Discrimination

Unless otherwise noted, the following data are from the CDC HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas, 2005.

Some forms of advertising-based education, particularly, try to get the safer sex message across by making people afraid of the potential consequences of becoming infected with HIV.
This can, in certain circumstances, be an effective way of bringing about changes in people’s behaviour, but it also carries the risk of increasing stigmatisation of positive people by making them appear to be at fault for having become infected. This is especially the case where targeted education campaigns highlight the dangers to specific risk groups - injecting drug users, for example, or prostitutes. No one deserves to become infected with HIV, however it happens. There is also the danger that this type of advertising may make the target audience afraid of positive people, by portraying them as a danger.
left picture : The Grim Reaper. Is this an appropriate image of a HIV positive person? And is it likely to reduce discrimination against positive people?

Somebody else’s problem

In much of the developed world, AIDS education still has to correct misapprehensions spawned by media portrayals of the epidemic. Much of the media still does not represent the broad face of the epidemic, but prefers to adopt the ‘somebody else’s problem’ approach by focusing it’s attention on risks to specific groups - young gay men, injecting drug users, and more recently people from Africa. AIDS education is in the position of having to convince people that they are not safe simply by virtue of having not being in one of these groups.
Moral views
A recent study has shown that young people who take one of the increasingly-popular ‘abstinence pledges’ are just as likely to become infected with STIs as those who don’t. This is not because they have as many sexual partners, but because they are more ignorant about the risks of infection - and because this approach supports the ‘somebody else’s problem’ attitude.
Nevertheless, moral attitudes are being allowed to dictate the practicalities of AIDS education, especially in the USA. President Bush’s 2007 budget allows for $204 million to be spent on abstinence-only programs. The Planned Parenthood Federation of America (a leading sexual health adovacate and provider) argues that:
“Americans should be outraged that huge amounts of money are being poured into ineffective abstinence-only programs for purely ideological reasons. Let me be clear, it isn’t the ‘abstinence’ we object to, it’s the ‘only’. Abstinence should be part of any responsible sex education program, but it is deeply irresponsible to omit lifesaving, medically accurate information that teens critically need.” 2
Human Rights Watch argues that this form of education actively opposes basic human rights. According to a 2002 Human Rights Watch report on abstinence-only sex education in Texas, Bush’s home state, a condoms-don’t-work ad campaign led sexually active young people to have unprotected sex.3

Religious messages

In many places, any discussion of something involving sex will eventually be commented on by religious groups. AIDS education has been no exception. In the US, particularly, education in schools is increasingly being suborned by those with a religious agenda, and sex education of young people is increasingly focusing more on morality and less on physical know-how. Education about the dangers of HIV is one victim of this approach to sex education, as young people are increasingly told that sex before marriage is sinful, that condoms don’t work, and that they should practise sexual abstinence until marriage.
The Vatican, for example, says that ‘abuse occurs whenever sex education is given to children by teaching them all the intimate details of genital relationships’
The Pope and the head of the Vatican’s office on the family have also endorsed the claim - which has been proven to be wrong - that sperm and the AIDS virus can pass through latex condoms. The Vatican says that “safer sex is. . . a dangerous and immoral policy based on the deluded theory that the condom can provide adequate protection against AIDS”.
Increasingly, faith-based groups are becoming very involved in AIDS education, especially American right-wing Christian organisations, which are taking a growing interest in Africa. If these groups are to gain funding, it is very important that the money they receive isn’t spent on religious messages. Bibles may help some people who are in distress, but they can’t take the place of anti-retroviral medication.

