A doksi online olvasásához kérlek jelentkezz be!
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2011. március 20.
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Censure In this paper entitled „HIV/AIDS and injecting drug use: Information, education and communication” the authors (Peter Aggleton, Paul Jenkins, Anne Malcolm) approaches the field of HIV/AIDS prevention and harm reduction among injecting drug users. We all know that it is a broad context to deal with, but here the readers can learn more about a specific point of view: how information, education and communication (IEC) can affect the behavior of injecting drug users (IDUs), emphasizing different kinds of intervention. Those who work (or interested) in the field of HIV/AIDS prevention all know that nowadays the spreading of HIV infection is a growing problem among IDUs, not only in developing countries but in developed countries as well. The result of interventions used mainly in developed countries can be encouraging for IDUs living – for example – in countries in transition, that the risk of HIV infection may be successfully reduced. The authors emphasize that IEC can also
be used for the prevention of HIV among injecting drug users, despite the fact that there is not too much evidence for its success. One of the most important things related to this is that IEC by itself cannot “work a miracle” rather combined with other means it would be much more effective. Published materials of this field discuss that the different IEC strategies work mainly on the individual level, so how individual IDUs can change their behavior to reduce the risk of HIV infection. Moreover, when analyzing the IEC approach, people must take into account how the applied intervention works, as well as its result and effectiveness in the programmes. This paper also points out that in case of the prevention of HIV/AIDS three main factors are needed for the achievement of positive and remarkable effects. Most importantly, without good quality information, health services and supportive social background there is little chance that anyone, trying to reach sustainable result in this
field would be successful. Regarding the levels of interventions, the authors discuss and distinguish between six types of individual level approaches (mass reach interventions, outreach work, harm minimization, drug cessation/treatment programmes, voluntary and confidential counselling and testing, risk reduction counselling) and two kinds of structural interventions (structural and environmental outreach work). HIV/AIDS related information campaigns are the widely used form of mass reach intervention, however it is difficult to find out whether this kind of intervention is really successful in the prevention of the spread of infection among IDUs. The paper mentions that there are many elements that are needed for a mass reach intervention to be successful: among others the most necessary ones are vocabulary, language, the style in which the IDUs are addressed, not to mention the stressing of short term effects rather than the long term results. 1 Besides mass reach
intervention, the outreach intervention can be also useful in reaching the IDUs, since the main aim of it is to give them information on how to get to know with the available medical care and social services, so ensure them that they are not alone with their problem. Similarly, IEC can play an important role in informing IDUs what kind of treatment facilities and programmes are available, not to mention the fact that IEC can be successful in harm reduction too. In their difficult situation the decision-making of IDUs can be supported by counselling approaches (voluntary and confidential counselling and testing, risk reduction counseling). The mentioned individual level interventions of IEC can have the most sustainable effect in the prevention of HIV/AIDS among IDUs when combined with the structural approaches that aim to create a safer environment that surrounds IDUs, including the hard to reach as well as the marginalized groups. In my opinion, information, education and
communication play an important role in the prevention of HIV/AIDS, despite the fact that there is little relevant evidence for this. The paper mentions different forms of intervention that can reach the IDUs, now I would like to take a closer look in the massages that are provided through audio-visual media. We all know that TV programmes nowadays have a great effect on people watching and hearing television or radio broadcasts, that is why I would surely increase the number of programmes dealing with the topic of HIV prevention. Moreover, it would be a good idea to establish a TV channel that deals only with this topic: there could be interviews with invited IDUs, doctors, specialists working in this field etc., who could share their knowledge or give advice, for example how to change their risk-related behavior, where to go for medical care, what kind of available prevention programmes are available. I think, IDUs who were invited to take part in such TV programmes can then talk to
