Governments and public health practitioners have capitalised on the ability of the mass media to send out information to various populations on a wide range of issues. These include public health efforts about population control, family planning, childhood vaccination exercises, healthy eating and anti-smoking habits, and in recent times, safe sex practices. Mass media campaigns on health are usually aimed at influencing the secular or normal trend for information available on a given health topic in a system (Randolph & Viswanath 2004).
This influence, according to Randolph and Viswanath (2004), may take two forms; 1) increase the amount of information available on the topic of interest. 2) Redefine or frame the issue as a public health problem to make it salient, attract the attention of the target audience, and suggest solutions to resolve the problem (pg420). Therefore, successful HIV/AIDS media messages should provide people with information, well above what they already know about risks of infection and its consequences.
In addition, these messages must also go a step further to draw peoples’ attention to practices they can adopt to avoid infection. Finally, the messages must also provide the benefits of HIV/AIDS free environment to the individual and the community as whole. Public Health and Mass Media Current public health advances was built on the tradition of public health as it was first defined and used in the late nineteenth century. At that time, health was considered mainly an issue of personal hygiene and therefore, required health education that led to sanitary engineering and regulations (Green 1999).
Since then public health and its attendant educational needs have been driven by contemporary problems arising in public health. The increasing number of the world’s population and an ever-increasing demand for healthy living has made the need for health education more pertinent than ever before. Health communication as a specialised field was therefore created to help with the growing need, policy interest in health promotion, and disease prevention (Rice and Atkins 2002). According to Rice and Atkins (2002), public health education is:
“(a) Purposive attempt; (b) to inform, persuade, or motivate behaviour changes; (c) in a relatively well-defined and large audience; (d) generally for non-commercial benefits to the individuals and /or society at large; (e) typically within a given time period; (f) by means of organised communication activities involving mass media; (g) and often complemented by interpersonal support” (pg427). With an ever-growing population, the role of the media in health education has not been more important than in recent times.
Mass media plays an important role in public healthcare and therefore the need to understand how media messages influence peoples’ perceptions and behaviours. The impact of health communication messages on people’s lifestyle/attitudes is driven by various factors. These include the content of the message, personal characteristics and motivation of the audience, and the effect of the social environment in which the communication takes place (Markova & Power 1992). With HIV/AIDS achieving worldwide notoriety, the media has been used as major tools in large-scale campaigns, to help reduce infection both on national as well as worldwide levels.
Despite these massive media campaign efforts, worldwide infection rates are still on the ascendancy (UNAIDS 2006). This trend has led to discussions aimed at finding ways to make communication about the disease more effective than it has ever been. As far back as 1999 UNAIDS in collaboration with Pennsylvania State University held a series of consultations with communication workers from Africa, Asia, Latin America, and the Caribbean, on ways to make HIV/AIDS communications more effective (UNAIDS & Penn State 1999).
This consultation led to the identification of five universal factors that influence HIV/AIDS communication efforts. These are government policy, socio-economic status, culture, gender relations and spirituality. Interestingly, these findings lend support to the main aim of this study — examination of culture and gender in health communication messages. It is the belief of this researcher that gender and cultural theories, in addition to behavioural theories when applied to media messages, will provide the necessary influence that will lead to behavioural change.
The meeting between UNAIDS, leading researchers, and practitioners in HIV/AIDS communication from the five regions of the world also reviewed existing theories and models used for HIV/AIDS communication. The consensus was that; “most current theories and models did not provide adequate foundations on which to develop communication interventions for HIV/AIDS in the regions- Africa, Latin America, Asia, and the Caribbean” (UNAIDS & Penn State 1999, pg14). Health communication theories should provide reasoning for social, structural, and cultural conditions that help to determine people’s consumption goals of health message s.
In addition, these messages, which are designed to promote healthy behaviours, must also apply persuasive methods to the communication process in order to achieve the desired results (Salovey Schneider & Apanovitch 2002). According to findings in some recent studies, HIV/AIDS campaigns in Africa are yielding high condom use and awareness (Centre for Development and Population Activities 2002). Although there is high condom use and awareness, these are not translating into lower infection rates especially, among women.
This gap between condom use and awareness and rising infection rates is unsettling. This gap reveals that there is a missing link in the chain of effects. Either the messages are not persuading women enough, or the messages are not influencing women because they are not identifying with the message. This position is not ignorant of the fact that HIV transmission is a complex problem, which not only deals with sexual practices between and within the sexes, but also one that brings cultural and social relationships between the sexes into play.
However, one can admit that even if such complex social and cultural issues are dealt with and yet HIV/AIDS messages are not effectively geared towards the target audience, we will continue to face the same problems. Due to the conception and development of many of the theories and models of health behaviour change in Western cultures, it is believed that they are steeped in assumptions of individualism — one of the identifying tenets of western culture. In Western cultures, the decision-making responsibility for an individual’s life and health lies with that individual only.
However, in most non-Western cultures, this decision-making responsibility is a collective effort by the individual, the family and the community as a whole. Unfortunately, health communication models adopted for most HIV/AIDS communication campaigns are steeped in Western assumptions of individualism (UNAIDS & Penn State 1999). Thus, a conflict arises between the messages presented by these health campaigns and culturally accepted structure of responsibilities and decision-making. This conflict is believed to have contributed to the failure of some HIV/AIDS health campaigns (UNAIDS & Penn State 1999).