BBC Media Action Feed

Let's Talk HIV

2013-11-29T11:27:45+00:00

Film is not just a big business in Nigeria. It’s huge. Every year nearly 2000 movies are made, a production rate which beats Hollywood, only coming second to the world’s largest film industry, Bollywood. But when the important topic of HIV and AIDS comes up in many Nollywood movies and Nigerian songs, it’s often not accurately - or helpfully - treated.

Our team at BBC Media Action in Abuja recently set out to tackle this by talking directly to the musicians, comedians and filmmakers behind our booming entertainment industry.

As part of the ENR (Enhancing Nigeria’s Response to HIV) project funded by the UK’s Department for International Development, we ran two workshops in Lagos. These aimed to not only inform the producers, directors, singers and scriptwriters about HIV but also encourage them to tackle the subject in their songs and films.

This year World Aids Day – 1 December – is encouraging people to ‘act aware’ (Photo by Brent Stirton. Getty Images for the GBC)

According to Nigeria’s National Agency for the Control of AIDS, 3.5 million Nigerians are currently living with HIV. But misconceptions about HIV and AIDS are common.

Our workshops gave people – including some of the biggest names in the industry – the space to ask questions and fill in the gaps in their knowledge.

From left to right: Musician Ade Bantu, comedian Koffi, musician KA$H-11, HIV-prevention specialist Dr S Oyedeji, music producer and actor David Nnaji, and musicians Tee-Y Mix and Daddy Showkey.

I remember one filmmaker admitting he didn’t know enough about the effects of HIV and another asking about whether hair clippers can transmit the virus.

And as well as the scientific facts, participants learned about audiences’ knowledge and behaviour – and met people living with HIV.

Producer, writer and director, Elimihe Osezuah told us that the experience was life-changing: “Opening my mind to the fact that HIV is manageable and seeing healthy HIV-positive people is mind-blowing. I shook their hands and hugged them.”

By the end of the workshops, many of the participants also appreciated the role they could play in tackling HIV. One filmmaker told us that she had learned “that HIV and AIDS-related messages are not as over-flogged as I thought. Awareness [of HIV] is less than enough.”

We also scored some exciting, immediate successes: two filmmakers gave their recently completed scripts to our team so they could be checked for accuracy and several of the filmmakers who attended agreed to work with us to produce scripts for four short films about HIV.

By the end of the two days, many others had made promises to interweave information and messages about HIV into their music, films and blogs.

Nigerian/German Ade Bantu said he would “engage my audience by sharing condoms and leaflets during shows, incorporate HIV messages in our music videos and use my blog to share information about HIV and AIDS”.

Singer J’odie said she would “subtly weave in the urgency of [tackling HIV] into my work”, writing a song to “inform and entertain people, nudging them towards a new mind-set towards HIV”. Another filmmaker, meanwhile, promised to write short comic skits targeted at 15-24 year olds which would be available online.

Almost all the participants told us they’d be happy for us to hold them to their promises.

And I, for one, just can’t wait to see what they create.

Related links

BBC Media Action’s work in Nigeria

BBC Media Action’s work on health

World Aids Day

Follow BBC Media Action on Twitter and Facebook

Go back to BBC Media Action

Getting to Zero?

2012-11-30T12:23:48+00:00

From the despair of the 1990s and early 2000s, there is hope. Hope that the theme of this year's World AIDS Day, Getting to Zero, isn't just a pipe-dream. What does getting to zero actually mean? It means zero new HIV infections. Zero AIDS-related deaths. Zero discrimination.

OK, so according to UNAIDS, during 2011 around 2.5 million people were newly infected with HIV. But that's down from 3.2 million in 2001. And half of the decrease of new infections over the past two years alone has been in newborn children. That's proof that getting to zero new infections among infants is entirely achievable. It should be among adults, as well. We know how.

Globally, there were half a million fewer deaths in 2011 than in 2005, a reflection of the ever-increasing availability of anti-retroviral therapy (ART). Again, proof that zero AIDS-related deaths isn’t an entirely unrealistic thought.
Zero discrimination is probably the hardest to achieve. Though if the first zeros are achieved, then this too will become a thing of the past.

I first became involved with HIV while working as a reporter in Thailand in the mid 1990s. Visiting orphanages for babies and very young children dying from AIDS was a desperately sad, profoundly moving experience. There was no one there over the age of five. They had all died.

