|Communications Framework for HIV/AIDS: A new direction - A UNAIDS/PennState project (Best Practice - Key materials) (UNAIDS, 1999, 101 p.)|
|The Contextual Domains: A New Direction|
Lower socioeconomic status makes a group more susceptible to many diseases, including HIV/AIDS. People in poor health have repeatedly been shown to be more likely to develop AIDS soon after infection with HIV.
Economics is a factor in providing individual, group, and governmental access to an adequate supply of condoms - and to combination drug therapies, where they are available. In resource-poor countries, various studies and reports have dealt with socioeconomic status and other factors related to HIV/AIDS. In Thailand, for example, women with more education and greater household income displayed more accurate understanding of HIV/AIDS than lower-income, less-educated women. There is new evidence that the 100 percent condom policy that was adhered to by sex workers is increasingly difficult for sex workers to uphold, due to the economic downturn in Thailand. Sex workers who once refused higher payment for not using a condom are now accepting such payments.
Knowledge of HIV/AIDS was found to be almost non-existent among respondents in urban slums in India, especially among women. Another study in India found that illiteracy, linked to poverty, created a gap in knowledge about HIV/AIDS. Urban women of low socioeconomic status in Argentina were found to be particularly vulnerable to AIDS as a result of their gender and lower-class status.
It is evident that the socioeconomic context is a crucial domain in the success of HIV/AIDS communications. The following key issues related to socioeconomic status must be considered in the implementation of the framework:
· Issues of affordability, especially in clinical interventions such as combination drug therapies and technological interventions such as supplying condoms, must be dealt with. Many governments and most individuals could not afford combination drug therapies even if they were available. Economic factors are particularly salient when the potential sustainability of behavioral outcomes beyond the end of a planned intervention is assessed, as it should be.
· Address the impact of poverty on individuals and communities and its relation to safer health practices.
· HIV/AIDS should be considered a developmental and social problem. Consequently, the allocation and distribution of resources to address the pandemic should be considered along with other existing social and development problems.
· Other issues affecting general accessibility to health care must be analyzed within each context and addressed in the planning of communications interventions for media and interpersonal communications.