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Student Publications
Author: Mark Wellington
Title:
Communication In A World Of Aids
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INTRODUCTION
This may be the final Essay-Type paper that I will write for this
University degree. This
paper and its focus is not a mere coincidence, but was structured
accordingly in the
Curriculum Design to be the final essay paper and its content is
expected to flow into The
Research Paper.
The curbing of HIV/AIDS1 will require some revolutionary cultural
changes in behaviour
in order to keep the epidemic under control. Since we are already
aware that, behaviours
and habits are difficult to change, then HIV/AIDS shall be a
challenge for the foreseeable
future.
HIV/AIDS by its very nature has commandeered a level of
pro-activeness among
governments of the world to combat the spread of the disease. The
seriousness of the
illness is not only characteristic of the illness itself but those
whom it targets. In other
words, the disease is most prevalent among the sexually active and
this group of persons
is often times those who are an economys productive force, i.e.,
those in the labour
force. It stands to reason that this ,,dreaded illness has the
propensity to "wipe out"
economies entirely by virtue of its general target population2.
That being the case and seemingly understood by global economies to
be the case, most
countries of the world are educating their population on HIV/AIDS
and continue to
disseminate messages on how its spread maybe curtailed.
We can see on our local television (here in Jamaica at nights) the
following
advertisement; "HIV/AIDS is dangerous... use a condom every time."
It may be critical
to note that most media entities are every prescriptive/normative in
their solution to the
control or curbing of HIV/AIDS. In other words, the Bullet Theory3
of Communication
1 The deadly virus that attacks the Immune system of human beings
making us susceptible to opportunistic
infections which may be fatal.
2 Those in the work force.
3 One way flow of information with little scope for feedback.
1
comes to bear heavily on how messages are
disseminated on issues surrounding the
disease.
In fact, we know that cultural beliefs and affiliations have made
persons come to believe
that the use of condoms for example is wrong! Religion is also a
part of such cultural
orientations. We also know that, in some cultural contexts, to have
more than one partner
is the norm! However, Western Style Communication (WSC) on HIV/AIDS
would seek
to suggest very broadly that medical research on the disease give
technocrats4 the
autonomy to disseminate information, through advertisement and
counseling without
much feedback from the populace on their perceptions of the messages
received. Hence,
communications5 can play a vital role in curbing of HIV/AIDS,
however, the discussions
have to be more interactive to facilitate mutual understandings
between the general
population and the technical experts through communication
technologies.
This paper then sets out to achieve the following:
1. To review the need for effective communication6 in curbing or
controlling
HIV/AIDS.
2. To review communication that is likely to be most effective in
effecting
changes in peoples attitudes to the epidemic.
3. To review the impact of "Cyber Space Technology" on the spread of
the
epidemic as well as its control.
4. To review how health care providers assist in the control of the
spread of
HIV/AIDS, through communication utilizing communications.
4 Those who have studied the virus, its patho physiology and its
ultimate effects.
5 The technologies.
6 Interactive discussions, ensuring technocrats and populace
understand the implications of the disease to
mean the same thing.
2
What of Attitudes?
In order to give this discussion some focus, we must indulge
ourselves into the
psychological realm by looking at the concept of attitude. J.
Richard Eiser in his book;
Attitudes, Cognition and Social Behaviour claimed that there is
little or no relation
between peoples behaviour and their verbally expressed attitudes
(1996; P.52). He
pointed to the "scientific nature" of his comment by saying that
studies have been done
that compare verbal expressions of attitudes with behaviour and
highlighted that a rather
confusing picture emerges. In fact, this is not a difficult
observation to exemplify. In fact
friends and acquaintances will claim to have protected sex at all
times! Nonetheless, they
sometimes contract sexual transmitted diseases including HIV/AIDS!
Now, the possible
dilemma arises, when one seeks to understand that which is perceived
to be "protected
sex." Is communication between population and States7 operational in
terms of uniformed
meanings on sexual behaviours and attitudes?
Eiser pointed out that Wicker in 1969 concluded that; "only in a
minority of cases was a
close relationship found between verbally expressed attitudes and
overt behaviour, the
typical result being one of only a slight association or no
association at all (1996;P.52).
The point to be captured here is that in many instances measures of
attitudes and
behaviour fail to correlate. That being a scientific fact/fact of
life; can disseminated
messages on HIV/AIDS be considered as effective in curbing peoples
behaviours? This
question then becomes the "nucleus" of our concern and the kind of
research area we
would want to embark on for future economic planning as this
epidemic encapsulates us.
