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Talk and its Importance in HIV Prevention

This study explores the critical role of communication in HIV prevention, focusing on formal health campaigns, counseling, and everyday conversations. It analyzes the impact of talk within micro and macro contexts on safe sex practices in Australian gay communities and Ugandan populations. By comparing the outcomes of different communication paradigms - individualist and social - it emphasizes the power of collective action and community engagement in driving positive behavioral changes. The findings underscore the necessity of building community capacity and promoting social connectedness to effectively combat the HIV epidemic.

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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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