HIV prevention and role of media

Mahfuz Anam, Editor & Publisher, The Daily Star

The issue of the role of the media in HIV prevention has been around for quite sometime. Now we have a quite good amount of knowledge about HIV and AIDS since we identified HIV in Bangladesh in 1989. I think we do not have to invent the wheel again because we can learn from Africa, the US or Europe how the media has been handling HIV and AIDS. That does not mean that we do not have to care for the specificity of our culture or society. So, and this is my first point that we should bring together regional and international experiences.

HIV deals with a very intimate personal issue, one's sexual habit. People do not want to talk about it. They do not admit it. In our culture, it is far more of a challenge. So we have these slogans like “Bachte hole jante hobe”. We do not know what it is that is to be learnt. Here we face a life and death situation, and yet we cannot talk about this openly. How to pass on the message directly. We have to think seriously about that.

We have been living with AIDS for the last 22 years. Our public is not yet fully ready, but nevertheless far more ready than before to talk about it. However, religious feelings and social stigma is still very strong here. We really have to trade very carefully on that.

Arthur Erken, Country Representative, UNFPA

It is said that education is the best vaccine to prevent HIV and AIDS. In that respect, the media has a very important role to play. To educate people about the disease, about the people who are affected, and what can be done to eliminate stigma and discrimination against those who have contracted this disease. Despite the fact that many people know about HIV and AIDS, correct knowledge about it is still very low. They have heard about HIV and AIDS, but knowledge about how it spreads, how it can be prevented, is still very low. It means, we have failed, decades after the first person with HIV was detected in Bangladesh, to educate our young people about how to prevent this infection.

On top of it, there is a lot of denial among the general public when it comes to HIV and AIDS in Bangladesh. How often do we see a story in the newspapers or on TV about a person affected with HIV? It is still hidden. It is still not widely debated in society. I think this denial is driven by stigma surrounding HIV and AIDS, because it is linked with sex. And it is difficult to talk about this issue in Bangladesh. So, people who have HIV or who have full blown AIDS are, of course, facing great difficulties in our society.

We know media have done wonders in many countries to open the debate; to give AIDS a real “face”. Because, after all, we are talking about real people who have are HIV-infected or have AIDS. That is the most important thing we can do for those people who contracted the HIV virus or who have full-blown AIDS. Also for our society, and particularly our young people, these real-life stories are important to prevent others from getting AIDS, because only correct knowledge can help us dealing with this epidemic.

We also talk a lot about vulnerable people, marginalized people, most at risk population. And rightly so! But do we know who are increasingly the most at risk people at the moment? Married women! They are getting infected by their husbands, who frequently returning migrant workers. We do not talk about that. We think about drug users, commercial sex workers, and of course, they are vulnerable, they are at risk, but married women are the most vulnerable in this country. In that situation, stigma, discrimination, denial and the role of women in society are extremely hindering the campaign of prevention of HIV and AIDS.

Dr . Khandaker Ezazul Haque , UNFPA

At the UN Special Session on HIV, it was stated, “Beyond the key role played by communities, strong role by governments, UN systems, people living with AIDS and vulnerable groups, media, parliamentarians, community organizations, traditional leaders are important.” Media is given that green face. They can be involved so that they can contribute in the light of HIV preventions based on the national context.

We still have low prevalence of HIV; it is below 1%. But every year the total number of HIV positive patients is increasing, number of death due to AIDS is increasing.

Though we are a conservative society, there is a lot of extra-marital sex and a high demand for paid sex in Bangladesh. We need to talk about these issues and create a supportive environment so that people, especially adolescents and young people, can have clear knowledge about these issues.

Media can play a unique role in this case. For example, some print media have readers' forum, and these forums are based at the community level. They have engagement with local population, teachers, guardians, community leaders, religious leaders and so on. Media can thus create forums so that all sections of the society feel encouraged, feel confident to discuss this sensitive issue openly.

Collaboration among media, grass roots organizations, service providers, government agencies for services like counseling, testing, promotion of condom use and even treatment can do a great job.

Media can help making information available like how test can be done, where one should go.

Media can make HIV and AIDS messages charming and appealing to avoid monotony to ensure easy understanding of the messages. Meena cartoon is a very good example.

Media can do a lot in mainstreaming HIV and AIDS issues. Media can reach a wider section of the society, bringing policy, advocacy and positive social changes. Media can organize coordinated and multifaceted campaign for greater effect.