Government control

In many parts of the world, there is considerable governmental control of the media. It is also common to find legal constraints on the education that young people receive, and in some places, sex education is actually illegal.
Some types of AIDS education have been criminalized in various parts of the world by laws aimed at suppressing the target groups.
Even in highly developed countries, there are still often legal barriers to sex education. In the UK for instance, section 28 of the Local Government Act 1988 prohibited the promotion of homosexuality by local authorities until recently. Commonly this meant that local authorities, unsure of what was meant by ‘promotion’, would simply err on the side of caution and keep their sexual health education to the bare minimum necessary for biology lessons. A large aspect of AIDS education was ignored in schools, actually making it almost illegal for young gay men to be informed about protecting themselves. It is likely that this piece of legislation is responsible for HIV infections which might otherwise have been prevented.
Some types of AIDS education have been criminalized in various parts of the world by laws aimed at suppressing the target groups. In parts of Central America, for example, projects aimed at educating gay men about the dangers of HIV have been forced to close, and in much of the US, programmes giving information and clean needles to injecting drug users have been banned.
Even today in the UK, lobbyists such as the group ‘Family and Youth Concern’ are against sex education in schools, saying that it is tantamount to child-abuse, a subject which the UK media has recently made highly charged.
Governmental control can be a positive thing - laws have been passed to reduce discrimination against HIV positive people in the labour market, for example. But - as in the case of Section 28 - it can also have a negative impact on the spread of the epidemic.

Learning from the past

The first major government education campaign in the UK came in 1986 when the government launched a leaflet campaign, targeting every household in the UK with the ‘AIDS - Don’t Die of Ignorance’ slogan. Around this time, the media covered stories about gay men and drug users becoming HIV positive, whilst portraying people who had become infected through contaminated blood transfusions as the innocent victims of a disease spread by the immorality of others. Tabloid newspapers carried scare-stories about people being attacked with dirty needles - much more memorable than the government’s leaflet. This is a formula which is still, to some extent, true today.
In these early years, much attention was given to the fact that the virus seemed to be especially prevalent amongst such groups as gay men and people who shared needles. Targeted education programs aimed at harm reduction amongst these groups may have been effective to some extent but, when disseminated by the mass-media, this message also reached people who were not in the target group. This seems to have had the effect of giving people the impression that, if they are not in these high-risk groups, then they are not at risk at all.
Government campaigns often do not have the impact that they need in order to change people’s behaviour, and the media disseminates the idea that HIV affects minority groups. These two sources of information need to be able to coordinate and inform people in an effective, appealing manner.

Turning knowledge into action

Many people are now aware of the dangers of HIV, and yet the number of infections continues to climb. This suggests that, although people are being told the necessary information, they are not listening or are either unwilling or unable to act. It is clearly not enough to simply dispense information to people if they cannot or will not turn this knowledge into action.
In order for people to be able to use the information that AIDS education gives them they often need more than simply the facts about HIV transmission. AIDS education will fail to help people to protect themselves if it gives no more than the biological facts. Some other identifiable needs are:

• Motivation. People need to know that what they are learning about the epidemic is personally relevant to them. They need to know that they can themselves be affected by HIV if they do not take steps to protect themselves. Sometimes this motivation comes only when people see their friends dying, and it would be preferable if education could persuade people to act before they are frightened into doing so.
• Empowerment is also crucial to people’s ability to protect themselves. They must be in a position where they are able to take control of their sexual behaviour or methods of drug use. In many parts of the world, women have limited control of when and with whom they have sex, and less control of whether condoms are used. This may be because they are sex workers, because they are in abusive relationships, or simply that such a situation is endemic to the society they live in. AIDS education needs to help people to take control of their sexual and drug-using behaviour, and to help both men and women to act responsibly and evolve strategies to avoid risky situations and to say no to sexual encounters which are risky or unwelcome.
• Condoms should be available. There is little point in teaching people about the need to practise safer sex if they are unable to access condoms. Ideally, condoms should be freely available, and should be accessible to young people, regardless of whether they are over the age of consent or not.
• Needles and injecting equipment need to be made available in the same way, regardless of legislation prohibiting drug use. In some parts of the world, a person found by the police in possession of drug injecting equipment can be prosecuted, which tends to encourage injecting drug users to share equipment. This is clearly unsatisfactory, and people need not only to be taught how to inject without risking the transmission of HIV, but to have access to the equipment they need to do so, without fear of prosecution.
• Medical supplies are also crucial to putting AIDS education into action. Medical personnel can be taught how to prevent HIV transmission during their work, but actually do this they need sterile needles and surgical equipment, non-infected blood-products and latex gloves. Nurses and doctors need to have the facilities enabling them to protect both themselves and their patients.
• Testing facilities are also a priority. When a person has a positive HIV test, they can be educated how to protect their partners from infection and how to live well with HIV. This is not possible in a situation where there are insufficient testing facilities.