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Educate the Mass Public Polls repeatedly show that the American public supports HIV prevention programs. But as NASTAD’s HIV Prevention Blueprint explains, "While America’s support for our work is broad, it is very shallow." Most Americans, while sympathetic, perceive HIV/AIDS as a problem faced by "other" people. Consequently, they are not immediately willing to compromise their own interests to promote the wellbeing of others, particularly those in the United States (U.S.) who are at risk for or living with HIV/AIDS. Because policy priorities and appropriations that fund most prevention programs are driven by the relative value the voting public places on these programs and, ultimately, how the public’s view is acted upon by legislators, sustained education of the mass public must be an essential principle in the nation’s fight to end the HIV/AIDS epidemic. Support for HIV prevention among the American public is tempered by limited exposure to information about HIV/AIDS as well as persistent myths about who is impacted, how transmission occurs and what the long-term implications of HIV/AIDS are for individuals, communities and the public as a whole. A recent survey suggests that twenty-one percent of Americans, more than one in five, would be "very" or "somewhat" uncomfortable working with someone with HIV/AIDS and thirty-nine percent, almost two in five, would be uncomfortable living with someone with HIV/AIDS.1 As the recent release of the new Centers for Disease Control and Prevention (CDC) national estimates of HIV incidence attests, much of the information about HIV/AIDS prevention (and care and treatment) is complex and often challenging to communicate in layperson’s terms. Yet by elevating HIV/AIDS in the public’s view and reinforcing accurate information about the epidemic, we can continue to cultivate the general public’s ongoing support for HIV/AIDS prevention and also begin to address the stigma and discrimination associated with the disease. The new national estimates also convey that HIV/AIDS remains a condition of marginalized populations in the U.S., particularly gay men and other men who have sex with men of all races and ethnicities, Black and Latino Americans and youth. Since the beginning of the epidemic, we have faced an uphill battle in this regard because "oppression and stigma are at the root of the disease" and because our efforts to promote "scientific fact does little to counter ideological concerns" (NASTAD Blueprint). Therefore, to help the public internalize the true impact of the epidemic, we must educate them about the economic, social and health consequences HIV/AIDS is having on our society and we must do so accurately and precisely. This means that primary and secondary schools, as well as colleges and universities, must incorporate comprehensive HIV/AIDS education (and education on viral hepatitis and other sexually transmitted diseases (STD)) into their curricula to ensure the upcoming generations are aware and have the information they need to protect themselves and others. And we also must invest in a sustained national media presence that brings knowledge and information to all corners of the nation. This epidemic can no longer be owned by the infected and affected alone; it must become part of the national consciousness so that the nation recognizes that when one is infected, all are affected. We believe that most Americans will be willing to set aside their own interests if they understand the magnitude of the problem our nation faces. A new investment in public education—both through comprehensive sexuality education to young people and a sustained national media presence—can help this happen. The following two profiles provide examples of strategies that are needed to educate the mass public in ways that more effectively, efficiently and accurately convey who is being impacted by the epidemic, why and what is needed to prevent further transmission of HIV. These are but two examples of myriad strategies currently underway to educate the mass public. Following the profiles, we have included an inventory of several national media campaigns that have taken place throughout the epidemic. We encourage our readers to share other interesting or innovative public education strategies via the NASTAD Resource Bank. For more information, contact Lynne Greabell. Reference: 1. The Kaiser Family Foundation, National Survey of Americans on HIV/AIDS: March 24-April 18, 2006 back to top > The Landscape of Educating Youth One of the chief ways to educate young people about HIV/AIDS as an entire group or cohort of people is through our educational system. The provision of comprehensive sexuality education in our nation’s schools has been the subject of intense debate for some time. Much of this debate has been fueled by misinformation and ideological perspectives that suggest that talking to young people about sex is morally inappropriate and encourages their engagement in sexual activity. Yet, on the contrary, a central aim of comprehensive sexuality education is to delay early sexual debut, and this approach provides school-aged youth medically accurate information about healthy human behavior, relationships and sexuality. Moreover, those who provide comprehensive sexuality education strive to make these programs culturally and age- appropriate and teach young people about the importance of correct and consistent