Education as "a social vaccine" in the fight against HIV/AIDS - INEE

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these inner forces can be induced, eliminated and reinstated by varying external influences. Thus,the determinants of behaviour reside not within the individual or organism but in theenvironmental forces. Although this theory has been criticized for reducing human beings to mererespondents of whatever influence comes upon them, it points out that through a process ofreciprocal determinism, behavioural, environmental and other personal factors interactinterdependently. The theory further points out that individuals have self-regulatory capacitieswith the ability to exercise some measure of control over their own behaviour by arrangingenvironmental inducements, generating cognitive support and producing consequences for theirown actions. This theory has a lot of implications for HIV/AIDS prevention programs that focuson behaviour change as will be discussed later in this paper for it will help in the deeperunderstanding of several factors that influence various approaches used in behaviour changecommunication in HIV/AIDS education.2.1.2 The Health Belief Model (HBM)The Health Belief Model (HBM) was developed in 1950s in the United States as a result ofwidespread failure of people to accept disease preventives although they were provided at lowcost or sometimes for free. According to this theory, an individual exists in a life space composedof regions categorized as positively valued (positive valence), negatively valued (negativevalence) and relatively neutral regions. Negative valence is undesirable thereby forcing people tomove away from it while being pulled by positive forces. Taking the disease as an example of anegative valence, in order for an individual to avoid the disease, one needs to believe that he/sheis personally susceptible to it (perceived susceptibility), that the occurrence of the disease wouldhave at least moderate severity or serious consequences on some components of his life(perceived severity) and that taking a particular action would in fact be beneficial by reducing hissusceptibility to the condition or if the disease occurred, by reducing its severity. Also, theindividual has to believe that taking such action would not entail overcoming importantpsychological barriers such as costs, pain, convenience or embarrassment, etc. hence perceivedbenefits. The theory further argues that a person’s beliefs about the availability and effectivenessof an action determine what course he/she will take. But this is not the case in all situations sinceaccording to Bandura (1977), beliefs are also influenced by the norms and pressures of thatindividual’s social group or external influences.Even then, the individual does not take action immediately according to this theory. Thecombined levels of susceptibility, severity and less barriers do not guarantee an overt action. Aninstigating event (Cue to action) must occur to set the process in motion and such event may be3
internal (like perception of bodily state) or external (like interpersonal interactions, the impact ofmedia and communication, etc). Further than that, the theory further points out that these cues toaction must be intense and the levels of susceptibility and the severity must be adequate.2.2 Relevance of the theories to HIV/AIDS EducationThe above theories put emphasis on what should be considered when planning the delivery ofHIV/AIDS education aimed at influencing positive change of behaviours and attitudes. It showswhat it takes to effect behaviour change, seemingly to suggest that different approaches arerequired to reach different people while using appropriate means at different stages in theprocess. The theories help to explain what motivates behaviour change and this helps me toanalyse whether the programs in the implementation of HIV/AIDS education in Uganda considerthis as an important component. The environmental and social settings, the media ofcommunication used, the economic, social and demographic characteristics of the individualsreceiving HIV/AIDS education need to be considered and these theories provide a framework foranalysis.HIV/AIDS education that adopts a behaviour change approach is among other components ofHealth Education based on the recognition that individual behaviour plays a pivotal role in thedevelopment and maintenance of proper health. Positive change in behaviours has a majorpreventive and health enhancing value (Hornik 2002; Koelen and Anne 2004). I claim thatHIV/AIDS education in Uganda is based on this paradigm. Using the Behaviour ChangeCommunication education, it is widely believed that provision of knowledge is important as it isexpected to eventually lead to change in behaviour. But increased knowledge does not often leadto expected behaviour effects and if an effect is found, it is usually of small magnitude (Koelenand Anne 2004). Thus motivation, skills and perceived self-efficacy are important conditions toenhance behaviour change (Bandura, 1977). After all, much of the health-related behaviourwhether positive or negative, occurs or is learnt in a social context.3.1 Education ‘a social vaccine’, where is the evidence?An inverse association between the disease burden and the level of education exists for mostinfectious diseases (Vandemoortele 2000) based on the assumption that with increasedinformation, knowledge and awareness, the behaviour of the educated people changes faster thanthat of illiterate and poor people. This concurs with the view that the level of education goes handin hand with a person’s socio-economic status (World Bank 1995). This hypothesis implies thatin the absence an immediate cure of HIV/AIDS, education is the best available protection against4
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Education as "a social vaccine" in the fight against HIV/AIDS - INEE

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