We need prominent coverage of this issue. Electronic media should dedicate some time for discussing HIV and AIDS so that people can have the confidence that HIV and AIDS can be talked about openly.

Leo Kenny, UNAIDS Representative

I am particularly impressed by the robust and very comprehensive coverage on AIDS by media in Bangladesh.

Bangladesh made a commitment to end AIDS. This is the inspirational goal to have zero new infection, to have zero discrimination and zero AIDS related death by 2015. Media's role in stimulating partnership between people living with HIV and community can not be underestimated. We have seen in every country of the world the robust response of the media in this regard.

Media has a critical role of playing the watchdog role. It has mechanism of evaluation and monitoring. Bangladesh made a commitment in the UN General Assembly in the last year. For example, Bangladesh is going to make sure that by 2015 we would reduce sexual transmission by 50%, cut HIV TB related death by 50%, cut IDU related infection by 50%, address laws that is stopping us reaching the target, show zero tolerance to sexual and gender based violence. Media can be a watchdog on this. They can be pro-active too. Media has tremendous role in giving voice to people living with HIV.

To take a look at human rights situations, the laws and practices of Bangladesh which may stop us from reaching the 3 zeros. For example, the law which allow a sex worker to be a sex worker but do not allow her to have control over own sexual and reproductive health rights. Media has a role in telling that you can be a sex worker but you cannot work in a brothel which is the only we can help protect the rights and really organize those people.

We have to be strategic in how to use media, and how to build partnerships we are talking.

Journalists should be trained so that they can report effectively, and then offer incentives to report more effectively.

Dr. M. Ziya Uddin, Unicef

Our most important task is to increase our literacy rate so that we spread this message of HIV infection through our education system.

We usually talks about sex workers, IDOs and MSFs, but we have to include women, children and adolescents in our programmes. Media can play a role in moving our concentration beyond our usual concentration.

Media should work more in a manner of facilitation rather than some scoop news, which holds back the response.

Media have to do the job of monitoring and finding the existing bottlenecks.

M.S Mukti, Executive Director, MAB

Most of newspapers have health pages. Time to time they can dedicate a page to the HIV positive people. We usually find pages or features on AIDS day. However, we need regular publication.

Many of the projects has been stopped .Media should find out these issues, and create pressure on the government and NGOs to continue these programmes.

HIV people often face violation of their human rights. This side should be considered seriously.

Dr. Zeenat Sultana , BCCP

My experience says that media are interested in publishing news on this issue. We have to help them get information about the real picture.

There is a silence about the issue; there is stigma. Journalists can come forward strongly to break the silence. In media, we have to bring real life story or human story of HIV positives rather than only providing statistics. We should involve decision makers of media.

Early marriage makes young girls prone to HIV infection. Therefore, there is a nexus of these social issues with HIV infection. Journalists should be made aware of that.

Abdul Quayum, Associate Editor, Prothom Alo

The prevalence of AIDS is quite high in our neighbouring countries. Therefore, there is still risk for our country. We have to be aware of that, and media can create that awareness.

Many Bangladeshis have been going abroad for work. They have little education. There is high risk of contamination of AIDS by them when they back home.

We have to make people know about the science behind AIDS. They should know how HIV contracts one. We know that it mostly contaminated by blood. So we have to emphasise on blood screening. We have to make people aware of safe blood donation as well as taking.

We have to create campaign against drugs. Because when several drug users use same syringe then there is high chance to get infected by HIV virus.

We have to be very careful about taking services from dentistry. It should widely published that after every time of use all the equipments should be properly cleaned with medicine. If we can disseminate these scientific messages then it will help break social stigma.

Akhtar Jahan Shilpy, Technical Specialist, NASP

In the Third National Strategy Plan, there is a clear guidance about the role of media in HIV prevention.

Through media we have to create awareness among people so that they can learn about the support and services available to HIV positives.

We have emphasise on our youth population. On one side they should made aware of HIV infections and on the other they can work as a volunteer in this cause.

We have to explore new media like internet and mobile phone to disseminate HIV related messages.

Leo Kenny

Through the Third National Strategy Paper, the government has recognized the role of media. Only information about HIV is not enough. We have to tell day-to-day story of HIV positives so that we can bring out real picture and make people aware about the rights of HIV positives. Media's duty is to give voice to the voiceless.

Another important aspect of media is ensuring accountability. Multi-million dollars has been invested in HIV projects. Where the money goes? Whether is it utilized properly? Is there any corruption? Media can go through these issues.

