Role of information, education and communication materials in HIV control: A perspective

Globally, number of people living with HIV/AIDS (PLWHA) was estimated to be 35.3 million and an estimated 1.6 million people died of AIDS-related illnesses by end of 2012. ^[1] Although a significant progress has been achieved in global HIV response since 2001 like 33% reduction in number new HIV infections in 2012 compared with 2001, AIDS-related deaths have decreased by 30% since 2005, a large proportion of HIV-infected people in need are far from receiving effective anti-retroviral treatment (ART), care and prevention. ^[1],[2] As per WHO estimates, over 16 million HIV-infected people, mostly in low and middle-income countries, do not have access to appropriate ART in 2013 and still there is no cure. ^[2] Thus, in resource-poor setting countries, reducing sexual risk behaviors by raising HIV/AIDS awareness and dispelling myths about HIV/AIDS at the individual and community level remain the mainstay of prevention and control of this deadly menace.

From the start of HIV epidemic, the HIV-related stigma, discrimination and denial have fuelled the transmission of HIV, impeding positive response to adequate care, support and treatment worldwide. Information, education and communication (IEC) campaign is one of the most common cost-effective behavioral intervention strategies implemented so far to fight against HIV/AIDS. ^[3] The primary goal of such IEC program is to inspire and educate people about prevention, care and/or treatment of HIV/AIDS and for a better understanding of HIV in a more comprehensive way. ^[3] Findings from prior research have indicated the usefulness IEC messages and materials in improving stigmatizing and discriminatory attitudes towards HIV positive people. ^[4],[5]

Although prior research have shown a positive impact of IEC materials, existing HIV/AIDS-related knowledge, attitudes, and beliefs of people are far from satisfactory. A great deal of ignorances and stigma are still prevalent among people all over the world. A systematic review of pre-post educational, behavioral and psychosocial intervention studies among young adults aged 11-25 years in less developed countries like Africa and Latin America published in 2004 indicated that these interventions were not much successful in increasing HIV/AIDS-related knowledge and influencing their positive behavior. ^[6] Studies have also revealed significant information gap about HIV among physicians, nurses and other health care providers, and more so among the other high risk groups like men who have sex with men (MSM), female health workers (FSW), injecting drug users (IDU). ^[7],[8]

Existing HIV/AIDS related IEC materials are often insufficiently comprehensive or inadequately designed to local needs and issues. In many instances, print-based IEC materials are too lengthy, often repetitive, extremely generic, boring, outdated and even inaccurate at some places. The biggest concern is the poor translation of the materials from English to local language by nonprofessionals. Another problem identified is the lack of consistent collaboration and communication among different organizations that deal with HIV/AIDS including NGOs and Government, which have resulted in duplication of funds and IEC materials.

The effectiveness of IEC materials largely depends on relevance, appeal, uniformity, simplicity of the content and language, accuracy of information, length of the material, cultural appropriateness, availability and modes of dissemination such as videos, brochures, posters, pamphlets, booklet, new flip book, and interpersonal communication. Designing and developing specific IEC materials targeting specific groups like adolescents, pregnant women, general population, school dropouts, bridge population like migrants, truckers, other high risk groups like FSW, MSM and IDUs, PLWHA and their family members is also essential to change community attitudes. Increasing access to such materials through an organized distribution network and proper utilization of mass media are vital steps in improving overall HIV-related knowledge of a community which in turn will help to build a more positive social environment. Smaller organizations with limited funds might help in raising awareness by disseminating mutually reinforcing messages through establishment of a centralized resource center like organizing the drama, theatre and puppetry in the communities. Dissemination of HIV/AIDS related information through internet might be a good option for young people as it offers confidentiality. Availability of nonprint materials or materials in simple language with more graphics for communities with low literacy levels might be useful in raising HIV/AIDS awareness. There is also a strong need for monitoring and evaluation of IEC materials at regular intervals to incorporate the necessary changes as evident from ongoing research over time.

In addition, training of health care providers including physicians, nurses, community workers and other outreach workers and updating existing materials are strongly recommended. Building good rapport and perceptions of trustworthiness by clients are important predictors of a successful IEC campaign. These behavioral interventions should be combined with the provision of other services (free or at minimum costs like distribution of condoms, treatment of common illnesses) and strong political commitment for its sustenance.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.144996