HIV / AIDS Behavior Change Communication (BCC) for adolescents in developing nations
Statistics (UNFPA, 2003) indicate that 70% of over a million children ranging between 10-19 years live in developing nations. Increase in the need for formal education, computer technology and knowledge of the internet, media exposure to new ideas, different employment opportunities and telecommunication mark the major differences between the modern children and their parents. There is also a remarkable change in the environment in which young people make decisions related to sexual and reproductive health. The initial age that the young people learn about sex during adolescence is also on the rise as many learn more at younger ages (Ali & Cleland, 2005; Gupta & Mahy, 2003), with the concept of childbearing closely disassociated with getting married (Bearinger, Sieving, Ferguson & Sharma, 2007).
Almost every country in the Sub-Saharan Africa suffers from the epidemic of AIDS, with early sexual activity ranking top on the risk factors that has led to the widespread of HIV (Pettifor et al., 2004).
The spread of HIV among adolescents in Sub-Saharan Africa is ranked top compared to any other part of the world (Joint United Nations Program on HIV / AIDS, 2004), with young people accounting for close to two-thirds of the population. Programs that are taught in school have proven to be of great impact on the youth regarding their choice for sexual and reproductive health education because they obtain at least some form of education (United Nations Department of Economic, 2008). Despite this positive development, latest reviews on the interventions of HIV programs taught in school have on the other hand proven to have mixed results on the population (Paul-Ebhohimhem, Poobalan & Van Teijlingen, 2008; Kirby, Laris & Rolleri, 2007).
Adolescents who do not attend school, however, miss out on such interventions. Regulations that are ideologically driven have additionally prevented interventions on sexual and reproductive health lag behind (Cleland & Ali, 2006). The limitation that comes about because of lack of money has made many countries shift their attention to community-based programs on HIV prevention as opposed to sexual and reproductive health. Another major way that sexual and reproductive health can be taught is through the guidance of parents that they give to their children.
This avenue is however a bit inconvenient because the same parents never received any form of knowledge from their own parents or teachers, a situation that has rendered them incapable of passing that same knowledge to their children.
All over the world, different programs have been on the front line to provide possible solutions to the sexual and reproductive health needs of adolescents. This is because it is the adolescents in the present time that will give way to the social, economic, sexual and reproductive health and overall well-being of all nations worldwide in the coming years.
The context of the rapidly evolving world provides need for the correspondence between communications and other interventions meant to improve the sexual and reproductive health of adolescents (Hindin & Fatusi, 2009). In dealing with adolescents in developing countries, donors, partners, collaborators and potential collaborators have managed to develop the use of the HIV / AIDS strategy as documented by the Behavior Change Communication document below.
Behavior Change Communication (BCC)
BCC is an inclusive process with communities that help come up with approaches that develop positive behaviors, increase individual well-being, change of community and societal behaviors and maintain good behaviors. In relation to the AIDS epidemic, BCC is a vital part in providing services like medical, social, psychological and spiritual, and commodities like condoms, needles and syringes. For successful behavior changes, there is a need to understand HIV facts, change attitude, and access required services for prevention, perceive the environment as promoting change and maintaining safe behavior.
The community needs to give an appropriate environment to discuss relationship, sex and sexuality, risks and risk behaviors and cultural practices that promote transmission as opposed to the notion that HIV is only a sexually transmitted infection. The environment should also provide support for reducing stigma, discrimination, and law / policies as well.
Cultural practices and ideologies that promote transmission should also be eradicated because of the epidemic. A wider socioeconomic impact of the epidemic should mobilize the program politically, socially, economically and provide responsible interventions to the program.
Role of behavior change communication
For a broad prevention, care and support of the HIV / AIDS program, BCC is a very necessary aspect that needs to be put into consideration. An effective BCC has many different but equally related roles too:
Make sure that people receive the basic conceptual facts concerning HIV / AIDS that they easily understand in a language they are familiar with to increase knowledge.
With the help of BCC, community and national discussions are made possible. Once the dialogue is stimulated, various facts about HIV / AIDS are discussed, factors (risk behaviors and risk settings) (e.g. The use of drugs) that contribute to the spread are also talked about, environments and cultural practices that create the conditions are put to the table as well. Various ways of prevention, care and support are also made known in the process of the discussion.
Teaching and reinforcing of new skills and behaviors that encourage improvement skills for self-efficiency is also covered by BCC. A sense of confidence when making and acting on decisions is made possible for instance the use of condoms, negotiating after sex and practices of safe injections.
With BCC, individuals and communities are made bold so as to demand for information about HIV / AIDS and other related services of the same.
Once BCC is done, the risk of stigma and discrimination is made possible. Communication about HIV prevention and reduction of AIDS should seek to address the problem of stigma and discrimination and also try to influence how the society responds to them as well.
Attitude change is also a factor that is covered under the BCC. How one perceives the risk of HIV infection, how they believe and access their rights and responsibility, how they adopt the use of safe practices, broadening their mindsets about the infected and affected population and carrying out the provision of services without judgmental attitude can all be changed by BCC.
BCC is also capable of promoting services for STIs, orphans and vulnerable children (OVCs), voluntary counseling and testing (VCT), support groups for people living with AIDS, intravenous drug users (IDUs) and prevention of mother to child transfer (MTCT).
Framework for BCC Design as a Process of Changing Behavior
Behavior change theories serve as the basis of the development of BCC dating from the past years. Its foundation holds a lot of worth to use in coming up with a well elaborated communication strategies and programs, e.g. The Diffusion of Innovations model by Everett Rogers. The process of behavior change involves many steps for individuals, community, or institution that goes through it.
Such steps include moving ahead, backwards or even skipping others at times. There are certain instances when the individual, community and the institution may go back to their old behaviors as much as they have taken into use the new behaviors.
Different avenues have proven effective at different stages for achieving different goals, with that same reason is vital to understand where majority lie in the change process when designing a BCC strategy. Communication is vital to ensure the right information is received by a target population for positive attitude response.
The policies of the wider social environment on the contrary become more important when an individual or community is driven towards trying out new behaviors. The availability of the activities, services or products for promotion is a must-have when the target population is ready for change.
The main goal of the program is to reduce the prevalence of HIV among adolescents in developing countries.
Behavior change goals include the increase of condom use, delay first-time sexual performance, reduce the number of partners, and increase STI behavior when in need of care.
Among the goals of BCC include increasing the demand for services and information about HIV, promote the manner in which communities accept youth sexuality and value reproductive health, change attitude about condom use and gain the interest of policy makers to invest in youth-friendly VCT services.
The above mentioned BCC goals relate to particular issues that have been identified during the process of assessing the situation, knowledge, attitudes and skills that require change in order to achieve behavior change and goals related to the program.
The world record of the total number of people under 18 years stands at 2 billion; a number that makes up half the population in developing countries and below a quarter of the developed ones. They suffer from basic survival to discrimination and being exploited as major challenges. In as much as children worldwide have similar traits, optimism, open mindedness and curiosity being their strength, which is the one thing that they beat adults with.
Children in different countries…