AIDS (Acquired Immune Deficiency Syndrome), the possible end-result of HIV infection (Human Immunodeficiency Virus), has been and continues to be an epidemic that is having catastrophic effects on the world’s populations. Since the early 1980s when the disease was first diagnosed, no cure has been found even though scientists have been working assiduously at it. HIV is an infectious virus transmitted through the exchange of bodily fluids such as semen and blood. As with most diseases with no known cure, the effort to curtail the disease’s spread has focused on preventive rather than curative strategies.
These preventive strategies include interpersonal communication and mass media messages aimed at explaining the dangers posed by the disease. These messages provide citizens with information about ways of preventing infection. Despite efforts aimed at curtailing further spread of the disease among the world’s populace, recent reports from UNAIDS (Joint United Nations Program on HIV/AIDS) and WHO (World Health Organisation) indicate that infection rates continue to rise worldwide, especially among women (2006).
The snowball effect of the disease’s physical, social and economic effect on individuals, families, communities, countries, and the world as whole has led to increased calls by civil society for concerted efforts to help curb its further spread especially, among the world’s female population. These efforts include calls for strategies to help reverse infection trends. In light of the ‘feminisation’ of HIV infection worldwide, calls have been made to address women’s vulnerabilities to the disease.
Public health education, one of the most effective ways of combating various health issues, has been at the forefront of the fight against the disease. In areas where the disease has had catastrophic effects, especially in Sub Sahara Africa, various campaign strategies have been adopted to educate people about the disease. Due to women’s increased vulnerabilities to the disease, some of these public health education campaigns have been specifically directed at them as part of the concerted effort to reverse the ‘feminisation of HIV’.
Although there has been some progress in efforts to address gender in HIV/AIDS education campaigns (Wong 2003), little or no attention has been focused on the context of gender discourse in mass media messages about the disease. Commercial advertising has employed sophisticated communication strategies that effectively address the information processing abilities of various target groups. This strategizing approach has led to the developments of targeted communication for special groups, such as women, college students, and baby boomers, to mention a few.
Such targeted communication messages have been known to positively boost the sales of advertised products or services aimed at these special groups. Since these targeted strategies have been proven to work, then the same should be applicable to health communication messages aimed at special groups such as women. In line with what other sections of society are doing – examining gender discourse in HIV/AIDS infection trends, creators of health communication content also need to examine this discourse in order to create messages that effectively address the needs of women.
Because of its widespread prevalence, HIV/AIDS tops the list of priorities for the United Nations’ Development Program (UNDP). Integrated into the Millennium Development Goals (MDG) to be reached by 2015, the United Nations (UN) posits that each of the world’s problems are interconnected and calls for global partnerships in decreasing the tolls of infection. The UNDP and Joint United Nations Program on HIV/AIDS (UNAIDS) mutually agree that HIV/AIDS is a global development concern, one that deeply impacts and is influenced by contemporary globalisation practices (UNDP 2005).
Tufte (2005) makes a similar appeal regarding the global status of HIV/AIDS: HIV/AIDS is a pandemic, which is blossoming in societies with gender inequalities. It is a pandemic that travels with human trafficking or with migrant labour. And it is a pandemic that strikes hardest among those who cannot afford any form of treatments. HIV/AIDS is a symptom of social and economic injustice, and should be combated accordingly. It is not just about changing individual behaviour, to abstain from sex or using a condom.
That’s just treating the symptoms, and not the actual case. (Tufte 2005, pg107) Speaking specifically of HIV/AIDS, the UNAIDS 2006 report on the HIV/AIDS pandemic says rates of infection are decreasing globally yet skyrocketing in select regions of the world, such as in the South Africa. The UN recognises the link between poverty and HIV/AIDS, one that begets a vicious cycle where the virus impoverishes its victims and where the poor are made more susceptible to its grasp due to minimal resources (McMichael 2004).
