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Aids campaign strategies
discredited Sunday Mail Reporter
HIV and Aids campaigners have failed
to use effective communication strategies to change behaviour, a new
global survey says.
The survey says many control activities
are not culturally appropriate for handling taboo subjects like
death, sex and stigma.
The communication programmes think of
Aids as a dreadful, life-threatening disease that results from
promiscuous and deviant behaviours of "the others".
This
focus has resulted in alienating messages that are anti-sex,
anti-pleasure and fear-inducing.
Yet the reality is that
sexuality entails pleasure, adventure, giving, sharing, spirituality
and ritual.
Released last month, Combating Aids:
Communication Strategies in Action was conducted by Professor
Everett Rogers of New Mexico University and Dr Arvind Singhal of the
University of Ohio, leading communication experts, with funding from
the US-based Population Communications International (PCI).
The report highlights the role of communication in Aids
prevention, care and treatment in countries hard hit.
Popular culture was found with the potential to help people
understand the epidemic.
Yet, most communication campaigns
had focused on defining Aids as a biomedical problem.
"In
short, most HIV/Aids communication interventions are culturally
rudderless and fly blind," the report says.
The researchers
conducted surveys in countries considered serious about slowing the
spread such as Brazil, South Africa, Thailand, India and Kenya.
They sought to find out why Aids remains a major killer in
developing countries while it is not in developed ones.
The
success stories of Thailand, Uganda, Senegal, Brazil and Cambodia
were attributed to focus on prevention and firm government resolve
to control the epidemic.
The researchers say their
experience from more than 15 years of advising international health
organisations shows that most of them underestimate the role of
communication.
"Many HIV/Aids intervention programmes are
led by medical doctors, who certainly know all about the virus and
its effects on the human body, but are often ill-prepared for
developing and evaluating communication strategies that combat the
spread of the virus."
To be effective, the researchers
suggest, the programmes need to understand how the target audience
perceives Aids, condoms, monogamy, opportunistic infections,
anti-retroviral drugs and herbal therapies.
Most developing
countries depended on modern medicine, accessible only to a small
fraction of the population.
They avoided traditional
healers, who could help in managing the epidemic.
The
traditional healers charged low fees, offered personalised services
and were approachable, unlike university-trained medical doctors.
One role model for this was Mrs Pimjai Intamoon, who heads a
community health project in Thailand.
"In Asia, Africa and
Latin America, traditional healers are much better positioned than
are medical doctors to care for HIV/Aids patients," the researchers
conclude.
The report highlights how communicators can use
the media to set an agenda for Aids control.
The researchers
question why the tragedy involving cyanide-laced Tylenol in the US,
which claimed seven lives in 1982, could get front-page coverage in
New York Times, the most respected US daily newspaper.
It
ran four front-page articles on the tragedy and printed more than 50
other articles within three months.
Yet the same newspaper
remained mute for four years and 20 000 Aids-related deaths before
it could carry Aids on its May 25 1985 front page.
Even US
President Ronald Reagan shied away from speaking publicly about Aids
until May 1987, six years into the epidemic after 35 121
Aids-related deaths.
However, not all is gloom as the survey
highlights stories of hope.
One notable successful
intervention was the "San Francisco model", named after the first
urban centre for the epidemic in the US. It had become a haven for
gays.
Key features of this model include conducting
non-judgmental programmes that avoid stigmatising particular
lifestyles or other behaviours.
The other lesson was that
when several of an individual's friends have died or are dying from
Aids-related diseases, the adoption of preventive behaviour is
self-motivated.
Surveys of the effects of
entertainment-education programmes on HIV prevention in Tanzania,
India, Thailand and China offer great promise for the anti-Aids war.
The research found that differences in stemming the spread
could be attributed to cultural beliefs, resources, how and when
they are used, and political will.
The other is to use a
multi-disciplinary approach, drawing from social psychology,
anthropology, epidemiology, sociology and public health and
communication.
"If a developing nation does not have a high
degree of political commitment to controlling the epidemic, little
else matters," the survey concludes.
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