other IDUs, and in this way the necessary information can spread more successfully. As I read the paper, I missed the mentioning of today’s most widespread communication form: the Internet, a topic in which I am mainly interested in. My opinion is that if we talk about information, education and communication in any field of prevention, people cannot leave out Internet, since in the 21th century it has an important role in information provision as well. On the Internet, we can find millions of pages dealing with the prevention of HIV/AIDS, although I know that there are still people who do not have the chance for surfing on the webpages. For me, structural level intervention come into the picture here, since besides establishing drug user organizations, I would advise to make the access for the Internet for the IDUs easier, for 2 example in the rooms of the medical or treatment facilities. Of course, illiteracy or other limitations of the IDUs can be a hindering factor in using
the Internet, but with a supportive environment it might be achieved in my point of view. The paper discussed that there are many IDUs who are hidden, or difficult to reach. I would like to emphasize this factor of the article, since I can compare these IDUs to the homeless people, who rarely get in touch with the helping activities and programmes. That is why, social services should organize more events for the IDUs, in which they can get clean needles, necessary equipments similarly to an event arranged for the homeless when they get free meat and drink. I saw many such events, and I am sure that it would be successful for the IDUs as well. Another thing that raised my attention was the controversial example of using fear-based media messages in the prevention of HIV/AIDS. Earlier I attended an exhibition that focused on the prevention and the effects of smoking, and there I found models that showed very fearful examples for smokers. For example, there was the model of a dark black
lung, the result of smoking, and I can say it was a kind of shock tactic, as far as I am concerned. In my opinion, a similar exhibition could be organized, where people or the attending IDUs can get to know with the negative effects of injecting drug use. A third example, in which I would use the main ideas of this paper, is the school, where students can be informed as part of the curriculum about the dangers of drug use. Teachers could invite specialists working on the field of HIV/AIDS prevention to talk about the spreading of this infection and about its negative effects. I think the ideas of the paper could be continued from the injecting drug users’ point of view. Here we read a detailed argumentation about the role of information, education and communication in the field of HIV/AIDS prevention and about the different forms of intervention regarding the individual and the structural level. Despite the fact that the authors mentioned several examples for prevention campaigns,
established organizations and programmes, forms of interventions, I would like to read more about concrete examples and results, how IEC influenced the lives of IDUs. Of course, for this we need the words and experience of IDUs who are concerned with this problem. In my opinion, people can learn a lesson from the story of those IDUs who are still affected by the usage of drugs, as well as those who were IDUs in the past but know are healthy. 3 Reference HIV/AIDS and injecting drug use: Information, education and communication (Peter Aggleton, Paul Jenkins, Anne Malcolm)
be used for the prevention of HIV among injecting drug users, despite the fact that there is not too much evidence for its success. One of the most important things related to this is that IEC by itself cannot “work a miracle” rather combined with other means it would be much more effective. Published materials of this field discuss that the different IEC strategies work mainly on the individual level, so how individual IDUs can change their behavior to reduce the risk of HIV infection. Moreover, when analyzing the IEC approach, people must take into account how the applied intervention works, as well as its result and effectiveness in the programmes. This paper also points out that in case of the prevention of HIV/AIDS three main factors are needed for the achievement of positive and remarkable effects. Most importantly, without good quality information, health services and supportive social background there is little chance that anyone, trying to reach sustainable result in this
field would be successful. Regarding the levels of interventions, the authors discuss and distinguish between six types of individual level approaches (mass reach interventions, outreach work, harm minimization, drug cessation/treatment programmes, voluntary and confidential counselling and testing, risk reduction counselling) and two kinds of structural interventions (structural and environmental outreach work). HIV/AIDS related information campaigns are the widely used form of mass reach intervention, however it is difficult to find out whether this kind of intervention is really successful in the prevention of the spread of infection among IDUs. The paper mentions that there are many elements that are needed for a mass reach intervention to be successful: among others the most necessary ones are vocabulary, language, the style in which the IDUs are addressed, not to mention the stressing of short term effects rather than the long term results. 1 Besides mass reach