The people at the highest risk—women, youths, men who have sex with men, sex workers and their clients, intravenous drug users and some ethnic and cultural minorities—are still not adequately reached through prevention and treatment strategies (UNAIDS Prevention n. d. ). As one article (Associated Press 2006) describes, the growing focus on anti-retroviral drugs (ARVs) has unfortunately shifted attention away from prevention, thereby further undermining our perfunctory understanding of the contexts surroundings the rise and continuation of the epidemic.
With a limited knowledge on how to avert the social factors facilitating the disease, it becomes clear that we simply do not know how to best combat HIV/AIDS. No ideal model of HIV/AIDS prevention exists; each suboptimal, they often neglect the dynamism of human culture. Take, for example, the ABC campaign— Abstain, Be Faithful and Condomise. Despite good intentions, the ABC approach has limited success and fails to consider the specific social contexts of its audience. Behaviour does not change simply because someone wills it so (Mufane 1999).
A recent article in The Economist titled “AIDS: A Time to Grow Up” (2007) showcases the fallibility of abstinence-only sex education and the danger of prescribing similar tactics abroad with donation dollars as the lure. People’s reluctance to adopt safer sex practices has been attributed to the disconnect between common-sense rationalities of communication campaign producers and the common-sense rationality of the individual at risk of contracting HIV/AIDS (Hughes & Malila 1999). As mentioned on the UNAIDS website, prevention campaigns tend to be haphazard, fragmented and unevenly distributed:
At present, prevention services reach only about 20 percent of people in need of them worldwide, and the epidemic continues massively to outstrip efforts to control it. Effective HIV prevention programs are comprehensive, and work on several levels simultaneously. They target individuals to help convince them to avoid risky behaviour. They address the social, political, cultural and economic factors that make people vulnerable to infection and limit their ability to protect themselves (such as poverty and the subordination of women).
And they seek to limit the impact of HIV on families and communities, which often renders them vulnerable to further spread of the virus. (UNAIDS Prevention n. d. ) Thus, the difficulty rests in redefining communication paradigms upon the development of concrete strategies that permeate all sectors of society and reach issues beyond sexual behaviour (Tufte 2005). Similarly, Mody (2005) recommends a long-term, multi-sectoral health and development approach biased in favour of the poor as the direction in which prevention campaigns must move.
Arguing that prevention media messages have reached fewer than one in five people at risk over the past 20 years and that those it reaches tend to be middle-class, male and educated, Mody revives the call for a more holistic structural attempt. She offers a design that, “learns from rather than imitates someone else’s best practices, builds social choice, citizen participation, and democratic deliberation into the design and functioning of local health and development institutions and uses health education interventions via media and face-to-face as one essential component” (2005).
Likewise, Gillett (2003) writes that a bottom-up orientation of HIV/AIDS support, prevention, research and initiatives aims to offset embedded structural constraints and injustices. This approach has been championed as the best attempt at an effective communication strategy. Not without its own limitations, the bottom-up approach is under threat of replacement by top-down communication approaches. When linked to the growing institutionalisation of HIV/AIDS organisations, Gillett posits that debate and perspective are restricted as mainstream discourse appropriates marginal discourse and silences divergent ideas.
According to Tufte (2005), a fundamental rethinking is required, one that questions current practices and recasts them according to the needs of the affected, all the while generating trust and cooperation. Much of the recent literature on HIV/AIDS pushes the epidemic from being primarily a health issue to one of fundamental human rights. In a world where the gap between rich and poor widens daily, people are increasingly struggling to hold on to the livelihoods they once had.
Those needing the greatest help and support often find themselves voiceless—unable to access governmental help and paralysed by stigma (Meerkotter 2005). Unfortunately, HIV/AIDS prevention and treatment efforts have historically mirrored inequalities intimately linked to disparate power relationships, such as gender and wealth, in development (Meerkotter 2005). Like the recent discourse on development, the UNDP argues that the structural forces creating and perpetuating extreme inequality must be overcome for the MDGs to succeed.