Eiser pointed out that attitudes are pre-dispositions to respond to
some class of stimuli
with certain classes of response (1996;P.53). Now, his definition is
very pointing. We all
know that to prevent HIV/AIDS, we should use a condom all the time
(or so they say).
We also know that "sticking to one partner sexually" reduces the
risk of transmission.
Hence our verbal attitude to our next partner may explicate our
behaviours in accordance
with scientific expectations and that such verbal attitudes are our
intended behaviours.
However, our actual behaviour may be substantially different. Hence,
we may find that
7 Government policies and joint efforts to curb the epidemic.
3
the core issue of danger in contracting HIV/AIDS
is not "weighted" by all in the same
way and so variations in perception on the issues surrounding the
virus may cause
behaviour deviations but similar verbal sentiments.
Eiser points us to three (3) major characteristics of attitudes;
1. Affective: Evaluative Feelings and Preferences
2. Cognitive: Opinions and Beliefs and
3. Behavioural or Conative: Overt actions and statements of intent
[1996;P.53].
If attitude is constituted of all three components listed above and
HIV/AIDS is predicated
on facts of the natural sciences i.e., its route of infecting and
inflicting harm follows one
scientific logic then differing views of such logic based on the
Affective, Cognitive and
Behavioural cannot therefore create a uniform response to the
epidemic as such variables
provide for various interpretations of and actions to the scientific
bases of the disease.
Hence, communication may not be achieved across cultures and so
deviant behaviours
will continue to increase the spread of the virus causing more
social conflicts and
economic woes for economies.
Further Clarifications Ernest R. Hilgard in his book;
Introduction to Psychology states
that; "in ordinary social exchange, the attitudes, preferences and
prejudices that sway
people affect the satisfactions of living together" (1962;P.563).
Implied in this statement
is the fact that meanings disseminated throughout societies are
interpreted differently. It
is a fact of life that HIV/AIDS exists. However, it is a strong
belief of some persons in
society that it is a disease of homosexual men and it is Gods
punishment for their
"gruesome sinful act." And so, these persons are not culturally
inclined to envelope an
attitude of universal protection but to keep away from culture or
behaviour of
homosexuality. Such philosophical beliefs may be responsible for the
spread of HIV in
the heterosexual community. Hence, attitudes and opinions will
impinge on a unified
approach to the combat of HIV/AIDS.
4
The Role of Effective Communication
Natural Sciences have often sought to explain phenomenon while the
Social Sciences
seek to understand realities. Communication in a World of AIDS
seeking to merge the
Natural Sciences explanation of the epidemic with the Social
Sciences aspect of
understanding the epidemic sometimes approximate to "pouring oil on
water" where the
two ideologies are not "miscible." Hence, messages disseminated
through
communications about HIV/AIDS in not to provoke dialogue or shared
meanings but to
present raw scientific facts with prescription(s). In some cultures
people take such facts
as fiction and so attitudes to the epidemic and subsequent behaviour
result in wider
spread of the disease regardless of communications used to educate
the population as a
whole.
Can We Avoid the Epidemic Crises?
We may start by classifying our working population/the young of the
society as the
"AIDS generation." The fact is that the spread of the disease
continues to increase and
millions of persons have already died. Hence, curbing HIV/AIDS
requires comprehensive
strategies to focus on the "sexually active" of our population.
According to Population
Reports, "of our 60 million people who have been affected
with HIV/AIDS in the past
20 years about 50 percent [50%] became infected between the ages of
15 and 24."
[Source:
www.inforforhealth.org/pr/112edsum.shtml]
It cannot be any clearer that our young people who are producing and
those with abilities
to produce are generally the victims. Hence, corrective measures
must be taken towards
approaching the curtailing of the disease taking into consideration
socio-cultural and
economic variables.
According to Michael J. Kelly and Brendan Bain in the book;
Education and HIV/AIDS
in the Caribbean; "the United Nations signaled international
recognition of the security
implications of HIV/AIDS" (2000;P.1). According to them, heads of
government of
Caribbean Community (CARICOM) countries in July 2000 publicly
highlighted that the
5
disease sought to cripple economic development
in the region. Hence, in February 2001,
the Pan-Caribbean Partnership against HIV/AIDS (PANCAP) was
inaugurated.
Similar models were adopted and instituted in African States as well
as in Baltic States in
2001. Needless to say that today, almost all countries have some
response policies or
joint coordinated efforts with other countries to combat the spread
of the disease.