What really stirred me into 'doing something', were visits to a hospice for people abandoned by their families to die lonely, painful and frankly, at that time, undignified deaths. And this was the result of stigma. As a reporter, I was able to give these people a voice, I offered them a space in which to tell their stories to a wider audience, to slowly break down the stigma.

This is just one role media and communication can play in getting to zero. It offers those infected and affected by HIV an opportunity to shape the response to the epidemic. It can, and has, also led to positive social and behavioural change. BBC Media Action’s work in India around condom use is one such example.

The role of communication is also rapidly changing, as the range of prevention and treatment technologies increases. There may be no vaccine yet, but the lone, loud cry of 'ABC' (abstinence, be faithful, or use a condom) has fortunately be joined by other prevention strategies.

As long suspected, the role of ART in prevention was formally recognized earlier this year. Taking anti-retroviral therapy reduces the amount of virus in a person’s body, making them far less infectious. This has increased the imperative for getting more people on to ART, both for their own health and for the health of others.

As well as a huge challenge for health systems, it’s also a communication challenge. People need to know how to take ART properly so it doesn’t fail. Those needing ART also need services that meet their requirements. Sticking rigidly to a daily drug regimen is hard if the nearest clinic takes a day to reach and supplies have run out when you do get there. Media can help people voice their needs.

Scientific trials have shown that medical male circumcision can reduce a man's risk of becoming infected with HIV through heterosexual transmission by up to 60%. As a result many countries are trying to scale-up voluntary medical male circumcision services. Again, communication has a large, integral role to play at both the mass and interpersonal levels.

Male circumcision is far more complicated than a simple operation. It's an issue rooted in tradition and culture. Communities need understand the benefits and risks of services being made available. People need to be empowered to make informed decisions about whether or not they choose to have the procedure (or to circumcise their infants). They also need to know that circumcision is not a magic bullet. It doesn't offer as much protection as condoms. It needs to be part of a package of prevention strategies.

Media and communication also have a role to play in intensifying prevention efforts around three key groups: men who have sex with men, people who inject drugs and sex workers. Without focusing on these highly stigmatized and marginalized groups, we won't be getting to zero. While interpersonal communication is of utmost importance, mass media can reduce societal stigma and discrimination; it can also enable people to realize their rights.

The challenge is still huge. The number of new infections and deaths is still unacceptably high. But at least there is now genuine hope. And BBC Media Action is committed to continually innovating in its work around HIV to make getting to zero a reality.

Related links

World Aids Day

From the BBC Media Action blog:

Skating around social and behavioural change in the global response to HIV

Elsewhere on BBC Media Action:

Nigeria: Tackling stigma and delivering long-term change

India: Condom is just another word

BBC Media Action’s health work

Go back to BBC Media Action

Skating around social and behavioural change in the global response to HIV

2012-08-03T14:30:13+00:00

Waiting to cross the street outside the International Aids Conference in Washington DC last week, two teenage skateboarders noticed my branded conference bag and asked what it was all about. One asked about HIV testing, the other wanted to talk about how he could protect himself, confiding that he hasn't always used a condom.

Knowing that my conference goody bag included a pack, I asked if he wanted some and handed them over. As I crossed the street, I turned back and reminded them, "Don’t forget to use a condom every single time!"

Back at the conference, which was on its fifth and final day, I was struck by the lack of discussion about the role of awareness and behaviour change. With HIV having been around for decades and with most of the seriously affected countries having invested in information campaigns over the years, basic awareness seems to be taken for granted.

But is the job done? What about the next generations and tackling misinformation or denial about risky behaviour? Even in a country like the US, with universal education, and in the city with the highest prevalence of HIV in the country, this skateboarding duo had limited information.

So if the International AIDS Conference wasn't talking about awareness, what was the buzz? The biennial International AIDS Conference is usually dominated by announcements about progress in HIV science, such as advances in medicine to prevent mother to child transmission of HIV or improved drug therapies for treatment. This year, the big topics were treatment as prevention and voluntary male circumcision.

Treatment as prevention is a reference to treating an HIV positive person with anti-retroviral drugs that improve the health of the patient as well as reduce the probability of the virus transmitting to uninfected sexual partners (because treatment reduces the potency of the virus in the infected patient). Studies have also found that circumcised men have a reduced chance of infection than uncircumcised men.

