Rawjee (2002) suggests that when communicating behaviour change in relation to HIV/AIDS and to different sectors of society, it is of utmost importance to consider the complex nature of the context within which the particular group comes from. This intricate contextual network is made up of social relationships, power dynamics, cultural interpretations and values. Bauer and Gaskell (1999) suggest that the contents of the communicated behaviour change, the way in which it is transmitted and the consequences of this communication, all playa role in the
continual development ofthe given appraisal ofmV and AIDS. Without key stake-holders involved in the communication around HIV and AIDS, this will not be possible.
4.11.1 HIV/AIDS campaigns in South Mrica
Many of the participants asserted these abovementioned theories when sharing their opinions around the role that behaviour change campaigns play in shaping perceptions around
vulnerability towards my. Firstly, participants agreed that there was a plethora of campaigns attempting to target education and behaviour change in regards to the HIV epidemic that South Africa is currently facing:
Participant 4: "The thing is that,
if
you look around you, there is so much of campaigns going around, there is a lot of information and awareness campaigns ... a lot of prevention campaigns, there is so much in the media and still, South Africa has one of the highest, like [HIV} is still growing and uh, people dying of AIDS. "Participant 4 suggests that in the midst of several campaigns around mv related issues, we still do not seem to be halting the spread of the virus. Westville students are faced with a barrage of HIV awareness and prevention campaigns and modules during the course of their degrees completed at the university. Hence, the health scie~e students are eligible to comment on the state of current programmes being disseminated around South Africa. Participant 3, when
referencing the current campaigns that are being disseminated within South Africa was quoted as stating the following:
Participant 3: "I think that in some ways and to some extent, to some it does work, but not the majority I don't feel. Because
if
it was, there would be some change but we are still seeing escalation instead of like you know, decrease, and you know, there is something wrong there. You know, years of dissemination of information should actually bring the numbers down, not have the opposite effect ... "Within the communicated prevention campaigns that are currently being disseminated around South Africa, two multifaceted behaviour change programs are noteworthy in their attempt to reduce sexual risk behaviours (Delany-Maretlwe et aI., 2006). Soul City is a multimedia programme disseminated through television, radio and magazines; and LoveLife is a media campaign focusing on adolescent-specific health care issues and services. Because of the nature of such campaigns, it is difficult to measure the success of their efficacy. However, Delany- Maretlwe et aI., suggests that preliminary evaluations show that the two campaigns have in fact significantly impacted young people's awareness and knowledge about
mv
and AIDS. The interventions have also played a role in shifting misperceptions of the virus in communities affected by HIV. Hence, from an education point of view, the campaigns have been successful.However, as previously noted, behaviour change cannot occur solely through education.
Such campaigns have generally focused on their target groups arising from a specific
socioeconomic level as well as from specific communities. However, one can see from the outset that these campaigns again displace the responsibility of risk management and behaviour away from the experts and into the individual's hands (Beck, 1992). The ABC (abstain, be faithful or condomise) campaign is another example of the individualisation of risk management that the DOH has promoted. In Achmat's (2006) speech at the University of Cape Town, he directly criticised the ABC campaign stating that is focuses solely on the individual and not m the social inequalities and power imbalances that inform an individual's ability to choose. He called for more comprehensive prevention and management strategies to be implemented.
This begs the question of what makes a communicated behaviour change or educational campaign viable. Some of the participants gave descriptions as to why they thought that some campaigns were flawed and how this could be improved:
Participant 1: "Like a lot of the focus of the campaigns ... and I think I also tend to do it myself. .. is also focusing on a specific group which is the Black, sort of underprivileged ... because they seem to be more vulnerable. So I think that a lot of our people and our training as well ... a lot of mention is made and, on not looking at other population groups. "
Participant 1 is suggesting that the target group for the campaigns has been focused
predominantly on Black people from underprivileged communities and this leads to an absence in focus on other population groups. She explicitly states that she al'io tends to stereotype the focus of prevention programmes on people from the same social group. Perhaps the way in which the abovementioned prevention programmes are targeting this socioeconomic group, it adds to this participant's already existing schema that
mv
and AIDS affects people from a lowsocioeconomic background or Black people and hence, because she is White, she feels less vulnerable to contracting the virus. This target range may also be informed by the cultural and racial make-up of her patient load.
Participant 3 furthers this exploration of prevention programme target groups by suggesting that the practical nature of access to such campaigns must be taken into consideration when putting together such programmes:
Participant 3: "You know having a supplement in the newspaper is not going to reach everybody that it should reach and I mean, the poor .. . like we buy newspapers but not everyone does. So the method of giving out
information also like using high tech media like television you know, like is not always the appropriate way and I think there is a lot of work to be done in terms of finding out how we can give out the information because the information is being given out but we just need to find the right way I feel ... "
These statements fall in line with Rajwee's (2003) suggestion to ensure that one must always consider the complex nature of the context within which the particular target group comes from.
But, this may affect some peoples' perceived vulnerability towards contracting HIV rep ending of whether they identify as being part of that target group. A possible rationale as to why the
participants feel that the campaigns are not corresponding to the content of the campaigns to the different social groups in South Africa is because the DOH, as part of its prevention and
management plan for HIV/AIDS, has undertaken the responsibility of constructing these
campaIgns. However, Hassan (2006) has documented that when entering into talks about constructing such management plans and campaigns in combating HIV/AIDS, the DOH has repeatedly excluded and marginalised key stake-holders. This has resulted in the construction and implementation of several HIV / AIDS campaigns that are not informed by the broad spectrum of stakeholders in South Africa that are attempting to manage and curb the spread ofHIV.
Hence, key information which may make the campaigns more suitable to their target audiences is being excluded.
Two of the participants illustrated how they felt the content of the campaigns bring disseminated around South Africa were generating mixed messages. Participant 3 spoke specifically about th~
LoveLife campaign and that she agrees with part of its message about healthy lifestyles.
However, she disagrees with how the campaign is seemingly attempting to prevent the spread of HIV while at the same time seems to advocate sex with multiple partners as long as it is
constitutes what is termed safe sex. She furthered that she tears up the LoveLife pamphlets before her young brother has a chance to read them because she maintains that she does not want him to read some of the information that the campaigns promote:
Participant 3: "So in the media there is mixed messages coming across; on the one hand you are promoting safe sex and like on the other hand you want
prevention of HIV ... ya ... the two can go together, I mean obviously safe sex can prevent HIV but then if safe sex with anybody, are you just saying you must have safe sex with anybody that you want to have sex with, you know ... regardless of who they are ... "
Participant 6 also has similar views on this issue:
Participant 6 "It is like promoting like, you know, wear a condom but condoms aren't 100% protective so um, I think it is um, there are some media that promote um abstinence, uh abstainingfrom sexual contact until you are
married or having one sexual partner ... there are some media that just do promote the right things and then there are others that are just looking
for something temporary, not 100%. "
As previously stated by Bauer and Gaskell (1999), the contents of the communicated behaviour change, the way in which it is transmitted and the consequences of this communication, all playa role in the continual development of the targeted public's appraisal of HI V and AIDS. Perhaps this is another variable that contributes towards the differing ways in which the participants appraise their vulnerability towards contracting