Syed Kamrul Hasan, BNNRC

I think there is huge potential in community radio. We have now 14 community radio operations in 13 districts. 500 people are working in this profession. This is a booming media. Through community radio, we can reach deep into a community, and provide them information related to HIV infection and AIDS. There is a scope in community radio to localize the information so that they can be easy communicating with the message.

We have to provide proper training to these new professionals so the can learn how to present these messages to their community.

Arunthia Zaidi Urmi , Manager, Counselling & Training, ICDDR,B

In our media we lack coverage of specific issues. Now we have to go more in details about AIDS rather just slogans. Media should publish expert opinions on HIV regularly. It is also important to disseminate the information about facilities from where one can get service.

Many service providers do not know many facts about HIV. They should be trained properly.

Checking up HIV status is very important. Everyone should be aware of that.

Early detection can reduce threat of death.

Habiba Akter, Executive Director, AAS

Right information is very important. We have to disseminate the information how HIV positive people have been surviving taking cares.

We find that HIV positive people suffer discrimination even among family members. This is due to persistent stigma in our society.

Migrant workers are the most vulnerable section who are infected and infect their family member back home. However, we do not have any programme for them. How can we reach them with right information? Where can you get help from HIV testing centre. We have to provide such information.

Policy makers should be involved in follow-up process. They just sign declarations, but they do not follow up their commitment. Media can bridge this gap.

People commonly think that HIV means death. So their suffering remains in silence, waiting for a disrespectful death. This is because of stigma. Many people come at the last stage; if they could have been addressed early, they would have been cured.

The government will give anti-retroviral therapy free from December 1. This is good news. We should disseminate this message.

We have to be accountable to ourselves. Every when we attend roundtable on HIV/ AIDS day we should review what we have done over the last year.

People commonly think that HIV means death. So their suffering remains in silence, waiting for a disrespectful death. This is because of stigma. Many people come at the last stage; if they could have been addressed early, they would have been cured.

The government will give anti-retroviral therapy free from December 1. This is good news. We should disseminate this message.

We have to be accountable to ourselves. Every when we attend roundtable on HIV/ AIDS day we should review what we have done over the last year.

ABM Kamrul Ahsan, UNODC

I appreciate media's role; they are vibrant and complementary. We have seen in the last decade that the situation has changed. Information giving is not enough now. If you look at survey, you will find people get first information from media print and electronic. We have to address different information need of different groups, and which information will be disseminated through which media. We have to shift our focus on information that is more complete, cause and consequences.

Respecting self-esteem of HIV positive is very important. It makes treatment easier.

We have to mainstream HIV positive people. We have to help them in maintaining normal life- access to education, job and other basic rights. Media can play a positive role here.

AIDS is a behavioral disease. It is very much related to our life style. So we can use media for shaping our life following good practices and avoiding bad practices.

Sabir Mustafa, Editor, BBC Bengali Service

Media have to play watchdog role in every governance issue otherwise there is not point of being media. If the media become too close with public health campaigns then they will loose that ability to hold authorities to account. Media is most effective if it retains its credibility. And the only way the media can retain credibility is when the audience accept that the issues the media is covering are done in an impartial, balanced and fair way. Otherwise they will think that media is the partner of the campaign, they are not critical to the issue.

The primary role media is providing news, analysis and investigative reporting which will help inform the public. Media can create awareness, but it should play role in delivering public health interventions. That is the role of government and NGOs. Media's role is to hold them accountable. It can only do that by keeping a distance.

Media is fantastic all over the world in covering the HIV issue not just as fact and figures but also bringing out the human element, human suffering.

Back in 1995, I did a study for Unicef on the use of oral dehydration therapy in treating diarrhea. I find in my study area that everyone know how to oral saline. How did they know? They heard it on the radio. It was not a door-to-door campaign of an NGO or government health official. All the housewives said I heard it on the radio. The radio message was so frequent that they memorized it. But for private broadcaster that is not so easy. State broadcaster often deliver message without thinking about its editorial value. But a private media will think hard before putting a message like that because media are not bill board. The message has to have an editorial value. There are international organization that are very skilled in providing message so that media can know about the editorial value of that message. So it is also important how organizations are dealing with media. One should also understand the media as the fourth state. Your interaction with the media has to be at that level.

Back in the 1980s when in Britain HIV patients were still suffering from severe stigma like they are in Bangladesh , Princess Diana went to a hospital and shook hand with a patient in bed and had a chat with the HIV patient. It practically destroyed the myth that HIV could be transmitted by touch or proximity. Perhaps one day a Bangladeshi leader will go to an HIV positive's home , spend time with the family, have share a meal with them, and that will destroy a lot of myth exists today. That a media cannot do. It should be dealt at another level.

