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Cultural approach to HIV/AIDS prevention and control

It is increasingly being recognized worldwide that the conventional Information, Education and Communication (IEC) campaigns have utterly failed in bringing in-depth and long-term changes in risky behaviour for halting the spread of HIV/AIDS pandemic. The mass media information has also been predominantly general and non-targeted information on HIV/AIDS prevention and care; the form and content of the messages are mostly not tailored to be understood and integrated by diverse population groups. This major shortcoming has been unambiguously acknowledged by the UNESCO and the UNAIDS, which have admitted in their country assessment reports that the national policies to-date have not brought significant changes in behaviour among the population in respect of HIV/AIDS prevention, care and support.

The failure of the IEC, including mass media campaigns, has been essentially because of the fact that HIV/AIDS prevention strategies and policies; have been considered purely a bio-medical problem or a cognitive issue; rather than as a complex societal and cultural phenomenon.

Besides the insufficient consideration and integration of people’s societal and cultural references and resources (which include, people’s life style, their ways of thinking, and their motivational responses); the HIV/AIDS control and prevention strategies also have other serious deficiencies like standardized communication messages, pre-cooked preventive education, partial and fractured involvement of the community as well as inadequate and passive involvement of the stakeholders and civil society.

A major rethinking has been taking place globally to reorient, rejuvenate and reframe the HIV/AIDS prevention and control strategies so as to optimise their impact. This process has been sphere-headed by the launching of the joint project on “A Cultural Approach to HIV/AIDS Prevention and Care”, by the UNESCO and the UNAIDS, with the initiative of the former in May 1998. The cultural approach to HIV/AIDS prevention and care, seeks to integrate the cultural resources/ features and references of a given population; which include their ways of life, traditions, ethos, beliefs, values, family system, ethical factors, religious practices, spiritual observances, indigenous knowledge, traditional know-how, social structure/ stratification, taboos and creativity; in building, implementing and evaluating HIV/AIDS prevention and care strategies and policies. The culture approach to HIV/AIDS prevention and care facilitates the reinforcement of the positive elements in the local culture of a given population to foster positive behaviour and attitude as well as seeks acceptable and relevant changes in the not-so-positive elements in the same cultural process to motivate the given group or persons to avoid risk-taking behaviour and vulnerable situations.

The HIV/AIDS prevention and care strategies and policies are; therefore, have to be comprehensive, multifarious, inter-disciplinary, trans-institutional, and inter-sectoral. To sum up, the factors to be considered in the cultural approaches may include;

  • the links between the epidemic and its social environment need not only to be recognized, but also should be translated into convergent action;
  • social and cultural factors should be considered not only as obstacles, but as positive factors in the developmental process; and
  • the overall characteristic of culture, including the whole fabric of a society should be considered.

Strategies
SANKALP’S strategies and policies on HIV/AIDS prevention is the real-need replication, appropriate application, and effective extension of the cultural approach to HIV/AIDS prevention and care in the national, regional and local cultural contexts to meet the varied needs of the diverse population groups.

Activities
HIV/AIDS epidemic is a multi-faceted issue, which requires multi-dimensional responses; and accordingly the broad goals of SANKALP’S action plans include;

  • ensuring mass mobilization of the communities, groups, families, individuals and governmental and non-governmental organisations;
  • raising public awareness towards behaviour change;
  • building community-based prevention and care programmes;
  • supplementing and supporting new creativity linked to HIV/AIDS prevention and control; and
  • giving special attention to the endangered groups.

SANKALP’S strategies seeks to provide realistic responses to the individual and collective vulnerability to HIV/AIDS and, therefore, attempt to avoid the pitfalls in the communication process to bring the desired behavioural change; which include; i) over-information; ii) under-information; iii) rushed-information; and iv) precooked-information.

One of the thrust areas of SANKALP’S HIV/AIDS prevention and control activities is school HIV/AIDS prevention education. The Organisation recognizes that there are serious obstacles for imparting HIV/AIDS education in schools. These impediments include;

  • the subject is considered too controversial;
  • the curriculum is overloaded;
  • prevention education may be limited to certain age-groups;
  • only facts about AIDS, not behaviour skills, are taught; and
  • there may be only partial coverage of schools/ students in a big country like India.

SANKALP’s school HIV/AIDS prevention education distinguishes the diversity, complexity and changing characteristics of children, youth and adolescents; their living environment; their life styles; and the cultural references and resources they represent. These distinctive characteristics are essential to build up appropriate responses for the in-school children.

The thrust of such prevention education is on new creations and appropriate innovations in HIV/AIDS prevention strategies to ensure behavioural and attitudinal changes by providing knowledge, fostering attitudes and conferring skills through culturally sensitive and effective communication. These include; orientation workshops, intensive workshops, refresher courses, trainings, peer education, group discussions, interactions and creative activities; with participatory involvement of the students, teachers, parents, officials, community representatives and local self-government representatives in the design, implementation and monitoring of the programmes.

The core of the whole process is empowerment- to provide knowledge, foster attitudes and confer skills through culturally appropriate, relevant and sensitive communication and education for a healthy life style.