0.6 Condoms and controversy  (Page 2/2)

Role models (movie stars and sports figures) have engaged in a public relations campaign to restore pride and dignity toHIV-infected people ("I am Positive"). While such a campaign may be essential to ensure civil rights and active participation in society, anunintended consequence may be the elevation of one's HIV-Positive diagnosis as a status symbol.

Addressing resistance to condom use - 2 studies

There are several HIV-AIDS programs designed to change behavior. Some focus on facts where little information isavailable. Others try to infuse frightening messages about HIV-AIDS. Still others integrate the personal elements (showing the effect ofknowing someone with AIDS on one's own behavior, for example).

Each HIV-AIDS program must be designed with evaluation techniques that use consistently accurate appropriatedependent and independent variables and analyses that can quantify the connection between education programs and changes in behavior.

As was shown in the Topic: "Resistance to Condom Use," attempts have been made to reduce feelings of invulnerability so that youngpeople do not engage in unprotected sex. The key is to integrate factual material with personal identification and engagement in order for the lessons to rundeep.

Two studies have been conducted with young people to determine the clues and strategies for helping them change their behavior.We have chosen to focus on these two approaches to HIV-AIDS education because they integrate personal engagement and good teaching. We stressthat the creative presentation of programmatic materials is as important as the factual presentation of materials.

In the first approach , researchers focused on whether or not young people really "knew" about a person's HIV status, based upon a look atphotographs and that person's brief statement about his/her sexual history. Many students were unable to produce an accurate score of HIVNegative and HIV Positive people. This study was based upon the idea that a student's sudden confrontation with his or her failed perceptions wouldchange behavior. In this case, such a change would result in not relying on appearance and a statement from a potential partner. Protection would thentake place as a matter of course.

It has been suggested that the study using photographs take on longitudinal elements by following the lives of young people picturedin the photographs for several months or years. In this way, several variables can be studied, including: a) a longer term analysis of thestaying power of the exercise itself - is it continuing to work? b) a reinforcing of the point, such that subsequent groups of studentsparticipating in the photo-identification project could see the deterioration in the lives, over time, of those infected by HIV. Aseemingly bright and beautiful face one day then turns into the face of disease.

In the second approach , researchers focused on negative health events as a compelling way of demonstrating a willingness to usecondoms. In such cases, young people spoke about the STDs contracted. In addition, a 20-minute video was shown. Studies have shown an initialcommitment to use protection, though it is not entirely clear whether or not the pressures surrounding participation in the study itself may not havehad an effect on young people, who may feel pressured to provide the "appropriate," rather than the truthful, answer.

Both approaches were followed up by questionnaires at three and six months asking whether or not the young people had been sexuallyactive in the intervening time and the degree to which they intend to use condoms.

FINDINGS&FOLLOW-UP

The intention of both studies is to reduce feelings of invulnerability and increase condom use. Both approaches showed demonstrable effects in reducing feelings of invulnerability andincreasing the intention to use condoms. The results of this "stand-alone" intervention may be limited to some degree. The message remains. Theteenagers' lack of ability to guess accurately the health of those in the photographs translated into a sense that: a) they may be wrong; b) thepicture they viewed could, perhaps, one day be of them.

Future studies are being tested to overcome obstacles to condom use that extend beyond the perceptions of teenagers -availability in numbers and ease of access, social stigmas, myths about condoms, for example.

The post study is as important as the study itself, for the questionnaire itself is explicit about questions directed to youngpeople about their own sexual behavior. These private issues are public insofar as the young people are participating in such a study and thefollow-up surveys, which acknowledge their sexual activity. (We do not know what the drop-out rate is to determine the degree to which fear of suchquestions may have frightened some participants away.)

A conclusion that can be made, however (based upon a larger body of research in adolescent psychology) is that threatening orfrightening images or programs showing the connection to and consequences of a particular behavior (in this case, unprotected sex) have beenmarginally effective, but short term. Recent studies have shown success in mitigating cigarette smoking amongst teens by showing dirty lungs, but theeffects do not last because such messages are not personalized. Even more, some young people resist such messages as authoritarian and, therefore, goin the opposite direction - toward greater risk taking.