According to the Uganda Aids Indicator Survey 2011, nearly 3 in 4 women and 80 per cent of men in Uganda are knowledgeable about HIV/Aids. The survey also shows that more than 97 per cent of women are willing to go for HIV test, men stand at 94 per cent. Therefore, the story about a young woman committing suicide after a routine HIV test as reported in the press recently, gets one thinking - what are we not doing right?
The government of Uganda, the development partners, and the media, have played a big role in providing information and health education on HIV/Aids. Thus today, many Ugandans are knowledgeable and even agree to have HIV tests. But what causes stigma to the extent of some one committing suicide on discovering that they are HIV positive? Why are partners not disclosing their sero status to each other? It is time to move beyond providing information, education and communication to focusing on behavioural change communication to tackling the increasing HIV prevalence rates.
Aids is often characterised as a disease of intolerance and ignorance that is compounded by social and economic factors such as gender inequity, poverty, and recently lack of leadership will, among others. Common myths and misinformation about HIV/Aids also stand in the way of greater awareness, discussion, and acceptance of individual and social behavioural change to reduce risk of infection.
HIV-related stigma can also be a barrier to the status acceptance, and can prevent people living with the disease from accessing resources for positive living. Inadequate counselling services can make it difficult for someone who is infected to understand the options available to them to make an informed choice about appropriate treatment, and reproductive health, among others.
Fortunately, behavioural change communication interventions can make a difference in informing, equipping, and motivating people to make appropriate choices about HIV prevention and care.
In Uganda, there are already HIV/Aids communication efforts like HIV/Aids prevention strategy. This strategy addresses Combination Prevention, which fortunately addresses the whole prevention, care, support, and treatment.
Approaches to behavioural change in the early years of the HIV pandemic focused on providing correct information about transmission and prevention. This based on the theory that lack of accurate information about HIV transmission and acquisition was a primary catalyst for the spread of infections. Unfortunately, this approach fell short of producing the desired effect.
HIV is a challenging disease given the number of issues that need to be addressed. Providers should focus on individual behavioural communication such as focusing on individual risk behaviour. Persuade those engaging in risky behaviour to change instead of focusing on risk groups as this can lead to stigma and discrimination. Behavioural change communication involves promotion of the available HIV/AIDS services, such as counselling and testing, care and treatment, and support groups.
Therefore, individual behavioural change communication should emphasise the availability and ease of use of HIV services. Stigma plays a vital role in fuelling the epidemic. Behavioural change communication explains how stigma (language, attitudes, and conduct) allows the epidemic to thrive. It also explains how people often stigmatise others without realising it and how people can cope.
Effective behavioural change communication should be designed in response to the specific client’s needs. Behavioural Change communication is promising response to HIV fight. Therefore, barriers that have prevented the use of factors such as lack of defined processes, and misunderstanding of the communication approach for health, should be addressed. Perhaps only then shall we see a reduction in HIV stigma as well as new infections.
Ms Mirembe works with Programme for Accessible Health, Communication and Education