Kelly and Bain pointed out that, "successes in response to the
epidemic are of immense
significance in reducing suffering and setbacks for affected
individuals and for the
communities and countries concerned" (2000;P.4). The response to the
epidemic must to
some degree involve different approaches as in all instances the
disease affects people of
different cultural orientations. In such an event, curbing
strategies may be different due to
the context of culture in which the technocrats operate.
Let us link the realities of the epidemic to my home country
Jamaica. Today [10.09.05],
The Gleaner Newspaper reported that an estimated 22,000 persons live
with HIV/AIDS
in Jamaica. The Gleaner cited the health ministry as reporting 244
new cases for the first
three months of this year. During this same period the ministry
reported 170 AIDS deaths
compared to 109 for the corresponding first quarter of 2004.
[Source: The Gleaner;
2005.10.09;P.5]. The numbers suggest that the rate of infection is
on the rise.
It would be agreeable to highlight that communication messages to
populace about the
nature of the illness and how to avoid becoming infected is also on
the increase.
However, as the advertisement and counseling increase, so does the
pandemic. Hence, we
may want to agree that communication concerning the illness may not
be effective
enough in modifying behaviours in order to curtail the dreaded
illness. Are we therefore
loosing the fight against HIV/AIDS? Maybe we are! Why is this the
case? A natural
science understanding of the disease versus a social science
perception of the illness
maybe different. The fact is that a natural scientist due to his/her
intimate nature with
explaining phenomena is far more "signified" by the real depth of
danger of the virus
over those who seek to understand the diseases pathophysiology. The
truth of the matter
6
is that, it will take that much longer to fully
educate "the man" who is not a scientist than
"the man" with a natural science background. Hence, transference of
meanings is in no
way hampered by technology, but meanings are usually not uniformed
and so there is a
lot of information in societies about the epidemic but lack of
shared meanings continue to
trigger the spread of the disease at an alarming rate.
According to Kelly and Bain, "the epidemic has spared no country in
the world"
[2005;P.5]. In such an event, the universal message of how to
control the spread of the
disease would have reached most countries of the world.
The Scientific Dilemma: Kelly, Bain and The Scientific Community as
a whole have put
forward and analyzed the nature of HIV/AIDS. They pointed us to what
Kelly et al called
the silent invisible epidemic of HIV infection, that in most
countries is spread by sexual
activity. What becomes the concern to readers and scientists alike
is that the deterioration
of the human immune system infected with HIV is long, slow and
seldom detected
[2005;P.9]. The above points imply that for years infected persons
may show no
signs/symptoms of being diseased. During this time, scientists have
pointed out that
infected persons ignorant of their HIV status can transmit the virus
to others. Now, the
above being accepted as fact of science; what communication
message(s) could truly
curtail the spread of the disease? What are the implications for
sexual activity and the
development of families? Are people willing to simply go getting
tested for HIV, being
symptom free? The answers are not forthcoming in any scientific or
logical form but to
say that, the uniqueness of the virus activities on the immune
system of the body makes it
difficult for communication to have its maximum effect on the lives
of peoples of
societies. Oftentimes when persons heed to warnings on communication
messages are
when they can identify with the meanings the messages is conveying.
At this stage for
most "full blown AIDS" have taken over the immune system and in the
latent period
many other sexual partners have been infected and the cycle
continues.
7
HIV/AIDS Information Dissemination vs.
Communication
There is no "shortage" of information with regards to the viral
infection HIV. In fact all
media and the Internet have a wealth of information on the epidemic.
However,
information, i.e. raw data and communication, i.e. meanings shared
by individuals about
data are two (2) different things. In other words, communication
depends on information;
however, the information must be understood by a group of person(s)
to mean the same
thing. If this cannot be achieved, we would have failed in
effectively addressing issues
relating to HIV/AIDS.
If we were able to communicate with any group of persons on the
implications of
contracting HIV/AIDS and to reach consensus on how the disease may
be contracted,
then we would have started to address effectively this epidemic.
According to Population
Reports; Youth and HIV/AIDS; young people are particularly
vulnerable to HIV and
other sexually transmitted diseases (STDs) due to physical,
psychological and social
attributes of adolescence that make young people most vulnerable.
The Report also
pointed out "recent declines in incidence of HIV/AIDS in a few
countries accompanied
by signs that young people are changing their risk taking behaviour,
give hope"
(www.infoforhealth.org;
P.1).