Results from research published on the effectiveness of these two prevention methods offer new and diversified approaches to augment existing prevention efforts. These medicalised prevention solutions are particularly salient in countries where there is a generalised epidemic (where HIV prevalence is over 1% of the population) and in professional contexts (sex work) where risk levels are high.

But equally important to biomedical solutions is highlighting the importance of other major factors pertinent to the global response to HIV – social and behavioural influences on health and the significant role that information and communication can play in addressing these. In order for treatment as prevention to be a scaled prevention strategy, knowing one's HIV status is critical.

Globally, it is estimated that 33 million people are living with HIV, though only 25% are on treatment. Many people living with HIV do not know they are infected, which is one reason why UNAIDS estimates that 7 million people in low- and middle-income countries who are eligible for HIV treatment are not accessing it. It is important to get tested early, though many people are only tested once they have become ill.

It is not enough to address the supply side of testing alone – demand for testing needs to be tackled as well. Mass media campaigns can be effective at promoting testing and addressing the barriers to testing, such as ignorance and fear. For example, 20% of viewers of BBC Media Action's Indian TV reality show Haath se Haath Milaa (Let's Join Hands) said that they ever felt like getting tested for HIV compared to 11% of non-viewers.

Media and communications have been shown to be effective in addressing other influences on behaviour relevant to prevention. From 2007-2009, our condom campaign reached 150 million men across India and helped change attitudes towards condoms across a range of criteria. Based on impact measurement data, embarrassment around purchasing condoms decreased and men were more likely to discuss and use them, compared to men who were not exposed to the campaign.

Although the International AIDS Conference is a good representation of the latest global thinking and approaches to HIV and AIDS, my hope now is for sustained investment in social and behaviour change programmes in addition to bio-medical solutions.

In light of exciting new developments in science, we cannot forget about people like the skateboarders on the streets of DC who lack basic information or the men in India who fear negative judgment from their community if they are seen to be purchasing condoms. What is needed is a mix of solutions to truly achieve UNAIDS’ vision of "getting to zero" new HIV infections, discrimination and AIDS related deaths.

Related links

Condom is just another word

Word Aids Campaign: Getting To Zero

Elsewhere on BBC Media Action: Ringing in success: creative AIDS communication

Go back to BBC Media Action

Ringing in success: creative AIDS communications

2012-08-01T14:17:13+00:00

Jasoos Vijay, the HIV-positive, crime-fighting hero, was a huge hit on Indian TV.

It's been six years since I sat in the shade of a tree in a remote village in Rajasthan, India, chatting to a fan of our work. I asked the man of the house if he watched Jasoos Vijay, our TV drama series featuring an HIV-positive detective.

He jumped up from his stool, disappeared into his hut, and returned holding a deep tin box, the kind used to store foodstuffs to protect its contents from the desert heat. He smiled as he pried open the lid and allowed me to peep inside.

The box contained a small TV, which he said he would connect to a power source on Sunday nights to watch Jasoos Vijay (Detective Vijay). Despite an irregular supply of electricity in his village, this man was one of nearly 70 million people from across the country who tuned in to watch the fast-paced adventures of the detective.

While attending the International AIDS Conference 2012 in Washington DC, I reflected on how far we have come from the early days of AIDS communications. When BBC Media Action started working on HIV awareness in India in 2001, HIV was a nascent but growing concern.

Sexually active men were the key audience in our efforts to communicate basic facts about the routes of transmission and the means of prevention. We knew that men like adventure and car chases, and so the smart and street-wise Jasoos Vijay was born.

Jasoos Vijay was a weekly half-hour television drama that provided accurate information about HIV to viewers through entertaining storylines. First broadcast in 2002, it became a family favourite over the next four years, often featuring in the top ten most watched TV shows in the country and winning several television awards. Once it was revealed that the hero Vijay was HIV positive, and importantly, that access to testing and treatment in India was becoming a reality, we could address more complex issues related HIV diagnosis, treatment and on-going care.

By 2007, it was clear that HIV was considered a "concentrated epidemic" in India, meaning that the prevalence of HIV was concentrated among high-risk groups such as sex workers, injecting drug users and men who have sex with men. Therefore, the focus of our AIDS communication changed from awareness raising among the general population to more catered communications addressing the information needs of high risk groups.

We needed to tackle taboos surrounding condoms. Research showed that a major barrier to condom use was embarrassment in purchasing them and fear of negative judgement when seen to be a condom user. We produced a multimedia interactive advertising campaign on TV, radio, outdoor and mobile with the goal to 'normalise' condoms and associate them with smart and responsible behaviour. If we make condoms more socially acceptable, then men, especially those in the high-risk groups, will have a more supportive environment to use them.

