BEHAVIOR CHANGE COMMUNICATION (BCC)
FOR HIV/AIDS
A STRATEGIC FRAMEWORK
This work was supported by the United States Agency for International Development (USAID) as part of Family
Health International’s Implementing AIDS Prevention and Care (IMPACT) Project (Cooperative Agreement
HRN-A-00-97-00017-00) and does not necessarily reflect the views of USAID or FHI.
FHI implements the USAID IMPACT Project in partnership with the Institute of Tropical Medicine Management
Sciences for Health Population Services International Program for Appropriate Technology in Health and the
University of North Carolina at Chapel Hill
© September 2002
Family Health International
Institute for HIV/AIDS
2101 Wilson Boulevard, Suite 700
Arlington,
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INTRODUCTION
Behavior change communication (BCC) is an interactive process with communities (as integrated with an overall program) to develop tailored messages and approaches using a variety of communication channels to develop positive behaviors; promote and sustain individual, community and societal behavior change; and maintain appropriate behaviors.
In the context of the AIDS epidemic, BCC is an essential part of a comprehensive program that includes both services (medical, social, psychological and spiritual) and commodities (e.g., condoms, needles and syringes). Before individuals and communities can reduce their level of risk or change their behaviors, they must first understand basic facts about HIV and AIDS, adopt key attitudes, learn a set of skills and be given access to appropriate products and services. They must also perceive their environment as supporting behavior change and the maintenance of safe behaviors, as well as supportive of seeking appropriate treatment for prevention, care and support.
In most parts of the world, HIV is primarily a sexually transmitted infection (STI). Development of a supportive environment requires national and community-wide discussion of relationships, sex and sexuality, risk, risk settings, risk behaviors and cultural practices that may increase the likelihood of HIV transmission.
A supportive environment is also one that deals, at the national and community levels, with stigma, fear and discrimination, as
The Bradley-Reid Corporation addresses the HIV/AIDS epidemic by providing direct services to persons at risk for or diagnosed with HIV/AIDS. The organization also facilitates community conversations while implementing systems that strengthens its technical and management capacity. The organization's HIV/AIDS program activities include HIV risk prevention; HIV PreP awareness, HIV screenings; HIV/AIDS case management; self-care skills training; care giver skills training and peer educator training. Bradley-Reid further
According to a report published in the February 1998 edition of “Nature”, scientists identified what they believe is the earliest case of AIDs in a man from the Congo in 1959. (Lerner and Hombs 39) By the end of the year 1980, 80 men would have been diagnosed with at least of the opportunistic infections that are a characteristic of AIDs. (Lerner and Hombs 40) AIDs cases in the 1980s increased dramatically not only around the world but in the United States, primarily in larger cities like Los Angeles, New York City and San Francisco. The numbers of AIDs diagnoses and deaths spiraled out of control throughout the 1980s and towards the end of 1989 there were 117,500 cases of AIDS reported and 89,000 related deaths.(Lerner and Hombs 54) In the
This paper is to define and discuss the Evidence Based Practice Model Behavior Modification. Expounding on the various methods that are utilized to alter behaviors from positive to negative, and some of the tools implemented to enforce behavioral changes in various settings. This discussion will also explain various techniques that have been designed to make behavioral changes more effective and understandable. Exploring direct interactions from articles this paper will also discuss the benefits and barriers that one faces in dealing with behavior modification.
The first important parts of developing a behavior modification program is to describe the person’s behavior. This is important in order to understand the behavior that needs to be changed (Kuhlenschmidt, n.d.). For instance, if the unreasonable bad behavior that needs to be changed, the frequency and time of its usual occurrence need to be determined. The aspects that may possibly trigger that bad behavior must also be acknowledged. The next important part is to decide that behavioral change is needed. Making a decision to take the behavior modification program requires a strong level of commitment (Kuhlenschmidt, n.d.). Otherwise, developing the program will make no sense. Another important part of the process is the identification of potential intervention strategies. Depending on the type of target behavior, these strategies may range from positive or negative
19:1 in the United States and Europe; emphasis has been placed on sexual transmission of human immunodeficiency virus (Hrdy,1987). Factors thought to influence this sexual transmission include promiscuity, and sexual practices that have been associated with increased risk of transmission of AIDS virus from male to female and from mother to babies (Hrdy,1987). In Africa, promiscuity seems to be the most important cultural factor contributing to the transmission of HIV. For example, Olivia had been sexually abused and has contracted AIDS earlier in her life. Whereas social and cultural factors are the direct cause for the transmission of HIV from pregnant women to babies in India because women would rather have babies with HIV than to be homeless, beaten or abandon if they don’t conceive children (Bilheimer,
A study on HIV infections found that accessible sexually transmitted disease (STD) screening, community-directed interventions, sex education and services were the most beneficial (Kessler, Myers, Nucifora, Mensah, Kowalski, Sweeney, Braithwaite, 2013). However these services are not used prominently due to inconvenience, cultural reasons, and distrust towards the programs (Ma, Raymond, Wilson, McFarland, Lu, Ding, Xiao, 2012). These services need to become more community friendly, accessible and safe in order to engage the public (Ma et al., 2012). Governments cannot enforce the usage of these services but early HIV education in schools can be mandated to help eliminate stigmas and encourage usage of these services (Felten, Kok, & Kocken, 2016). Prevention measures work because they target HIV’s modifiable risk factors through education, circumcision, condoms, and a variety of other approaches (Kessler et al., 2013). Adequate prevention measures are needed to prevent negligence and
Although HIV is no longer the automatic death sentence it was in the 80’s, it remains a thorn even in our modern societies. For instance, HIV treatment is exponentially expensive, and can only be afforded by residents in developed countries. In fact, most third world nations are still in the 80’s as far as HIV treatment technology is concerned. Fatality rates particularly in Africa are astronomical to say the least (Rensburg 267). With prices, for
HIV is an epidemic that is present worldwide, the disease is concentrated in sub-Saharan Africa for the most part. In context, of the estimated thirty-four million cases of HIV in 2008, twenty-two to twenty-three cases were in sub-Saharan Africa. On the contrary, 1.4 million people are infected with HIV in North America. (Sigall K. Bell, MD, 2011, p. 38). Further, the sum of global infections approximately two million are under fifteen of age. Approximately 50,000 cases a year are in the United States due to the lack of prevention, which then leads to overall prevention. Potential causes of the spreading of HIV are non-effective educational messages along with the high-risk sexual behavior. Also, this just calls for increasing chances of acquiring
HIV/AIDS is a health issue that has affected the lives of 35 million individuals globally and has continued to spread due to social conditions which surround us. Risky behaviors such as men having sex with men, large number of homeless population, large number of African American men incarcerated, and injection of drugs also attribute to the large number cases of HIV/AIDS.
