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THE FIGHT AGAINST AIDS
Rachita Ota

The suspense is nerve-racking. Tamanna’s anxiety is palpable. Something has gone terribly wrong. Initially, Tamanna brandishes a shield of denial; you can almost hear her mind’s voice saying, ‘It cannot possibly be anything too serious.’ But her self-assurance erodes rapidly. The doctor informs her that she has tested positive for HIV. Something inside her breaks, and she’s a mess of emotions. The announcement sends her into shock. She withdraws from the world and locks herself up at home. When her employer visits her to enquire about her absence from work, she tells him the truth. Soon she comes to know that this truth of hers has changed the world around her. Suddenly, she has lost everything—her job, her career, her friends. Does Tamanna deserve this? Perhaps this article will help us find the right answer.
The US Centers for Disease Control detected the pandemic virus AIDS (Acquired Immunodeficiency Syndrome) in five homosexual men in Los Angeles on 5 June 1981. At that time, no one could have predicted that this disease would spread throughout the world and pose a terror to society. AIDS is quite common today. Even a school-going child has at least a vague idea of this pandemic. AIDS is a global problem and hence requires our serious attention. Unfortunately, even today people have misconceptions about the disease, such as the belief that they will not be infected because the disease is supposedly confined only among gays. Yet all over the world, men, women, and children are being infected irrespective of their class, caste, creed, race, sex or age. The number of people living with HIV worldwide continued to grow in 2008, reaching an estimated 33.4 million. The total number of people living with HIV in 2008 was more than 20 per cent higher than the number in 2000.
Many factors have contributed to increasing HIV prevalence rates around the world. In most of the Caribbean countries, the spread of HIV is due to unprotected sexual intercourse and intravenous drug use. HIV in Argentina was earlier seen among men injecting drugs and among those engaging in homosexual relations. But now due to increasing transmission among heterosexuals, the epidemic is also spreading among women. In North America and in Western and Central Europe, infections resulting from homosexual relations have increased while infections resulting from intravenous drug use have decreased. People in the Middle East and in North Africa are mostly exposed to HIV during work abroad or through drug use, sex with another man, or sex with a sex worker. So overall the reasons for HIV infection are the same for all the countries.
Various countries have adopted their own ways and means of coping with the problem. Governments in North Africa managed to sidestep the AIDS epidemic because they imposed strict rules governing sexual behaviour. Some Asian countries responded rapidly by launching extensive awareness-raising campaigns. A few countries also encouraged retroviral therapy.
Education has proved to be the best way of fighting AIDS. In this mission, the best resources are people with AIDS as they have the experience of living with the disease and they know how to survive under adverse conditions. Pride Vision, a Canadian television channel, has played a major role in raising public awareness through its news programmes, talk shows, interviews, documentaries, and other programmes related to HIV/AIDS. Television channels such as Pride Vision should be encouraged, and the media should broadcast more programmes that will increase awareness and dispel misconceptions. This is necessary for both the people who are affected and for those who are not. AIDS is a preventable disease, but people should be given the latest and most reliable information about it. They should be empowered to negotiate safe sex, and if they are intravenous drug users they should be taught to administer sterilised injections and use sterlised needles. Many lower-middle-class people go to roadside salons for haircuts or shaves. The use of unsterilised equipment in these salons can also spread the disease. Hence, proper precautions should be taken.
Some international programmes and campaigns that have contributed to creating public awareness and educating people are:
White Orange Youth WAD 07 activities (Sub-Saharan Africa)
The World AIDS Day campaign with the slogan “Stop AIDS – Keep the Promise” (Canada)
Public awareness march in Karnataka state (India)
Wake Up, Pune! (India)
Celebration of Life (India)
Count on Me! (India)
Red Ribbon Ball (Zambia)
Unite for Children, Unite against AIDS (Iran)
National AIDS Trust (UK)
These programmes are useful in fighting the stigma, rejection, discrimination, and violence faced by people with AIDS. Many people assume that AIDS is an airborne and contagious disease and believe that it is spread through physical contact. But the truth is that AIDS is transmitted only through unprotected sex, sharing of needles, blood transfusion, and from mother to unborn child. AIDS is associated with homosexuality, bisexuality, promiscuity, prostitution, and intravenous drug use. The violence faced by people who are HIV positive is so great that it discourages other people from getting themselves tested. We can combat this stigma only if we spread proper awareness among people.
India has made an immense contribution to AIDS awareness through programmes such as Buladi and Balbir Pasha, which were greatly influential in shaping the attitudes of ordinary Indians towards AIDS.
BULADI
The word buladi is readily understood by the people of West Bengal. All over Kolkata—and in the matrimonial pages of local newspapers—one can see this little big-eyed rag doll, clad in a blue sari, with an open and sympathetic expression on her face. From the end of 2004 to mid-2007, Buladi dispensed advice to people on issues pertaining to HIV/AIDS. She faced resistance, generated debate, but continued her work undaunted. After two and a half years, the Buladi campaign was phased out.
On 1 December 2004, the West Bengal State AIDS Prevention and Control Society commemorated World AIDS Day by launching a mass media campaign keeping in mind the broad theme of the World AIDS Campaign, which is “Women and Girls: Have a Say”.
The society hired the advertising agency Ogilvy & Mather (O&M) to devise a communication package for spreading awareness and for educating people about the disease. O&M felt the need for an ambassador with a warm, welcoming, sympathetic nature, someone whom women would trust, and someone who would help them realise that anyone could contract HIV. O&M decided to use Bengal’s traditional and much-loved nyakrar putul (rag doll) as the brand ambassador for the campaign.
