Advocating for HIV Vaccines: A Communications Framework

This article focuses on developing a communications framework for HIV vaccine trials. According to the article, based on the experience of the biggest international network in the HIV vaccine trials arena, the HIV Vaccine Trials Network (HVTN), responses to a web-based survey of 95 people from 17 cities and 21 research sites across the globe pointed out:

• critical socio-cultural differences regarding HIV vaccine trials across 4 regions (Africa and Asia, the Caribbean, South America and USA) that are not addressed by the HVTN;
• the critical need of promoting stronger debate about HIV vaccines in order to secure political support and participation of volunteers; and
• the need to strengthen the voice of community representatives to fuel community ownership and collective action.

HIV prevention efforts ranging from massive communication campaigns to face-to-face counseling have contributed to slowing but not to stopping the spread of HIV. The author proposes that a vaccine offers the best hope for coping with HIV. He explains how the testing of vaccines is a complicated process, with many ethical challenges, particularly in developing countries. From a communication for development perspective, "the most appropriate paradigm to revise this project is multiplicity, based on the principle that each society must define development for itself to find its own strategy. Accordingly, community education on HIV vaccines is linked to Freire’s idea of empowerment through education, where people are responsible of their own learning process and not merely empty recipients filled out by the knowledge of experts who are alien to their communities (Freire, 1970)."

The project discussed in this article chose the Communication for Social Change (CSC) approach. CSC proposes that communities should be the agents of their own change and social change is more likely to be sustainable if the most affected individuals and communities own the process and content of communication. It must encourage debate and negotiation rather than the transmission of information, and the emphasis on outcomes should go beyond individual behaviour to social norms, policies, culture and the supporting environment. The author explains that the framework developed by UNAIDS/PennState University to meet the particular needs of HIV vaccine trials was developed through an active exchange process led by researchers and practitioners from the communications field from Africa, Asia, Latin America and the Caribbean. According to Panos/UNFPA (2001) and Servaes (1999), this framework calls for moving away from individual-level theories and models of preventive health behaviours to more multilevel, cultural, and contextual explanations and interventions.

The research question posed by the author proposed was - How appropriate is the UNAIDS/PennState University communications framework for the HIV vaccine trials needs? It sought to identify main similarities and differences on HIV vaccine educational programmes taking place in the U.S and in the developing world in order to support their communication programmes; assess the communications performance and identify particular needs of different sites to improve HVTN’s performance; and develop a communications framework to improve upcoming educational and recruitment programmes in the HIV vaccines’ field.

The author discusses how media advocacy can contribute to political will to tackle HIV/AIDS was the result of media advocacy initiatives. He also explains that trials sites can and must learn from one another, but should always be aware of cultural differences. Experience in this respect warns against sharing communication materials developed in different regions. Gender relations must also be considered, and communication solutions should be designed to contribute to eliminate negative stereotypes of women that may influence HIV dissemination. Communicators at each site must also consider the level of influence of spiritual leaders –including traditional healers, voodoo priests, and others– in their community and which mechanisms spiritual organisations use to engage with governmental, private and civil society bodies.
Since HIV vaccine trials cannot take place without volunteers, the safety of participants and the delivery of accurate information about the progress of this search must be prioritised.

Recommendations from the author:

• Communications at the network level - to improve international participation and involvement, HVTN should take into account to use of the following five languages for all the materials produced by their communications unit, ranging from the website and graphic profiles to good practices guidelines: English, French, Portuguese, Spanish and Thai. Among training interests, it is highly important to note that communication methods and tools was the top priority, representing almost three more times the voice of those interested in improving their knowledge on HIV vaccines. It is also important to design and maintain a database in order to improve the exchange of resources and the quality of social impact measurement. Strategies that promote local community ownership should be encouraged and awarded.
• Communications at the sites level - sites must think about the needs of journalist and their audiences; be on alert for original stories among their volunteers; and never do anything that would compromise credibility. For those sites that have been involved in this search for many years now, in order to re-launch the interest of media in HIV vaccine research the use of humour to deflect opposition and apathy must be considered, as well as the incorporation of new media into their educational programs. To involve potential participants in this search key messages that appeal to the sense of belonging to the discovery of a vaccine and empathy for the loss of a close friend/relative must be developed and tested.
• The communications framework for HIV vaccine trials - to develop indicators to evaluate social change, in-depth evaluations of messages, attitudes and behaviours within communities are necessary. It is imperative to take into account alternatives to establish long-term relationships with governmental representatives. For this issue, it is necessary to find out what are the key lessons of the sites located in the Caribbean, which proved to be the more successful region on this issue.