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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


AIDS Communication – an international view

Dr. Barbara O. de Zalduondo
Project Director, TvT Associates/The Synergy Project
1101 Vermont Ave. NW,Washington, DC 20005
Tel: (202) 842-2939; Fax: 202-842-7646

What is an “international” perspective?

What appears to be different/particular about communication for development when the issue is HIV/AIDS?

If this is a turning point, where should we go from here?

What is an “international” perspective?




Distant from the grass-roots, from the most important locus of action

  • Opportunity to focus on the “forest”

A privilege and a duty

  • To listen, hear, and try to understand
  • To review and apply lessons from the past
  • To be vigilant about respecting and enforcing values of participation, autonomy and voice

HIV/AIDS Communication: Special Features

The HIV/AIDS community

  • There IS an HIV/AIDS community (solidarity)

The community has a culture (language, norms)

  • It’s all “us”
  • Involvement of PLHA, as agents and beneficiaries
  • Views and needs of PLHA are key; PLHA in the driver’s seat
  • No specialty/organization/individual can do it alone – partnership is the only effective way
  • Honors relationships, community, and emotions, not just technical analysis and data
  • e.g. Names Quilt

HIV/AIDS requires attention to sexuality, not just sex and its biological consequences

  • Motivations
    - Reproduction
    - Relationships - emotions
    - Desire/pleasure
    - Instrumental uses
  • Meanings
    - Sex-gender system ties sex into personhood
    - Meanings are “culturally constructed and socially reproduced”
    - Interwoven
  • Disconnects between ideal and real behavior
    -E.g., “norms” of fidelity that aren’t really norms, because there is no punishment for infractions

Requires grasp of sexual culture AND health beliefs, in the context of gender, age and SES


HIV/AIDS Related Stigma and Discrimination

“The term stigma, then, will be used to refer to an attribute that is deeply discrediting...” causing a person’s very identity to be “spoiled (Goffman, 1963:3).

...“a powerful discrediting and tainting social label that radically changes the way individuals view themselves and are viewed as persons” (Alonzo and Reynolds, p. 304)

AIDS-related stigma... refers to prejudice, discounting, discrediting, and discrimination directed at people perceived to have AIDS or HIV and at the individuals, groups, and communities with which they are associated. (Herek, Mitnick et al. 1998).

Double burden of stigma

  • Stigma associated w/ HIV/AIDS
  • Stigma associated w/ vulnerable populations
    -Men and women with multiple sexual partners
  • Stigma complicates all aspects of programming
    - Reaching people at risk
    - Targeting
    - Mobilizing support and resources for services
    - Engaging people to learn and take action

Vicious cycle of stigma

Silence is a VERB

Problems for communication

Where is the boundary between “Cultural Appropriateness” – and complicity with the silence?

How to direct and tailor communication to and for people most in need, without augmenting the stigma?

How to build cultural resonance in culturally diverse and complex places, countries, and regions?

HIV/AIDS Communication: Special Features

The most effective path isn’t the obvious path

  • Identify, label and exclude/quarantine the infected, v. taking personal responsibility for protection
    - Manage w/ medicine v. mobilize communities
    - Silence v. Openness
    - Sanction v. solidarity and compassion
    - Command and control v. participation and human rights
    - Fear v. hope
  • Every new audience has to work through these alternatives, to embrace effective approaches
    - Can’t skip or speed this process, or deliver it in capsules