condom use, choices in contraception and the role of abstinence in HIV, STD and teen pregnancy prevention. The Guidelines for Comprehensive Sexuality Education developed by the Sexuality Education and Information Council of the United States (SEICUS) outline the fundamental goals and principles of comprehensive sexuality education programs for grades K – 12. These key concepts cover human development, relationships, personal skills, sexual health and behavior and society and culture.1 SEICUS describes sexuality education as "a lifelong process of acquiring information and forming attitudes, beliefs and values about identity, relationships and intimacy…[and] addresses the socio-cultural, biological, psychological and spiritual dimensions of sexuality by providing information; exploring feelings, values and attitudes; and developing communication, decision-making and critical-thinking skills".2 In short, the goal of comprehensive sexuality education is to promote sexual health by helping young people develop positive attitudes about sexuality and preparing them to make responsible, informed decisions regarding their sexual health in adulthood. CDC estimates new HIV infections among young people aged 13 – 29 represent 34 percent of all new infections in the U.S. annually. In 2007, CDC reported 19 million new cases of STDs, with nearly half occurring in persons between ages 15 and 24.3 These statistics serve as an indictment of our education and public health systems’ efforts to adequately educate youth about the impact and repercussions of unprotected sex and how they could be at risk for HIV, STD and unintended pregnancies. Despite the unacceptable impact of HIV and STD on the nation’s youth, abstinence-only programs are still being promoted and funded by the federal government, despite the fact that studies have determined these programs are ineffective in preventing negative sexual health outcomes for youth.4 At the school and community levels, clashes over morality and local control often make it difficult to impact change in this arena. So many state and local health departments, recognizing the need to reach the youth most at risk with prevention education, have worked either in cooperation with school health educators or on their own to support programs for youth—both youth in and youth out of school—through after school programs, youth peer-mentoring and education programs and other programs such as those delivered in juvenile detention facilities. The landscape is challenging, but increasing collaborative efforts are paying off. In April 2008, Congressman Henry Waxman (D-CA) convened a hearing of the Oversight and Government Reform Committee to explore the effectiveness of abstinence-only-until-marriage programming in reducing the risks of HIV and STD infections and unintended pregnancy among school-aged youth. At this hearing, testimonials of national youth service organizations and young people participating in prevention efforts highlighted the failings of abstinence-only programs to reduce pregnancy and STDs, despite the fact that the government has funneled $1.3 billion dollars into abstinence-only programs.5 In the statement Waxman issued at the hearing, he pointed out that a major flaw of the abstinence-only programming is their singular message that abstaining from all sexual activity until marriage is the only way to prevent HIV, STDs and unintended pregnancies. Statistically, this narrow focus has not succeeded in delaying sexual debut among adolescents and has often provided misleading and medically inaccurate information about sex and the transmission of sexual diseases. And with its focus on abstinence-only-until-marriage, these programs do not address the sexual health needs of gay, bisexual, lesbian, transgender and questioning youth. The effectiveness of comprehensive sexuality education has been demonstrated through positive changes in behaviors among young people participating in these programs. In his remarks, Congress Waxman commented that, "More and more research shows that many well-designed comprehensive programs that teach about abstinence and contraception are effective. Comprehensive, age-appropriate programs have yielded results, including increasing contraceptive use, delaying sex and reducing the number of sexual partners."6 Information allows choice and fosters personal responsibility that offer young people opportunity for to make informed decisions about their safety and health, skills they carry with them into adulthood. Conversely, abstinence-only initiatives do not provide youth with the social tools and skills to effectively navigate the sexually suggestive messages from pop culture, the media and their peers. Accordingly, the medical, scientific and public health communities support the use of federal funding for comprehensive sexuality education programs that both emphasize the value of abstinence in HIV, STD and teen pregnancy prevention and teach about contraceptive choices and safe sex measures. In recognition of the need for comprehensive HIV prevention and the ineffectiveness of abstinence-only programs, we have seen an increasing number of state education agencies reject or return their federal abstinence-only grants. As of June 2008, 22 states have rejected abstinence-only dollars as the cornerstone support for their prevention programs targeting school-aged youth.7 In Colorado, the shift toward comprehensive sexuality education began