Culture and Prevention II

Entertainment-education programs are widely utilized to deliver educational knowledge about peer group norms, protective health behaviors, and ways of disease prevention in entertaining form. I was thinking what is the advantage of entertainment-education compared with pure education? Entertainment is an approach to engage the attention, interest, and curiosity of target audience. More importantly, the ultimate goal is to seek change of knowledge, attitudes, and behaviors to an issue. The social and cultural norms also might be influenced (Nariman, 1993). In the case of health, entertainment-education strategy is aimed to promote lifestyle change or prevent disease. For example, to address sensitive youth issues, combination of education and entertainment has been found to effectively influence young people about HIV/AIDS.

In this sense, I was wondering whether the format of entertainment would overweigh the purpose of education. Is knowledge of causes, consequences, and intervention of prevention of HIV infection sufficient to motivate behavior change such as promoting condom use? The concept of culture plays a vital role in understanding human behavior, which should be incorporated in disease prevention intervention. It makes meanings to the population in communities to their health status. Thus, it seems that knowledge transmitting may not enough to stimulate behavior change. It also needs to be cultivated through audience involvement, peer rapport, supportive social norms, and cultural beliefs. Individuals therefore are likely to talk about media knowledge within the social network. That might be the ways in which entertainment-education intervention build positive relationship between self-efficacy about control of self sexual behavior, mass and interpersonal communication about condom use, utilizing various media (Sood, 2002).

Besides entertainment-education strategy, cultural values, especially cultural gender norms regarding sexual behavior contribute to effectiveness of HIV prevention intervention. Condom use or request, the effective way to prevent HIV infection, is associated with many cultural and behavioral factors. Women are more likely to face difficulty in negotiating safer sex behavior with men due to the perceived power imbalance in sexual decision making. I was impressed by the assumption of McQuiston (2000), which argued that “the timing for condom use was never right”. For the men, communication is based on trust, while trust is built on communication for the women. Not only power imbalance exists between genders, but also male and female always behave differently because of distinct perceptions towards sexual behaviors. Requesting a partner to use a condom require the woman to obtain a dominant role in sexual practice – very hard in many cultures. For men in most cultures, condom use might mean distrust and bring sense of distaste. It can be extremely difficult to negotiate safer sex within complex situations. For steady partners, how can a woman gain power and improve condom use? Can the timing for condom use be right and match between men and women? One more question, what if the man has a spiritual belief that “God tells me do not use condom/control birth”? How do we, as researchers, persuade them to change the way to do it?