| AIDS prevention through health promotion: Facing sensitive issues |
This book is intended primarily for health promotion planners and educators dealing with the spread of acquired immunodeficiency syndrome (AIDS) in their countries. It examines one particular aspect of the AIDS pandemic: the reaction of individuals and groups to AIDS, and how health promotion programmes can take these reactions-which are often irrational from a public health point of view-into account.
The idea for this publication came from discussions with colleagues working in AIDS control, who pointed to major problems in their efforts to design information and education programmes about AIDS. They perceived a need for more insight into some of the sensitive issues surrounding AIDS, such as the denial by certain groups of the extent of the problem, the reluctance of decision-makers to admit that "unacceptable" sexual behaviour exists, the difficulties encountered in designing effective messages without offending religious beliefs and moral convictions, the social taboos that discourage open discussion about sexual behaviour, and the extreme fear experienced by some at low risk of AIDS who over-react and call for isolation of infected people.
Following these discussions, it seemed useful to search for examples of how others have faced the problems caused by reactions to the AIDS pandemic: reactions of denial, fear and blame, often retreating behind social mores and taboos. This publication presents case studies of this nature. It is divided into four sections. Part 1 focuses on the health promoters themselves: how they can deal with their own emotions and reactions to AIDS and AIDS education. Part 2 focuses on target audiences: how their emotional responses to AIDS can be used to increase the effectiveness of educational messages. Part 3 illustrates how patients and peer groups can motivate others to change risk behaviour, while Part 4 focuses on decision-makers and "gatekeepers", who can help or hinder health promotion, and examines how their support can be enlisted.
Although many of the case studies are based on experience in industrialized countries, where the epidemic first came to public attention, they are not without relevance to developing countries. The growing body of experience in developing countries now being recorded should, as it is
published, provide a most useful complementary source of information and lessons learnt.
This collection of case studies is the product of collaboration between WHO and the Royal Tropical Institute in Amsterdam, Netherlands. The contributions of Riet Berkvens and Maeve Moynihan of the Royal Tropical Institute are gratefully acknowledged.