a year ago when Gov. Bill Ritter signed legislation that required schools to offer sexuality education that is medically accurate, stresses abstinence and discusses the health benefits of using contraception.8 Still, the new law does not apply to school districts that continue to receive federal funding for abstinence-only-until-marriage programs and contains an "opt out" provision which gives parents the authority to keep their child out of sexuality education classrooms. In Kansas, the state’s abstinence-only-until-marriage policy was changed to abstinence-plus. Abstinence-plus education ranks sexual abstinence at the top of the hierarchy for safe sex practices but also includes education about the use contraceptives and condoms.9 While these are only two examples of small steps toward a more inclusive and comprehensive approach to educating our nation’s youth about HIV, STD and unintended pregnancy through comprehensive sexuality education, these signal a shift in the right direction to ensure youth receive the information they want and deserve, and that most parents support. References: 1. Sexuality Information and Education Council of the United States. Guidelines for comprehensive sexuality education, K – 12, 2004. Available at http://www.siecus.org/index.cfm?fuseaction=page.viewpage&pageid=521&grandparentID=477&parentID=514 2. Ibid. 3. Centers for Disease Control and Prevention. Trends in reportable sexually transmitted diseases, 2006: National survey data for Chlamydia, Syphilis, and Gonorrhea, November 2007. 4. National Alliance of State and Territorial AIDS Directors. Issue brief: Comprehensive sexuality education—Effective HIV prevention for youth, April 2006. 5. Committee on Oversight and Government Reform. Committee hearing: Assessing the evidence of domestic abstinence-only programs—Chairman Waxman’s opening statement, April 18, 2008. Available at http://oversight.house.gov/story.asp?ID=1898. 6. Ibid. 7. Freking, Kevin. States reject abstinence-only funding from federal government. Huffington Post, June 24, 2008. 8. Sexuality Information and Education Council of the United States. Sexuality education victories in Colorado and Kansas, 2007. Available at http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureid=949&pageid=517&parentid=514 9. Dworkin, S.L., & Santelli, J. (2007) Do abstinence-plus Interventions Reduce Sexual Risk Behavior among Youth? PLoS Med 4(9): e276 doi:10.1371/journal.pmed.0040276. back to top > The "SOY…" ("I AM…") Spanish-Language Media Campaign Since early in the epidemic, HIV/AIDS activists, public health providers and non-traditional entities have partnered to attract media attention to the epidemic. Fashion designers, celebrities and other well-known personalities have participated in public service announcement (PSAs) to raise awareness around HIV/AIDS, promote prevention and testing and reduce HIV/AIDS-related stigma. These messages have been important, according to a national survey conducted by the Kaiser Family Foundation in 2006, as six in ten Americans (61 percent) reported using media as their primary source of information for HIV/AIDS.1 In working to address the HIV/AIDS epidemic among Latino communities, community-based organizations and health care professionals have recognized the need to actively engage local and national media, including television, radio, newspapers and the Internet. One reason for this is that Latinos watch more television than any other racial or ethnic group. They also prefer their media be delivered in Spanish.2 Thus, PSAs can be effective instruments in delivering prevention messaging to members of Latino communities and informing Latinos living with HIV/AIDS about available treatment and care services. Because of the influence of media in Latino communities, the Kaiser Family Foundation and Univision Communication, Inc. recently launched a new campaign targeting Spanish-speaking Latinos to raise awareness around HIV/AIDS and reduce stigma around the disease among Latino communities. As the most-watched Spanish-language broadcast television network in the U.S., Univision is estimated to reach 97 percent of U.S. Latino households. In addition, Univision Radio is the leading Spanish-language radio group, which owns and/or operates 70 radio stations in 16 of the top 25 U.S. Hispanic markets and five stations in Puerto Rico. In conjunction with this year’s National Latino AIDS Awareness Day(NLAAD) on October 15th, the Kaiser Family Foundation and Univision debuted "SOY…" ("I AM…"), a groundbreaking Spanish-language media campaign that features the personal stories of a diverse group of Latinos living with HIV and the people who love them. For the first time in a national media campaign, SOY… profiles HIV-positive Latinos and their loved ones speaking openly about subjects not commonly discussed in Latino households. The individuals in this new campaign represent the great diversity found within Latino communities and vary in age, gender, sexual orientation and nationality. The participants of the campaign range from two teenage sisters (one HIV-positive, one HIV-negative) from Los Angeles to a 77-year-old grandmother in Puerto Rico and her daughter in Miami who has been living with HIV for more than ten years. SOY… includes 12 original PSAs, each in television and radio formats. The PSAs provide Spanish-language HIV/AIDS information and resources available online through a dedicated website and via a toll-free Spanish-language hotline (1-866-TU-SALUD). The campaign was developed as part of ¡Entérate del VIH y SIDA! (Get the Facts about HIV and AIDS!), a long-standing public information partnership established in 2001 between Univision and the Kaiser Family Foundation to provide culturally-relevant Spanish-language information and resources about HIV/AIDS. NASTAD is collaborating with Univision and Kaiser to distribute HIV/AIDS information resources and SOY… programming materials to community organizations, state and local health departments and local clinics across the country. Community Kits for the SOY… campaign have been made available to health departments and local providers and include:
