Tackling HIV Stigma What works?

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4 WHAT THE EVIDENCE TELLS US ABOUT THE EFFECTIVENESS OF HIV STIGMA INTERVENTIONS 4.1 Mass media campaigns Box C Don’t die of ignorance The mass media campaign of the 1980s, whose tagline ‘don’t die of ignorance’ accompanied the falling tombstones image, was undoubtedly very influential in forming public perception of HIV in the UK. In many ways it was a success in public information dissemination, in that it did increase awareness of HIV and AIDS amongst the general population; many people still remember the campaign today. 42 Lord Fowler, Health Secretary at the time of the campaign, noted that the TV adverts were the key to the campaign’s success in reaching a mass audience. 43 The campaign did have shock value which may also contribute to the salience it has in people’s minds. This, however, could have inadvertently led to some of the stigma that surrounds HIV in the UK today, in that it relied at the time on generating fear and some of this remains associated with HIV. It has never been followed up by a campaign on the same scale that updates people on the huge advances that have been made in HIV in the last 30 years. 44 42 Fowler, N, 2014. AIDS: Don’t Die of Prejudice. 1st ed. London: Biteback Publishing 43 HIV/Aids: Why were the campaigns successful in the West? Jon Kelly; BBC News Magazine; 28 November 2011 Available at: http:// www.bbc.co.uk/news/magazine-15886670 44 ‘“AIDS: Don’t Die of Prejudice”, by Norman Fowler’; Andrew Jack; Financial Times; July 11, 2014; Available at: http://www.ft.com/cms/ s/2/1a601c7e-010e-11e4-a938-00144feab7de.html History of advertising: No 109: The government’s Aids campaign; Campaign; August 21, 2014; Available at: http://www.campaignlive. co.uk/article/history-advertising-no-109-governments-aidscampaign/1308298 Use of mass media is a way of conveying information or a message to a wide population audience. The largest HIV campaign in the UK was ‘Don’t die of ignorance’ in the 1980s (see box C). This was a prevention campaign, but could such a campaign targeting stigma be effective today? Although no recent comparable HIV campaign exists to consider, there has been large scale targeted action on mental health stigma through the Time to Change programme. This campaign used television adverts alongside a range of other social marketing methods. Rather than being a one-off short term effort, it consists of a changing programme of activity since 2009 and has used a range of taglines and messages. This has had some success, with the most recent evaluation showing that 6% of the population reported improved attitudes towards mental illness – a modest but significant change. 45 Researchers found that greater awareness of the campaign was linked to greater improvements in knowledge and attitudes. 46 The social marketing, or media, elements of Time to Change have been particularly successful in reducing feelings of ‘prejudice’ and ‘exclusion’ towards mental illness and people affected by it. Whilst greater levels of ‘tolerance’ and ‘support’ have also been identified, the overall link between the campaign and these outcomes was not as significant. The researchers evaluating the programme concluded that ‘the campaign might have been better at disconfirming negative ideas around prejudice rather than enhancing positive attitudes and support’. 47 This was further backed up by less significant changes in intended behaviour, signalling that further activities may be needed to make a step from changing attitudes to changing behaviour. The Time to Change evaluation suggests that mass media campaigns can have a role influencing some of the drivers of stigma but are not sufficient alone. 45 Time to Change ‘Our Impact’ webpage and info-graphic on website http://www.time-to-change.org.uk/about-us/our-impact 46 Evans-Lacko. S., Corker. E., Williams. P., Hendrson. C, & Thornicroft. G. (2014) Effect of the Time to Change anti-stigma campaign on trends in mental-illness-related public stigma among the English population in 2003-2013: an analysis of survey data. Lancet Psychiatry; 1, p121 – p128 47 Evans-Lacko et al 2014, pp.125 12 NAT Tackling HIV stigma: What works?
4 WHAT THE EVIDENCE TELLS US ABOUT THE EFFECTIVENESS OF HIV STIGMA INTERVENTIONS This limitation was recognised in the early design of the campaign; local events and personal contact, on top of media activity, were seen as critical to achieving sustained impact. As well as providing grants for grass-roots activity, Time to Change developed a network of campaign champions to support local events that would reinforce campaign messages. Social contact between people with and without personal experience of mental ill health was shown to increase engagement with the campaign. Positive changes in intended behaviour were more likely among those engaged in this contact than in those only exposed to the media campaign. 48 Box D Mixing media to strengthen engagement with a campaign New communications channels present greater opportunities to reach people, but also challenges for campaigners as people engage with media in varied ways. Time to Change has targeted both mass and community audiences. A range of messages and taglines have been distributed via a mix of media channels. When asked to identify how they had been exposed to the campaign, a broad range of media channels were identified by survey respondents, not only the television adverts. In Scotland the Always Hear campaign on HIV stigma used several channels to reach people including social media platforms and news media. 49 Resources, designed to help people to engage with online video case studies, were targeted at schools and churches. These were distributed through existing networks – giving the campaign the potential to reach approximately half of the Scottish population. 50 Similarly a campaign in Italy used networks of employers to promote equality for people living with HIV in the labour market. For this campaign an online video was again backed up by explanatory resources and training sessions for businesses. 51 Print media was also used in some major cities, including posters and placemats for restaurants. 52 Unfortunately there has not been formal evaluation of these campaigns to assess their effectiveness or the relative reach of the different media channels used. However, both show the varied communication options available. 48 Evans-Lacko et al 201 49 Always Hear was run by Waverley Care with the support of the Scottish Government. More information available at http://www. hivalwayshear.org/ 50 Information provided to NAT by Waverley Care in 2015 51 Video available at: http://www.lila.it/it/component/allvideoshare/ video/featured/qualsiasi-sia-il-lavoro-l-hiv-non-conta 52 Information on the campaign provided by to NAT Fondazione LILA Milano ONLUS in 2015 Tackling HIV stigma: What works? NAT 13
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Tackling HIV Stigma What works?

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