The Report did not give information or should I say statistical
information about what "a
few countries" meant. However, the connotative focus would lead us
to believe that the
majority of peoples of the world are in serious trouble. The
population Report points to
AIDS as a wide social crisis as well as a problem of individual
behaviour. The Report
also pointed out that the AIDS epidemic is complex and thus only a
combination of
approaches can succeed. It was very interesting to note that the
Report has the following
quote on condom use;
"Condoms the only contraceptive method that can protect against
HIV
as well as against pregnancy are vital to controlling HIV/AIDS
among
youth. Condoms should be widely accessible and their use promoted
among sexually active people of all ages."
(www.infoforhealth.org; P.2).
8
The above is again a very prescriptive comment.
Since, the use of condom is two (2) fold,
how do we control HIV/AIDS among those who see condoms as a barrier
to pregnancy
but are ready to start a family, i.e. getting pregnant and having
babies? How about those
who believe condom use is wrong? The former question coupled with
the prescription on
condoms stated above would seek to suggest that un-protected sex
should post date HIV
testing between/among partners. That being the case, can economies
(especially poorer
economies) afford this frequency of testing? Are people willing to
be tested frequently
for STDs when in fact they feel healthy and well? Will information
dissemination about
the nature of the illness lead peoples of societies to change their
behaviours? From this
Report, one gets the impression that behaviours are changing but at
an extremely slow
rate.
Education and Communication
According to Population Report; "Young people need help to become
aware of risks for
HIV/AIDS and how to avoid them. Education and communication programs
must go
beyond merely offering information but to fostering risk avoidance
skills as well, such as
delay of sexual debut, abstinence and negotiation with sex partners.
HIV/AIDS education
should
begin
early,
even
before
children
become
sexually
active."
[Www.infoforhealth.org; P.2].
Hence, critical to the fight against the disease is communication
and by extension
negotiations. The concept of "negotiations before sex" is rather
novel and is one way by
which disseminated information on HIV/AIDS may be communicated.
Therefore, two (2)
persons do not have to share the same attitudes and behaviour
towards sex as a whole but
through mutual understanding between parties to the act, protection
and safe sex may be
achieved.
9
Communications role in the fight against
HIV/AIDS
Dearnley and Feather state that, "the economic structure of the
modern world is argued to
be dependent on information." (2001;P.43). We can all agree that
communications affect
the social, political and economic parameters of the Global
Political Economy and so
technologies are vital to the spread of information and more
importantly (in this context)
to facilitate communication. With HIV/AIDS on the rise, one may
speculate that
communications play two (2) roles;
1. Communication Technologies seek to provide information about the
nature of the
illness or should I say that technologies are utilized by
governments and non-
governmental organizations alike to educate the globe on HIV/AIDS.
2. The technologies are also used by other private entities to
promote sex (of all
forms) and other pornographic images and activities, likely stimuli
for the
adaptation to lifestyles leading to promiscuity and HIV/AIDS.
The question therefore to be asked is this: Can technologies with
such diverse and
controversial roles assist in the curbing of HIV/AIDS? In other
words, are young people
more inclined to use the Internet for continuing education on
HIV/AIDS or for the
purpose of Cyber sex, meeting new sex partners and the like? This is
why the
management of the disease can become so complex and to a large
degree so many
confounding variables are brought to bear on Education and
Communication with respect
to HIV/AIDS that no uniformity of meanings about the disease or a
unified sense of
purpose to fight the disease can be scientifically achieved.
Join the fight against AIDS in Jamaica A review of an article done
by United Nations
Programme on HIV/AIDS.
As the article highlighted, the Caribbean region has the second
highest incidence of AIDS
in the world. This comment is quite alarming as geographically we
are a small area of the
globe. Again the article highlighted, delayed diagnosis and lack of
treatment and care, to
be responsible for a 61% mortality rate. Now the above statements
maybe analytically
linked to all countries of the world contending with the epidemic.
This is so because of
the nature of the disease as discussed earlier in this text. We
would want to agree though
10
that those countries with resources to foster
better health care would have lower mortality
rates than us in the Caribbean for example.
The article made reference to the following; "Jamaica is at a
turning point. With a
prevalence rate of 1.5%, global experts say if efforts arent
expanded to effectively
manage the epidemic, it could spread to crisis levels." Source:
UNAIDS.
The article pointed to the following factors as being responsible
for fueling the epidemic;
Discrimination and Stigma
Multiple Sexual Partners
Early Sexual Initiation and
Inconsistent Condom Use.