Together, NASTAD, Kaiser and Univision are working to ensure a wide dissemination and utilization of the SOY… campaign. In addition to showing the SOY… clips at community events, local clinics and health fairs, health departments are encouraged to order additional SOY… materials for their local partners and to host forums that foster honest and open discussion around the key campaign themes—stigma, discrimination, testing and prevention. Also, health departments and their partners can utilize materials of the campaign to help empower local Latinos infected and affected by HIV/AIDS and encourage them to share their own SOY… stories through the campaign’s online community. Additional complementary resources are also available online and through the campaign’s toll-free hotline 1-866-TU-SALUD. For more information on NASTAD’s role in the SOY… campaign, please contact Francisco Ruiz. References: 1. The Kaiser Family Foundation, National Survey of Americans on HIV/AIDS: March 24-April 18, 2006 2. National Council of La Raza, Redefining HIV/AIDS for Latinos: A promising new paradigm for addressing HIV/AIDS in the Hispanic community: 2006. back to top > Inventory of Public Education Campaigns While not an exhaustive inventory of all the public education efforts, the following is a collection of some of the largest and most prominent national public service advertising campaigns directed primarily at U.S. audiences from 1981 to the present (as of June 2006). AIDS Prevention
America Responds to AIDS
Apathy is Lethal
Campaign to End AIDS
Country AIDS Awareness
Drug Abuse and AIDS Prevention
Entérate
HIV Stops With Me
I KNOW
Know HIV/AIDS
Know Your Status
National HIV Testing Day
National Latino AIDS Awareness Day
ONE
Pediatric AIDS
Rap It Up
Rumors
Stop AIDS Before It Stops The World
Think: Sexual Health/ ThinkHIV
We All Have AIDS
Weapons of Mass Instruction
Reference: The Kaiser Family Foundation, Evolution of an epidemic: 25 years of HIV/AIDS media campaigns in the U.S.: June 2006. back to top > Conclusion When one is infected, all are affected. NASTAD’s overarching premise for HIV prevention in the U.S. is that we cannot continue to allow the general public to dismiss HIV/AIDS as someone else’s problem. This does not mean that everyone is at risk for getting HIV, and it is important to continue to talk about those who are disproportionately impacted by HIV. But what this does mean is that we must redouble our efforts to find common cause, promote tolerance, reduce stigma and encourage a more thoroughly collective effort among all in the U.S. to fighting the disease. back to top > Meeting and Planning Calendar Capacity Building Opportunities: For a searchable database of CDC-supported capacity building trainings and events, please visit: the Capacity Building Branch’s Group Events Management System site. December 1, 2008 World AIDS Day February 7, 2009 National Black HIV/AIDS Awareness Day March 1-7, 2009 National Black Church Week of Prayer for the Healing of AIDS. March 10, 2009 National Women and Girls HIV/AIDS Awareness Day March 20, 2009 National Native HIV/AIDS Awareness Day April STD Awareness Month April 5-7, 2009 4th International Conference on HIV Treatment Adherence, Miami, FL. Sponsored by the International Association of Physicians in AIDS Care (IAPAC). April 16-18, 2009 HIV/STD Prevention in Rural Communities: Sharing Successful Strategies VI, Bloomington, IN. ABSTRACTS DUE FEBRUARY 6, 2009. Information and call for abstracts available on the conference website. May 2009 Viral Hepatitis Awareness Month May 18, 2009 HIV Vaccine Awareness Day May 19, 2009 National Asian and Pacific Islander HIV/AIDS Awareness Day May 21-24, 2009 HIV/AIDS 2009: The Social Work Response, New Orleans, LA. CALL FOR PRESENTATIONS DUE DECEMBER 31, 2008. Call and registration information available on the conference website. June 8, 2009 Caribbean American HIV/AIDS Awareness Day June 27, 2009 National HIV Testing Day August 23-26, 2009 National HIV Prevention Conference, Atlanta, GA. Abstracts due DECEMBER 10, 2009. |
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Credits, Feedback
and Input The NASTAD Prevention Bulletin is edited by NASTAD staff and is written by staff and prevention experts from around the country. This publication was supported by Cooperative Agreement Number 5U62PS323958-05 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. If you have an idea or program that you would like to include in the Bulletin, please contact Dave Kern or Lynne Greabell (202/434-8090). NASTAD welcomes feedback to issues presented in Bulletin. To submit commentary, please e-mail us at NASTAD@NASTAD.org. Electronic versions of the Bulletin are available on our webpage. |
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