Transmission of the HIV virus, as well as any other types of STDs, is a subject that needs to be discussed seriously and cautiously. There are many ways that one can acquire HIV/AIDS and it is very beneficial that every person is aware of the certain procedures to follow in order to avoid such an afflicting harm. The most common transmission of HIV is through sexual intercourse, where bodily fluids such as semen, vaginal secretions, or even blood are transferred from an HIV positive person to a non-infected person. AIDS is the deadliest sexually transmitted disease reaping about 13,700 deaths per year(Web, HIV in the US). There are approximately 36.9 million people living with the HIV virus, which is why more prevention techniques should be utilized across the globe.
Just as clearly, experience shows that the right approaches, applied quickly enough with courage and resolve, can and do result in lower HIV infection rates and less suffering for those affected by the epidemic. An ever-growing AIDS epidemic is not inevitable; yet, unless action against the epidemic is scaled up drastically, the damage already done will seem minor compared with what lies ahead. This may sound dramatic, but it is hard to play down the effects of a disease that stands to kill more than half of the young adults in the countries where it has its firmest hold—most of them before they finish the work of caring for their children or providing for their elderly parents. Already, 18.8 million people around the world have died of AIDS, 3.8 million of them children. Nearly twice that many—34.3 million—are now living with HIV, the virus [9].
One assesses multiple interventions, media, and options for information dissemination, finding the best practices in community health, and identifying community and cohort factors that influence acceptance and reception of information. Involving the community stakeholders helps this process by providing insight into an unfamiliar culture. After narrowing down the interventions to the ones identified as the best by both academic and community stakeholders, the preventive and treatment program is culturally adapted and integrated by considering the cohort’s preferred language and literacy, as well as their values and need for accessibility. Then, community support organizations are identified to assist with accessibility and dissemination of supportive information, and the interventions are performed. Finally evaluation of this strategy is performed and altered accordingly to further increase accessibility, knowledge, and support for the cohort experiencing health disparity (Nápoles et al., 2013). This could be done in Calcasieu parish with several interventions, such as providing brochures and posters with contact information of local and free testing centers and counseling centers for those who are HIV/AIDS positive in areas frequented by African-American men who have sex with men, such as in bathroom stalls of gay entertainment establishments. These establishments are a part of the community stakeholders. Collaborating with them to create a positive, caring, and
Leaders of 189 nations realized that HIV and AIDS is one of the most important issues in our nation. In 2001 they agreed to set targets that would help to reduce the epidemic by the year 2015.11 One of the things the UN has done is to train counselors, who can then provide services for people infected with the virus throughout the world.12 This is made possible through VCCT also known as Voluntary Confidential Counseling and Testing.13 The UN has also helped to spread the urgency of the epidemic by opening mini HIV and AIDS libraries which help make it easy to access information on the problem.14 An organization called UNICEF (United Nations International Children’s Emergency Fund) helps to organize a group that provides guidance and testing for
The HIV/AIDS virus doesn’t just affects individual people, it impacts households, communities, and the development and economic growth of nations. Many of the countries hit the hardest also suffer from other infectious diseases, food insecurity, and other serious problems.
Adding to this misinformation of the risk of HIV/AIDS and the misunderstanding of prevention methods, the lack of HIV testing and counseling is extant. In the late nineties in South Africa, 150 adolescents were infected with the virus every day (Maart, 1998). This is quite the misfortune considering that the disease is taking the population needed for development. South Africa, and other SSA nations could not let this continue to be the case; hence, the high level of mass awareness campaigns provided in the 2000s. Nevertheless, today, we have about 240 individuals who get infected every hour, the majority of whom are youngsters in SSA (amfAR, 2017). This means that the awareness is either not comprehensive, or that many youths are ignoring it. Regardless, several studies show that very few people seek HIV counseling or get tested for HIV (Maughan-Brown et al., 2016; Sommer, Likindikoki, & Kaaya 2015); Tillotson & Maharaj, 2001). Indeed, in a study conducted among Ghanaian