There had been a lot of advertisements on HIV prevention in India so it was essential that we produce a campaign that would get people talking and would be memorable. At the time, India was the world's fastest-growing mobile telephone market, with 300 million users and 10 million new subscribers a month. In a country where mobile ringtones are very popular, we capitalised on this trend, creating the first ever mobile ringtone with a health message – a condom themed ringtone!

Those who wanted to show support for condoms, or those who just liked the ringtone, could download it on their phones. When the phone rang, people would react – we hoped – and taboo-breaking conversations would ensue. The aim was that embarrassment about the word would gradually reduce and condoms would become 'normal' health products.

We received nearly 700,000 requests to download the ringtone and the government of India adopted the campaign and used it in its own HIV-prevention efforts. It made the front page of the Times of India, CNN listed it as the most novel condom campaign in the world and the ringtone topped a list of must-have ringtones in India. And, most importantly, condom purchases increased.

Mass media, whether it is through thrilling TV dramas, public service advertisements, or content on mobile phones, can be excellent platforms to deliver life-saving information and shape positive social norms. The popularity and effectiveness of Jasoos Vijay and the condom ringtone, among other initiatives in BBC Media Action's ten years of HIV and AIDS communication, reflects that’s it is possible to fulfil the BBC’s mission to inform, educate AND entertain.

Related links

BBC Media Action: Condom is just another word

Go back to BBC Media Action

Telling a new story: Somali journalists talk about HIV and AIDS

2012-07-26T10:34:45+00:00

BBC Media Action training tackles widespread misinformation and stigma in the media around HIV and AIDS

While world leaders and prominent scientists are among the 25,000 delegates attending the 19^th International AIDS Conference in Washington DC this week, I am reminded of a much smaller group that got together earlier this year to talk about the same issues. In March I gave a training workshop – part of a series of three – to 20 journalists and civil society workers from Somaliland and Puntland in Somalia to help them tackle widespread misinformation and stigma in the media around HIV and AIDS.

In Somaliland and Puntland sex outside marriage, homosexuality and talking about condom use are all taboo. In such a conservative environment, conversations about HIV are difficult. That silence is often filled by harmful misconceptions and prejudices which are repeated and reinforced by inaccurate reporting and stigmatising language. Widely held beliefs about prevention and treatment – that drinking camel urine cures HIV infection, and that female genital mutilation prevents it – only compound already complex cultural and human rights issues.

On the first day of the workshop I asked the reporters and civil society workers to write down how they felt about HIV and AIDS. Their responses, especially from the journalists, highlighted fear. They equated HIV with death, and expressed hatred against people living with HIV.

I was helped enormously in the workshop by three Somali women who live with HIV and are open about their status. For most of the journalists, the workshops were their first known encounter with someone living with HIV. During an exercise in which the reporters interviewed them, one woman felt that the reporter’s body language was tense and nervous – he was careful not to touch her. A second woman felt that she was being blamed for being HIV positive.

But over the course of the week, we all witnessed and experienced a marked shift in attitudes towards HIV and AIDS, from fear and misinformation to genuinely enhanced understanding and empathy. One journalist told me frankly that he never knew that HIV positive mothers could have healthy children. Over the course of the three workshops, the journalists became friends with the three women who bravely gave their time and energy to help challenge the stigma that surrounds HIV and AIDS, and were sharing food and hugs with them.

Though miles apart in terms of scale, the International AIDS Conference this week and the workshop that I gave are, to my mind, part of the same effort. While some of the greatest minds in the field share best practice on prevention and treatment in Washington DC, that group of 20 including eight radio producers who met in Hargeisa, Somaliland, early this year started something small but significant.

The journalists knew that convincing their station managers and editors to report on HIV and AIDS at all, let alone accurately and fairly, would be difficult. They were concerned that their motivation in reporting on HIV and AIDS would be viewed with suspicion, and about how reporting on HIV and AIDS would affect their ratings. However, they left the training with ideas for stories on landlords evicting tenants they discover to be positive and examining government budget allocations for HIV and AIDS programmes. In a country such as Somalia where news consumption is high, changing the way that HIV and AIDS are talked about in the media can change the way that they are talked about across society. One small group of committed journalists and civil society workers has the power and influence to shape how the story of HIV and AIDS is told.