Culture and HIV/AIDS

HIV/AIDS: The Creative Challenge was an action-research project that aimed to improve the effectiveness of HIV/AIDS prevention and coping strategies through valuing local cultures and employing cultural approaches approach to education, information sharing and community dialogue and communications. The project has produced a series of briefings and papers which synthesise and draw on the knowledge, concerns and insight of project partners in four regions as well as on literature and policy developments relating to the role of culture in HIV/AIDS prevention and care.

What's Culture Got To Do with HIV/AIDS?

Findings Paper No. 7 Healthlink Worldwide

Helen Gould & Mary Marsh

http://www.healthlink.org.uk/PDFs/findings7_hiv_culture.pdf

This paper looks at how the cultural dimension can be more effectively factored into HIV and AIDS communication programmes, which are often the area in which culture is most visible and effective. The paper addresses the following key points.

• Cultural approaches to HIV and AIDS have built trust and engagement at community level, increasing the likelihood of prevention.
• Cultural approaches to HIV and AIDS are gaining currency because they interact with the values, beliefs, traditions and social structures – the
• ‘webs of significance’ – in which people live.
• Culture is most visible in communication programmes but some programmes are culturally inappropriate and may contribute to infection and stigma because of their focus on behaviour change.
• Where a cultural approach is used in HIV and AIDS communication there is evidence of wider impact on awareness and attitudes, of stigma
• reduction, and of more inclusion of people living with HIV and AIDS.
• New forms of monitoring and evaluation are required to capture the impact of cultural approaches to HIV and AIDS beyond behaviour change.
• Culture can offer a real benefit to global strategy for HIV and AIDS if it is re-cast as an opportunity for action and engagement with communities, rather than as a barrier to prevention and to bio-medical approaches.

Briefing Papers

Briefing One: Why engage culture in HIV/AIDS communication?

Helen Gould and Clodagh Miskelly

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This briefing outlines the importance of thinking culturally to effective approaches to HIV/AIDS prevention and care. Drawing on the work of HIV/AIDS: the Creative Challenge partners, it outlines some of the different approaches to using culture both in terms of culture as part of daily lived experience and in terms of creative practice and addresses some ways in which cultural approaches can be supported and developed.

(Adobe PDF document 5 pages 675 kb)

Briefing Two: Culture and Context

Helen Gould and Clodagh Miskelly

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This briefing draws attention to the need to address local contexts and cultures to ensure effective strategies for HIV/AIDS prevention and care. It provides examples of projects that work with and through the 'webs of significance' that shape people's lives in order to have relevant and meaningful information sharing and dialogue.

(Adobe PDF document 5 pages 695 kb)

Briefing Three: Cultural Approaches to addressing the Social Drivers of HIV/AIDS

Helen Gould and Clodagh Miskelly

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Culture can play a role in establishing the practices, values and attitudes which create stigma and discrimination, gender and other inequalities. Cultural factors may in turn limit the behavioural choices which people make around HIV/AIDS prevention. Hence the need to engage through culture in engaging with the roots of that behaviour. Cultural approaches take into account the networks of values and relationships that shape people’s lives whether that might be to enrich or constrain them. Thus to address inequalities requires approaches which nvolve people in developing culturally relevant responses which tackle the specifics of their own experience.

Local organisations using cultural approaches are well placed to address social drivers. This briefing draws on the examples of a number of cultural practitioners involved in the Creative Challenge project who weave HIV/AIDS into the wider themes impacting on their communities such as gender inequality and poverty and make use of modes of cultural expression which are well suited to such complexity. It also expands on the use of cultural approaches in addressing stigma and discrimination.

(Adobe PDF document 5 pages 682 kb)

Briefing Paper Four: Moving from rhetoric to reality – donor engagement with Culture and HIV/AIDS

Helen Gould

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Policy makers are aware that culture influences policy implementation. However the role of culture in development, and within that HIV/AIDS prevention, is currently under-theorised. There is a need for further work to look at complexity of interactions between culture, gender, stigma and rights, and to develop practical guidelines which address the role of culture and cultural approaches in relation to social drivers.
There has been a tendency to view culture as a barrier to preventing HIV/AIDS – part of the problem, rather than part of the solution. It has been noted that much of the policy emphasis has been on ‘behavioural change’ and seeks simply to alter particular behaviours or practices without addressing the background beliefs or social structures of a community.

How does HIV/AIDS policy become culturally sensitive and what are the benefits of doing so? Culture needs to be incorporated at three levels by policymakers:
• In overall policy thinking;
• In regional planning and programmes;
• In advocacy and engagement with beneficiaries.

(Adobe PDF document 9 pages 705 kb)

HIV and AIDS Global Context 2008: To inform ‘HIV/AIDS: The Creative Challenge’

Robin Vincent, Senior Adviser, HIV/AIDS, Panos London March 2008

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This brief overview outlines a number of current broad trends in the international AIDS response, and a few more specific areas where developments are relevant for a cultural analysis and where there may be points of contact with Creative Exchange’s work on HIV and culture.

A principal relevant shift in the international response is that towards attention to what are commonly called the ‘social drivers’ of HIV – primarily stigma and discrimination, gender inequity and human rights, as well as ‘poverty’, or what others would rather term economic and political inequality. Culture is implicitly involved in such social, economic and political ‘drivers’ of HIV, though much less often explicitly recognised in these discussions so far. A particular opportunity in this case is UNAIDS’ renewed attempts to address the social drivers of HIV and AIDS in a recent initiative to support communication for social change programming at the country level. A related shift sees increasing focus on the social factors that underlie vulnerability to HIV infection, rather than the traditionally more narrow focus on individual ‘risk’ behaviours.

(Adobe PDF document 7 pages 119 kb)

Literature Review: Engaging with culture in HIV/AIDS communications

Mary Marsh (2004)

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This literature review explores current thinking and analysis of the role of culture in development communications addressing HIV and AIDS prevention, treatment and care. It takes as its starting point the relationship between culture and the global strategic response to HIV/AIDS,
tracing the implications of an absence in cultural thinking in global action strategies devised by lead bodies.
It explores recent progress in developing a cultural approach to HIV/AIDS, including work by UNESCO, and the challenges faced by current dominant modes of development communicationswhich draw on cultural approaches. The primary challenges, it argues, stem from an overt focus on behaviour change, coupled with the dominance of Western-derived IEC (Information, Education, Communication) methods which allow little space for community participation. A further challenge arises from current Monitoring and Evaluation methods.
The ‘levels’ model of culture and development, which evolved from the Routemapping Culture and Development project by Creative Exchange, is seen as offering an opportunity for a more complex understanding of the relationship between culture, development and development communications.
The review makes the point that adapting current modes of development communication to incorporate more culturally sensitive approaches will require greater commitment to community participation, and wider recognition of cultural issues among development actors.
To achieve this may require a shift in institutional thinking among donors and delivery agencies towards greater acceptance of culture in development and towards a partnership-based approach to HIV/AIDS strategy delivery. The review briefly addresses how further activities in this project are designed to contribute to this process.

(Adobe PDF document 26 pages 285 kb)