The two-year campaign was divided into three phases. Phase 1 addressed the prevalent myths regarding HIV/AIDS. Phase 2 focused on STD (Sexually Transmitted Diseases) and AIDS symptoms and linkages. Phase 3 addressed low self-risk perception or self-exclusion. Throughout the three phases, the call to action always focused on condom promotion and on ensuring increased hits to 1097, the number of the toll-free hotline tele-counselling services that operated in Kolkata and its suburbs. The campaign achieved incredible visibility and reach through a strategic mix of print advertisements, television and radio jingles, and advertisements on billboards, posters, bus shelters, and city crossings, in all the major languages like English, Hindi, and Bengali. It was widely accepted because it employed the vernacular. Before the Buladi campaign, only 9 per cent of people said that they believed HIV was a threat to India, but after this there was a drastic change. Now, to a large extent, people are able to identify the ways in which HIV can be transmitted.
Despite the wide acceptance of the campaign, some major controversies arose relating to Buladi. The principals and teachers of the city schools found the content of the advertising campaign objectionable. According to them, the campaign indirectly encouraged youths to have sex. It was also found that the thrust of the campaign was to educate women on issues of HIV/AIDS and sexuality so that they could sensitise their menfolk. None of the advertisements dealt with women’s or women’s health issues, except for a single advertisement featuring a woman talking to Buladi about her sexual health. The messages of the campaign did become bolder with each phase, but they did not challenge the existing social and gender roles, nor did they urge educated women to question the circumstances and conditions that made them more vulnerable to HIV/AIDS. Fundamental information regarding the disease was not adequately communicated through the campaign.
Although it had many weaknesses, the Buladi campaign laid the ground for similar campaigns in other cities of India.
If the people of West Bengal have Buladi, the people of Mumbai have Balbir Pasha.
Balbir Pasha: As part of the HIV/AIDS prevention programme Operation Lighthouse, a thought-provoking and aggressive mass media campaign in Hindi was launched in Mumbai in November 2002. The campaign was based on the belief that people learn by observing the behaviour of others, and to leverage this thought an alter ego with the catchy name of Balbir Pasha was created. The campaign was particularly important in Mumbai because the city is home to the largest red light area in India.
Although the Balbir Pasha campaign was made for all people, it was mainly targeted at males from the lower sections of society, who were mostly unaware of the disease and were most likely to be infected. The multimedia campaign employed advertisements in the print media, commercials on radio and television, and messages on billboards and on posters in local trains and on buses.
The campaign, while well intentioned, nevertheless drew some criticism. Detractors pointed out that all the advertisements were aimed at men and ignored women. They said that there should have been messages for women, such as sex workers who should insist that their clients should use condoms. Gays, lesbians, bisexuals, and transgender individuals were not addressed at all. Gays constitute a considerable proportion of the population in Mumbai, and they are more at risk than straight people. Critics claimed that the campaign failed to take into account the sentiments of the local people. As a result of all this criticism, during the fourth stage of the campaign, four days before it was scheduled to be launched, the campaign was withdrawn.
Despite its weaknesses and negative points, the campaign also had a few positive points:
It was one of the most popular campaigns recently launched in the city, and had a huge impact on the psyche of the Mumbai male.
The campaign was highly noticeable and had a great impact. This was discovered just after the last phase was over.
The number of calls to the hotline number increased dramatically.
A survey on the campaign found a marked improvement in the public’s understanding of how HIV is transmitted and a consequent change in people’s attitude and behaviour. Among men who practised high-risk behaviour, the proportion who felt that they would be at high risk of contracting HIV/AIDS through unprotected sex with a partner increased from 17 per cent to 43 per cent after the campaign. Calls to the HIV/AIDS hotline featured in the campaign increased by 25 per cent. More than half of the survey respondents had discussed a Balbir Pasha advertisement with their friends, family members, and colleagues. The campaigns “Let’s keep Mumbai AIDS free” and “Ye bimaari chhoone se nahi phailti” were the predecessors of the Balbir Pasha campaign. The campaign is now being adapted and replicated in Tamil Nadu.
In the early years, there was little understanding of HIV/AIDS. It was believed that people with this disease would die at any moment, thus generating fear, stigma, and discrimination. But after gaining a deeper and more accurate understanding of the disease, many people regretted their earlier unsympathetic, hostile, and even inhuman attitude towards people with HIV/AIDS. Today, people with HIV/AIDS do not face stigma and discrimination to the same extent as they did in the past. But these people are very few in number. Our battle against HIV/AIDS can be considered successful only when such positive behaviour spreads throughout the world. This mission cannot be accomplished by AIDS organisations alone. The government, the media, and ordinary citizens should also participate. Polio was eradicated through a mass effort; we require the same mass movement and public involvement if we want to defeat HIV/AIDS. Let us join hands to remove this pandemic forever and to bring happiness in the life of every Tamanna. People with HIV/AIDS have the right to be a part of their society and community just as much as anyone else.
References:
http://www.worldaidsday.org ; official website of World Aids Day.
http://www.worldaidscampaign.org ; website for in-country campaigns.
http://www.nat.org.uk ; National AIDS Trust, which works to transform attitudes towards AIDS.
http://www.usaid.gov ; a US aid organisation that helps people overseas struggling to make a better life, recovering from a disaster, or striving to live in a free and democratic country.
Ying-Ru J Lo, Padmaja Shetty, DSC Reddy, and Salim Habayeb, “Controlling the HIV/AIDS Epidemic in India,” NCMH Background Papers, Burden of Disease in India.
UNAIDS. AIDS epidemic update. UNAIDS/09.36E / JC1700E, December 2009.
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Academic Associate (Marketing), Institute of Rural Management, Anand
Email id: rachita@irma.ac.in