharing their feelings and experiences, particularly how they feared disclosing their status, in case the others ostracised them. The staff had not anticipated the power of the experience, nor the extent to which they would for the first time gain access to such deep levels of disclosure.

Staff learnt that the most significant concern for HIV+ teenagers is isolation and fear of rejection, and not knowing whom they can trust. As a direct result of the workshops, the Health Academy will develop new programmes that create opportunities for HIV+ teenagers to talk to each other and work together. 

Staff also came to understand better why teenagers sometimes fail to take their antiretroviral medication: not only does it stigmatise them, but many, taking it from childhood, had never been told what it was for (and did not know they were HIV+.

Meet our experts

Dr Lisa El Refaie

Dr Lisa El Refaie


+44 (0)29 2087 6338

Following our success with these workshops, we developed a project to create an Ebola booklet with young people in Ghana.