The above factors to some degree may be universally applicable. In
such an event
communication policies re: AIDS should seek to effectively address
these issues to
impact social behaviours and cultural beliefs in a society to
curtail the disease. In as much
as we are aware of the factors listed above, we can categorically
say that communications
have been employed consistently to highlight these messages. The
Jamaica AIDS Support
Organization (JAS) has been doing an excellent job in making that
effort to inform the
population on the prescriptions needed to be followed to combat this
epidemic. Why then
does the Gleaner yesterday cite the epidemic on the increase as
stated above? UNAIDS
has highlighted that Jamaica and other Caribbean countries have been
engaged in the
struggle against HIV/AIDS since 1988! If we analyze the inception of
efforts and the
growth of the illness we are experiencing an increase in Jamaica and
worldwide
generally. We are therefore, not sure whether or not our messages
are delivering to the
populace the full meanings/implications of lack of adherence to
prescriptions as outlined
by the experts. Again, verbally expressed attitudes and actual
behaviour are usually
different [see Eiser] and so it would seem to us as if messages re:
HIV/AIDS that
bombard us daily is treated simply as information and nothing else.
Are we therefore able
to communicate with our populations generally on the seriousness of
the disease? Are we
able to negotiate sexual behaviours with our populations? To our
minds that does not
11
seem to be the case as the statistical
information does not bear the facts out in the
affirmative.
Basis Country Statistic for Jamaica
Population (2002): 2.6 million
HIV Prevalence (14 49 years) (2002): 1.5%
GNP per capita (2001): US$2600
Life Expectancy at Birth (2000): 71.2 years
Source: UNAIDS: 2003.
We can safely say that in 2005 our HIV prevalence is greater than
1.5%. That being the
case, we are not very clear as to the real prevalence rate of the
disease in Jamaica or
across the globe for that matter owing to the fact that the virus
can remain in the body for
years and persons can be asymptomatic. Should it then be mandatory
that all adults age
15 49 be tested for HIV? If that is not done, how can we ever
control the spread,
bearing in mind all socio-cultural and economic variables that are
brought to bear on the
epidemic and are persons adhering to prescriptions set out to
control the epidemic?
The article highlights voluntary counseling and testing, structured
treatments and referral
systems for people living with HIV/AIDS! Are people going to be
volunteering ("without
symptomatic reasons") to be tested? It seems to us that
communication is not a profound
feature of the efforts to fight HIV/AIDS! We are more focused on
information
dissemination! How do peoples socio-cultural beliefs and by
extension behaviour blend
with these information?
The Epidemiology Unit of the Ministry of Health [Jamaica] is making
its best efforts. So
is the Jamaica AIDS Support Organization. However, their efforts
matched with the
statistical data still show increase prevalence of the disease. In
other words the
information dissemination is not effecting the change in social
behaviour we were all
anticipating.
12
Will communication and communications assist
with the delivery of interactive
transference of meanings as related to HIV/AIDS? Can shared ideas
and meanings make
the difference? We still do not know, as communication for the most
part focuses on the
verbal aspects of the process and so we must remember that our task
is to make verbal
attitudes and actual behaviour "one and the same."
The Role of Health Care Providers in Curtailing HIV/AIDS Utilizing
Communications
Health Care Providers are often "schooled" in the discipline of the
natural sciences. That
being the case, natural scientists oftentimes have a "prescriptive
outlook" on life and
solutions to problems. There is always a dilemma in reconciling
opinions of social
scientists and facts of the natural scientists.
Against such backgrounds, it is quite easy to deduce that natural
scientists (health care
providers) will utilize communications to disseminate information on
facts related to
HIV/AIDS and some prescriptions as to how to avoid and curtail it.
The same
communication technologies will bring to bear understandings of the
disease and how
they perceive to understand [not explain] it and to manage it. The
two (2) ideologies
bring us back to the original question being asked about "science".
What is science? This
burning debate has led to strong disagreements over the years as to
the validity of the two
(2) concepts. In that same vain, we may find discrepancies and
disagreements on
concepts of and "roads to and from the path of HIV/AIDS."
Hence, Health Care Providers often use the Internet to give
scientific facts about the
disease. So do they use other media? Having given the facts, the
prescriptions are
highlighted as solutions. Health Care Providers (HCP) are not often
concerned about
peoples socio-cultural beliefs, attitudes and behaviours. In other
words, there is "one
prescription" for all!
Social Scientists often seek to understand socio-cultural beliefs
and attitudes and make
the effort to address the epidemic from those perspectives.
