HIV Education Thought of the Day

As activists and passionate people we like to think that we can make a huge difference in preventing disease through awareness efforts. Witness the increasingly-ridiculous facebook status updates in support of breast cancer prevention, for example, but also the general attitude embodied by groups like SIC (who I volunteered for in college) that put tons of effort into education.

In the population I’m studying (Malawi), however, awareness of HIV is about as high as it can possibly get and that hasn’t seemed to slow the epidemic. What’s more, I’m increasingly dubious that campaigns by NGOs and so forth have very much to do with people’s awareness of the disease. This is a virus that infects more than one in ten Malawians and almost invariably kills those who get it, who are prime-aged adults. It would be impossible not to know about it at this point.


About Jason Kerwin
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2 Responses to HIV Education Thought of the Day

  1. schwartz1983 says:

    Hey Kerwin,

    In bioethics we were taught the difference between understanding and appreciating consequences. Understanding is defined as recognizing causal links (unprotected sex can lead acquiring HIV). Appreciating is defined as applying this recognition to oneself (if I have unprotected sex, I could acquire HIV). People are generally better at understanding consequences than appreciating them. In medicine, the research on encouraging behavior change is discouraging. However, I wonder if we could find ways of messaging that improve appreciation rather than just understanding.

    On a side note, in my time in South Africa and Botswana, I’ve seen people who are very aware that HIV is a problem, but their knowledge is imperfect. Some think it can be acquired casually (e.g., sharing plates), which may prevent people from protecting themselves in high risk situations (e.g., sex), because they figure they’re already exposed everyday contact. Also, lots of people think drugs can cure HIV. Many don’t know exactly what HIV is or what it does or how it does it. Knowledge and understanding of HIV is variable and tied to cultural contexts, but I think we need empirical data before we can draw firm conclusions about a given group’s awareness. You’re more in touch with the situation in Malawi, but where I’ve worked it’s a bit murkier.

    • Jason Kerwin says:

      There’s almost surely a disconnect between people’s awareness of HIV and what they’re actually acting on. Although maybe not, Emily Oster has a neat working paper that argues that we see roughly the response we’d expect given lower life expectancy in Southern Africa:

      But even if you think, like I do, that folks aren’t fully internalizing their knowledge of HIV, that actually points in the direction of awareness campaigns having changed very little. In that case there’s a subtle distinction from a case where we’re simply not getting through to people, though: we are getting the message out but we’re targeting the wrong kind of information.

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