ATHENS, Ohio –About 95 percent of the 40 million people with HIV/AIDS live in developing countries in Latin America, Africa and Asia — the epicenter of the AIDS epidemic. As governments and health officials look for ways to control the spread of the disease in these nations, they shouldn’t overlook the influence of communication, according to the authors of a new book.
“In the world’s front line of AIDS prevention, HIV/AIDS has been looked at as a biomedical issue,” said Ohio University researcher Arvind Singhal. “We argue that the world has underestimated the role communication can play in reducing HIV infection in developing countries, which is a social, cultural and gender-related problem — not just a medical one.”
Singhal and Everett Rogers of the University of New Mexico interviewed hundreds of doctors, government officials, HIV-prevention program directors and patients around the world for their new book “Combating AIDS: Communication Strategies in Action,” published recently by Sage Publications.
The work details the global spread of the deadly virus, pointing to factors such as political inaction, social stigma toward HIV/AIDS and the overall lack of funds available to control the spread of the disease. The researchers highlight the importance of using communication strategies that influence government policy and gender relations and harness the positive aspects of local culture and spirituality.
Two broadly successful communication strategies created from this program are entertainment-education soap operas and radio and television public health campaigns.
Entertainment-education programs reach a large audience and can effectively promote HIV/AIDS prevention behavior, Singhal said. Examples include the popular soap operas “Soul City” in South Africa, “Tinka Tinka Sukh” (“Happiness Lies in Small Things”) in India and “Malhacão” (“Working Out”) in Brazil.
“If a person keeps listening or watching a soap opera, they start to identify with certain characters in an entertaining way that isn’t preachy or didactic,” said Singhal, a Presidential Research Scholar and professor of interpersonal communications at Ohio University. “The best thing is that when the show is over, people continue to gossip about the characters and the message continues. Gossip is very important in stimulating action.”
Using communication strategies to bolster public health campaigns is another successful approach, according to the researchers. The number of new HIV infection cases in Thailand dropped from 143,000 in 1991 to 29,000 in 2000 due, in part, to a $48 million education and public health campaign. Charismatic political leader Mechai Viravaidya required the nation’s 488 radio stations and 15 television stations to air HIV/AIDS prevention messages every hour. He also promoted a 100 percent condom use program aimed at the country’s commercial sex workers. These strategies helped Thailand become the first developing country to successfully control AIDS.
“One key element in controlling the spread of AIDS is strong political action by government leaders,” Singhal said. “Leaders have a special responsibility because they can reach a wider audience. It’s amazing how a few champions can turn the tide and show what is possible in controlling the spread of HIV/AIDS.”
Using entertainment-education programming for HIV/AIDS intervention is a recent strategy in the fight against the epidemic, Singhal said, and only a number of programs exist in developing countries. While there haven’t been any opponents to the use of this intervention tactic worldwide, there are those in many nations who oppose any HIV/AIDS preventive action. According to Singhal, South African President Thabo Mbeki, for example, denies that HIV is connected to AIDS and prohibits pregnant, HIV-positive women from taking the drug Nevirapine, which limits mother-to-child transmission of HIV. About 4.7 million of South Africa’s 43 million people are HIV-positive.
In addition to HIV/AIDS prevention, Rogers said communication strategies can be applied to combat other global social problems such as racism, illiteracy and environmental issues.
“We feel that the model has broad applicability to other social problems, especially where stigma and prejudice are involved,” he said.