Invariably, both approaches
have failed to date as the disease on a whole is on the increase.
Can an understanding of
13
peoples behaviour and attitudes help to curtail
the pandemic? Can the facts of natural
sciences and prescription help? In our best estimation both may help
but not mutually
exclusive of each other. There must be merging of scientific
thoughts (be it natural or
social) to address the epidemic in a more wholesome way.
That maybe somewhat difficult due to the lively tension between
social as well as natural
sciences. However, all things considered, the two approaches merged
would be of some
merit to fight against this epidemic.
HIV/AIDS is a biological disease that has puzzled scientists and
non-scientists alike for
nearly two (2) decades. To the degree that no one is sure of its
origin or mode of
replication is to the degree that treatments are consistently
failing.
Assistance to the populace by technocrats as to how to curb the
disease is troublesome,
confusing and lack social commitment. This is so because
socio-cultural beliefs and
economic status of peoples of the world are different. Added to this
dilemma is the fact
that "natural scientists" that are so "factual" and "prescriptive"
about the disease are not
able to treat the infection effectively. In such an instance, there
are some skeptics who
believe that natural scientists do not understand the epidemic as
much as they claim to. In
fact it has been successfully argued, that had they understood fully
the pathophysiology
of the virus, they would have provided a cure in much the same way
they can effectively
treat a Syphilis infection for example. This point should not in any
way negate from the
fact that persons need to take the necessary protection as
prescribed by the experts.
However, one may ask: "From whence the virus came?" Is it really
sexually transmitted?
Is it Gods punishment to some men and women? Is it lack of proper
nutrition?
The fact is that we still are not sure! However, our communication
messages will still
follow the path of the natural sciences due to the "biological
nature" of the problem. We
cannot however see true communication emerging out of the
disseminated information on
HIV/AIDS, as "meanings" need to be common among all. It is
impossible to have
common meanings when no one fully understands the uniqueness of the
virus. That being
14
the case we are all surrounded by a virus, not
understood fully but being fought socially,
psychologically, economically and scientifically. What then does
HIV/AIDS mean?
"The Other Side of the Coin"
Unlike Eiser, Robert C. Hornick points out "there is good evidence
that public health
communication has affected health behavior" [2002;P.11]. He has
edited the book Public
Health Communication; Evidence for Behaviour Change and in it he
brought together a
variety of case studies from various health areas, prepared by
authors who have done the
original research. He has pointed us to the fact that "there is a
large amount of health
behaviour changes occurring in many important areas (e.g. smoking,
blood pressure
control, cholesterol consumption and condom use)" (2002;P.11).
In fact Eiser et al had pointed us to the opposite attitudes, i.e.
negative correlation
between verbally expressed attitudes and actual behaviour. Since our
core focus is
HIV/AIDS and attitudes, it is therefore reasonable to focus on the
research work
contained in Chapter 9 of Hornicks book; Effects of mass media
campaign to prevent
AIDS among young people in Ghana. Susan McCombie, Robert C. Hornick
and John K.
Anarfi conducted this research.
According to McCombie et al, "the first AIDS cases were reported in
Ghana in the late
1980s. In 1991, the Ministry of Health launched a multimedia
campaign designed to
increase awareness of AIDS and to promote AIDS prevention in Ghana
(2002;P.147). As
this team of researchers highlighted, AIDS awareness in Ghana at
that time was very high
but felt that the disease was a problem of prostitution and people
who traveled out of the
country. In other words, their actual attitude to the disease was
one of being careful of
sexual contacts with prostitutes and foreign travelers. As was
pointed out earlier in this
text we in the Caribbean (at least some of us) felt that it was a
disease for homosexuals.
Within that context, the campaign was directed at predominantly
young people. It was
pointed out to us that the population of Ghana in 2002 was 18
million of which 47% was
under the age of 15 years. We are therefore left to deduce that the
campaign targeted
young people who were sexually active as well as those about to
experience puberty.
15
The Researchers used a combination of radio and television to
disseminate the following
messages;
a) AIDS is not a foreign disease"
b) A person can have the virus for 5 or more years and still look
healthy"
c) Personal behaviour changes are necessary to prevent its spread."
Source: Public Health Communication; Evidence for Behaviour Change;
2002;P.148.
Additional support material was provided to augment the messages
disseminated above.
The additional support included posters, comic books, badges, key
rings and t-shirts. The
narration and demonstration of the core messages listed took
different forms and spots on
TV and radio all ending with the phrase "Dont be careless, get
protection."
