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Talk and its Importance in HIV Prevention

Talk and its Importance in HIV Prevention . Susan Kippax Social Policy Research Centre University of New South Wales . Health Communications . formal health communications such as in HIV-prevention campaigns/interventions the advice given by clinicians to patients/counselling

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Talk and its Importance in HIV Prevention

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  1. Talk and its Importance in HIV Prevention Susan Kippax Social Policy Research Centre University of New South Wales

  2. Health Communications • formal health communications such as in HIV-prevention campaigns/interventions • the advice given by clinicians to patients/counselling • the informal talk between people as they go about their everyday lives.

  3. Under What Conditions • Who says • What to • Whom in • WhatMicro Contexts and • What Macro Contexts with • WhatEffects

  4. HIV diagnoses in Australia, by year

  5. Australian Gay Communities 1982-1998 • Who Gay peer educators • What Community Strategies • Whom Gay community • Micro Contexts Range of gay events • Macro Contexts Culturally familiar, High mortality • WhatEffects Safe Sex Practice

  6. Australian Gay Communities 1999-2014 • Who Gay Educators & High Profile C’tors • What Community & Biomedical Strategies • Whom Gay community • Micro Contexts Gay events & Clinics • Macro Contexts Optimism • WhatEffects Decline in Safe Sex Practice

  7. Median HIV Prevalence of ANC Attendees: 1997 to 2009.

  8. Ugandans : late 1980s to 2003 • Who Family/friends • What Community Strategies • Whom Family/friends • Micro Contexts Range of informal settings • Macro Contexts Culturally familiar, High mortality • WhatEffects Safe Sex Practice / Decline in HIV

  9. Ugandans : post 2004 • Who Government, churches • What Abstinence and Monogamy • Whom General Population • Micro Contexts Clinics, schools, churches • Macro Contexts Declining epidemic • What Effects Decline in Safe Sex Practice / Increase in HIV

  10. Conditions of Success • Collective agency/action lies in people’s connectedness to others • Talk is the central element in that connectedness • The building of community capacity (via funding and support from the state)

  11. Individualist Paradigm • Neo-liberal rational agent • Communication typically top-down from expert to individual • Purpose to change individual’s behaviour/s

  12. Social Paradigm HIV prevention as a matter for communities who, in response to the risk of HIV • Develop their own risk-reduction strategies, strategies that are not inimical to their cultural/social values, and • Engage with formal and other public health messages, talk about them, interpret them, accept, reject or modify them.

  13. Social Paradigm • Social beings are connected to others • Communication is typically horizontal within networks/communities of people • Purpose of communication is to change social norms and social practices

  14. Conclusions • If there is one thing that the last 30 years of experience in HIV has taught us, it is that communities and collective action provide the possibilities for change. • Social change is always a function of the collective actions and interactions of groups of people. • Sustained individual behaviour change depends on the above.

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