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Does direct messaging work? The HIV and Stigma perspective


Does direct messaging work? The HIV and Stigma perspective

To: The Health Communication Network with The Communication Initiative

Sophie Chalk from International Broadcasting Trust on HIV/AIDS, stigma and direct messaging. Do you agree with this perspective and the recommendations from the IBT report HIV and Stigma - the Media Challenge? Which of the quotes from Japhet, Scott and Hohlfleder is closest to your perspective and why? Please reply by email or click Read More below and contribute online. Thanks

HIV/AIDS and Stigma: The Media Challenge

There has been a lot of academic debate around development communication and media messaging, much of which has centred on whether direct messaging works – does it genuinely engage the public and lead to behaviour change or is a more nuanced approach required? What more can be done to engage the public with the issue of HIV? IBT’s research has found that there is real fatigue with this story both among the public and in the media. We have published a piece of research examining the role of the media in HIV and stigma. Can the media play a meaningful role in reducing stigma which is one of the main barriers to testing and treatment of HIV? Will it play a greater role than it is? How can we persuade the media to get engaged?

Garth Japhet, the founder of The Soul City Institute for Health and Development Communication in South Africa, believes that a more subtle approach is needed: “The issues that we are dealing with are not slogan issues. You can say: ‘Wear a condom; prevent HIV.’ But it doesn’t hit you the way a story can. There is this wonderful theory called Parasocial Interaction – where the gap between reality and fiction completely blurs and people begin to see themselves in the characters.”

Dr Martin Scott, Lecturer in Media and Development at the University of East Anglia, and author of several previous IBT reports, believes that message-based behaviour change communication is inherently flawed: “It fails to take into account the structural factors around people’s lives which shape their behaviour rather than simply their knowledge. One of the biggest problems is that simply knowing that you should change your behaviour or having a different attitude to something does not necessarily mean you will be able to change your behaviour.”

Erin Hohlfelder of ONE agrees that understanding the cultural, structural and social context in which you are working is essential: “I think some folks are quite sceptical of messages around HIV - if condoms aren’t available, or if they don’t feel empowered socially to stand up to a partner and say no. One thing we heard time and time again is that increasingly you’ve got to look at gender and power dynamics as well as gender based violence issues to really understand the HIV epidemic as it stands now.”

Martin Scott argues for a more long term media strategy: “Instead of thinking about the media as a tool for delivering messages, you need to think of it in broader terms – as agenda setting, or framing, normalising, or socialising or cultivating – which are longer term ways of making things more normal, or over time challenging things, or giving people role models, or questioning things. It is a longer term cultural change which is required. Alongside this must be genuine changes on the ground – health provision, education, rate of migration and all the other things which affect HIV.”

In our report IBT makes recommendations that media content should be researched and targeted at specific audiences and that projects which demonstrate impact, such as drama, should be copied. We found there was little media aimed at key populations at higher risk of HIV exposure and this needs addressing. Ultimately we need to engage the public in whatever way we can so tone should be engaging, not preaching and journalists need to have access to human interest stories which draw the public in, rather than alienate them.

Sophie Chalk from International Broadcasting Trust

Health Communication
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