The campaign they say began in August 1991 and continued until June
1992. They
pointed that a school outreach component was also included. These
included lectures,
discussions by medical personnel, question and answer period and
films on HIV/AIDS.
The authors pointed out that the Annenberg School for Communication
at the University
of Pennsylvania was asked to oversee the evaluation of the project.
There were two
research questions:
1. To establish whether or not a substantial portion of the
population was exposed to
the campaign and
2. To establish whether or not they changed their beliefs and sexual
behaviours in
response to the campaign.
As per the questions to be answered, the research revealed that in
the whole sample 70%
watched TV at least once per week and from 68% to 69% listened to
radio at least once
per week. They concluded scientifically that greater than 90% of the
population could
potentially have heard the campaign messages. The research also
"catered for"
confounding variables like news broadcasts and other media
imperatives.
16
It was also instructive to note that after
1992, peoples responses changed to the question
of who can get AIDS. The percentage that said anyone could get AIDS
increased from
29% to 39% [2002;P.154]. There was a corresponding decrease in those
who pointed
"fingers" at frequent travelers as the source of the disease (14% to
10%). There was also
an increase in intentions to use condoms in the future [50% to 53%].
Now this Eiser et al
would describe in psychology as verbally expressed attitudes.
What of actual behaviour? The researchers reported that of a sample
of 1,667 there was
an increase in condom use from 12% to 16% over a 2-month period.
They pointed out
that the increase occurred predominantly among people who were
unmarried or reported
more than one partner. Overall the finding provides support for the
claim that response to
the campaign messages (i.e. concern about the disease) was
responsible for the change.
The research efforts highlighted in the edited text by Hornick would
seek to suggest that
there is greater correlation between verbally expressed attitudes
and actual behaviour
when health is the concern. This research effort showed no perfect
correlation or total
behaviour change, however changes were evident. The other fact is
that the study was
followed through for only two (2) years and in such an event total
attitudes and behaviour
to date were not observed and recorded. Hence, public health
communication may be said
to transmit meanings across cultures and sub-cultures and whilst
there is no evidence of
full behaviour change, we can all agree that messages transmitted at
times are
communicated with desired outcomes.
Information Dissemination on HIV/AIDS Evident Communication
Challenge
Singhal and Rogers cited Population Reports, 1989 as stating, "the
absence of a vaccine
for therapeutic cure of HIV/AIDS, communication strategies represent
a key social
vaccine against the disease" (2003;P.206). According to them,
communication is
necessary but not sufficient condition for preventing HIV/AIDS. In
fact this was bourn
out by the research work cited earlier as well as comments made by
Eiser et al re: verbal
attitudes versus actual behaviour.
17
Singhal and Rogers highlighted four (4)
challenges that communication professionals
face in combating HIV/AIDS.
1. Transmission Challenges: Due to the inherent nature of the virus
to infect the
body of humans and having those patients remain asymptomatic, then
likely
communication messages about the disease would not impact such
infectious
individuals, as they are not able to relate to the symptoms of the
disease as
relayed through communications. According to Singhal et al "an
unbelievable
90% of the 40 million people in the world who are HIV positive, do
not know
that they carry the virus (2003;P.206). In such an event, it is
difficult to see how
communication on HIV/AIDS would impact these peoples attitudes and
behaviour, they being ignorant of their HIV status.
2. Behavioural Challenges: According to Singhal and Rogers, HIV/AIDS
is a
disease that is attributed to multiple behavioural patterns of
humans in society.
They cited the following examples;
Older paying client with a sex worker
Sex and drug abuse
Sex and condom use
Homosexuality and so on
These are behaviours that are stigmatized by society and so
communication specialists
have the challenge of disseminating messages across different
psychosocial, socio-
cultural and socio-economic barriers.
3. Response Challenges: Communication specialists face the challenge
of
disseminating meanings to effect behavioural changes. For example,
communication with regards to HIV/AIDS needs to ensure that both
parties
comply with condom use, HIV testing, abstinence and monogamous
relationships. The challenge for communication experts is to convey
the
prevention message to the intended audience and foster a change in
behaviour.
18
4. Targeting Challenges: According to Singhal
and Rogers, it is sometimes difficult
to reach certain vulnerable populations with the communication
message of
HIV/AIDS. They highlighted gays, injecting drug users, commercial
sex workers
and slum dwellers. In such events, other modes of communication have
to be
instituted for example through peer educators to reach these unique
target
populations. Source: [Singhal and Rogers; 2003;Ps.206 207]
Back to the Caribbean Jamaica and the Bahamas
It is always useful to relate an issue such as HIV/AIDS to our own
countries directly.