intervention, the outreach intervention can be also useful in reaching the IDUs, since the main aim of it is to give them information on how to get to know with the available medical care and social services, so ensure them that they are not alone with their problem. Similarly, IEC can play an important role in informing IDUs what kind of treatment facilities and programmes are available, not to mention the fact that IEC can be successful in harm reduction too. In their difficult situation the decision-making of IDUs can be supported by counselling approaches (voluntary and confidential counselling and testing, risk reduction counseling). The mentioned individual level interventions of IEC can have the most sustainable effect in the prevention of HIV/AIDS among IDUs when combined with the structural approaches that aim to create a safer environment that surrounds IDUs, including the hard to reach as well as the marginalized groups. In my opinion, information, education and
communication play an important role in the prevention of HIV/AIDS, despite the fact that there is little relevant evidence for this. The paper mentions different forms of intervention that can reach the IDUs, now I would like to take a closer look in the massages that are provided through audio-visual media. We all know that TV programmes nowadays have a great effect on people watching and hearing television or radio broadcasts, that is why I would surely increase the number of programmes dealing with the topic of HIV prevention. Moreover, it would be a good idea to establish a TV channel that deals only with this topic: there could be interviews with invited IDUs, doctors, specialists working in this field etc., who could share their knowledge or give advice, for example how to change their risk-related behavior, where to go for medical care, what kind of available prevention programmes are available. I think, IDUs who were invited to take part in such TV programmes can then talk to
other IDUs, and in this way the necessary information can spread more successfully. As I read the paper, I missed the mentioning of today’s most widespread communication form: the Internet, a topic in which I am mainly interested in. My opinion is that if we talk about information, education and communication in any field of prevention, people cannot leave out Internet, since in the 21th century it has an important role in information provision as well. On the Internet, we can find millions of pages dealing with the prevention of HIV/AIDS, although I know that there are still people who do not have the chance for surfing on the webpages. For me, structural level intervention come into the picture here, since besides establishing drug user organizations, I would advise to make the access for the Internet for the IDUs easier, for 2 example in the rooms of the medical or treatment facilities. Of course, illiteracy or other limitations of the IDUs can be a hindering factor in using
the Internet, but with a supportive environment it might be achieved in my point of view. The paper discussed that there are many IDUs who are hidden, or difficult to reach. I would like to emphasize this factor of the article, since I can compare these IDUs to the homeless people, who rarely get in touch with the helping activities and programmes. That is why, social services should organize more events for the IDUs, in which they can get clean needles, necessary equipments similarly to an event arranged for the homeless when they get free meat and drink. I saw many such events, and I am sure that it would be successful for the IDUs as well. Another thing that raised my attention was the controversial example of using fear-based media messages in the prevention of HIV/AIDS. Earlier I attended an exhibition that focused on the prevention and the effects of smoking, and there I found models that showed very fearful examples for smokers. For example, there was the model of a dark black
lung, the result of smoking, and I can say it was a kind of shock tactic, as far as I am concerned. In my opinion, a similar exhibition could be organized, where people or the attending IDUs can get to know with the negative effects of injecting drug use. A third example, in which I would use the main ideas of this paper, is the school, where students can be informed as part of the curriculum about the dangers of drug use. Teachers could invite specialists working on the field of HIV/AIDS prevention to talk about the spreading of this infection and about its negative effects. I think the ideas of the paper could be continued from the injecting drug users’ point of view. Here we read a detailed argumentation about the role of information, education and communication in the field of HIV/AIDS prevention and about the different forms of intervention regarding the individual and the structural level. Despite the fact that the authors mentioned several examples for prevention campaigns,
established organizations and programmes, forms of interventions, I would like to read more about concrete examples and results, how IEC influenced the lives of IDUs. Of course, for this we need the words and experience of IDUs who are concerned with this problem. In my opinion, people can learn a lesson from the story of those IDUs who are still affected by the usage of drugs, as well as those who were IDUs in the past but know are healthy. 3 Reference HIV/AIDS and injecting drug use: Information, education and communication (Peter Aggleton, Paul Jenkins, Anne Malcolm)