Dr. Ian Boxill et al wrote a text this year entitled Tourism HIV
and AIDS in
Jamaica and the Bahamas. This text sought to link the spread
of HIV/AIDS in the
two (2) countries mentioned to tourism, the main foreign exchange
earner for both
countries.
Dr. Boxill cited Dr. Marjan de Bruin as stating that desperate
social and economic
needs of peoples of these two countries promote dangerous risk
taking behaviours
with regards to sexual promiscuity (2005).
The data collected did not to any large extent convinced me of a
great risk-taking
dilemma in the tourism industry, however, the data provided "food
for thought".
Dr. Boxill pointed out in his work that "qualitative interviews
point to the ignorance
of HIV and AIDS among the general population in both countries with
potentially
devastating consequences (2005;P.3).
That being the case, we may want to concretize the point that
information
dissemination on HIV/AIDS is not fully understood and so
communication is not
achieved. Hence as the "Ghana Study" revealed continuous work and
new strategies
must be adopted in Jamaica and the Bahamas to curb the spread of the
disease. My
main dilemma though is the contentious issue of lack of awareness
that individuals
are infected. Not based on mere carelessness but because of the
characteristic of the
19
virus to remain dormant in the body without any
general side effects. How can
communication therefore be fully effective? The truth is that most
of us cannot
reconcile this dilemma.
Conclusion
As was pointed out earlier by one author in this text, a lack of a
vaccine to curb the
illness would require continuing medical education of populations as
a whole to curb
the disease. Communication re: HIV/AIDS then becomes the "social
vaccine". It is
quite clear that effective communication must employ socio-cultural
strategies to
become operational. Economic issues of poor countries and
specifically poor persons
of societies must be addressed simultaneously in order for the
communication
messages to make sense.
Information on HIV/AIDS is globally adequate, however, information
and
communication are not one and the same. It is therefore imperative
that uniformed
meanings about the patho-physiology of the disease be achieved. We
can all agree
that this shall be a difficult task in current times and for the
foreseeable future.
Merged efforts of natural and social scientists alike would probably
"reap more
rewards" in terms of effective communication and likely behaviour
change. Let us
always keep in mind that verbally expressed attitudes and actual
behaviour
oftentimes do not correlate. Such is the characteristic of HIV/AIDS
and its spread.
20
Reference
1. Boxill; I.; et al; Tourism HIV and AIDS in Jamaica and the
Bahamas;
Arawak Publications, 17 Kensington Crescent, Kingston 5, Jamaica,
West
Indies; 2005.
2. Dearnley; J.; Feather; F.; The Wired World, An Introduction to
the Theory
and Practice of the Information Society; Library Association
Publishing, 7
Ridgmount Street, London, WC1E 7AE; 2001.
3. Eiser; J. R.; Social Psychology, Attitudes Cognition and Social
Behavior;
Cambridge University Press; 1996.
4. Hilgard; R. E.; Introduction to Psychology; United Press
International,
library of Congress Catalog Card Number: 62 11180; USA; 1962.
5. Hornick; R. C. (Ed); Public Health Communication, Evidence for
Behaviour
Change; Lawrence Erlboum Associates, Inc. Publishers, 10 Industrial
Avenue, Mahwah, NJ07430; 2002.
6. Kelly; M. J.; Bain; B.; Education and HIV/AIDS in the Caribbean;
Ian
Randle Publishers, 11 Cunningham Avenue, Box 686, Kingston 6; 2005.
7. Singhal; A.; Rogers; E,; Combating AIDS; Communication Strategies
in
Action; Sage Publications India Pvt Ltd., M-32 Market, Greater
Kailash I,
New Dehli 110 048; 2003.
8. Population Reports; Youth and HIV/AIDS;
www.infoforhealth.org/pr/112edsum.shtml; 2005.
21
9. UNAIDS; Join the fight against AIDS in
Jamaica; United Nations
Programme on HIV/AIDS (UNAIDS), 20 Avenue Appia, 1211 Geneva 27,
Switzerland; 2005.
22
Appendix
HIV/AIDS in the Caribbean 2004
Adults and Children Living with HIV 440,000
Number of Children Living with HIV 210,000
Adults and Children Newly Infected with HIV 53,000
STATISTICS: UNAIDS
NB: The Caribbean is the second most infected region in the world.
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