Dr Samir Kumar Howlader, National Programme Officer, IOM

We have no programme for migrant workers. We can use our media to reach to them because in abroad Bangla TV channels are the only source of information for many of them.

We have to take different actions for different sections of people.

We should strongly uphold the rights of the HIV positive people, and make people aware about different misconceptions.

Kazi Ali Reza, UNIC

We have to put a lot of stress on sexual behaviour. We have to make aware people about safe sexual behaviour. It specially comes to the people who are very active. That is why young generation is so important.

We can promote safe sexual behaviour by using celebrities who really attract young generation. 3 years ago, there was a poster where Ronaldo says, 'play safe'.

The UN that without the participation of media MDG cannot be fulfilled felt it. It is same to every social issue like HIV.

FM Radio is very popular among young people. If we can use this FM Radio to disseminate message about HIV, we would be able to have a wider young audience.

Journalists are not experts of technical issues but they can communicate people in easy language. We can disseminate our study findings through journalists.

SM Rahmatullh, Programme Manager, Bandhu

There are many challenges when we talk about MSM and Hizra population. We have to talk about them. Media can bring out their stories, why these people are discriminated. We often fail to broadcast messages due stigma and social conservatism. We should do advocacy with the media about this issue.

Dr.MD Enamul Haque , National Consultant, HIV/ AIDS, WHO

In this year, we have selected a serious slogan: “Zero infection, zero discrimination and zero AIDS related death.” When you say zero that means your strategy should be very different from other years. In addition, this slogan will continue until 2015.

The estimated number of HIV cases is 7500. Since the first detected case in 1989 until 2011, our total detected case is 2533. It means there are many hidden cases. And what ever strategy we take to attain zero we have to consider those hidden cases, either you work in media or in programme.

Why we are saying zero from 2011? If we see the epidemic curve, it was gradually growing high globally. From 2000 to 2011, the curve became flat and now it is decreasing because of availability of medicine, more detection of cases globally, more care and extended coverage of services. When we talk about zero death and zero discrimination, it must be very different from other strategy.

Many resources have been spent. Now it is time to account whether we are going to the right way. Therefore, we need monitoring and evaluation of our programmes.

When fund is withdrawn our programmes stop. So there is a lack of exit strategy. So when a programme starts we should put some focus on the exit strategy, it can mentioned in the proposal of the programme. It should be ensured how the government would take up the programme or continue the programme after stopping funding.

Tahmidul Islam, UNFPA Youth Forum for Reproductive Health

I first learnt about HIV and AIDS from textbook. However, it was not enough. We do not have any course on the issue in our higher studies. In addition, many young people do not go to school. Therefore, we need mass communication media. We should disseminate message through popular media like music, play, film.

Dr. Zeenat Sultana

I want to focus on the early marriage issue. If a girl gets married at an early age, she has no bargaining capacity with her husband. In addition, in Bangladesh ratio of extra-marital affair is quite high. Therefore, there is high chance of being infected by her husband. Therefore, if a girl gets proper education she earns some bargaining power, and avoids infection.

Arthur Erken

We are facing a relatively new phenomenon. Women are getting infected by their migrant husbands because , usually, most of the women do not have negotiating power when her husband comes back from abroad and want to have sex without a condom. We do not have any effective programme to address this issue.

Moumita Datta Gupta, UNFPA Youth Forum for Reproductive Health

Every returnee migrant should be properly checked so that they cannot infect their wife.

We do not get complete information. Bachte hole Jante hobe is not enough. It does not give any clear information rather it frightens people about the HIV issue.

We should use social media to connect young people and discuss among ourselves about this issues.

Hasina Shipra, FPAB

Many of our policy makers or public leaders are not quite aware of HIV and AIDS. Therefore, when we talk to them they hesitate to talk on this issue. Media can also play an important role here.

Leo Kenny

Across this South-East Asian region, there is an increasing epidemic of men having sex with men. One cannot talk about it here. Last survey shows that there is zero infection among men having sex with men. It is very strange.

In Bangladesh, I found print media more robust than electronic media in covering these issues.

Next year when will do the mid-term review of National Strategic Plan we should incorporate the role media in our strategy is particular manner with proper importance. We would be very happy if media practitioners would work with us.

We can bring international media like BBC in this endeavour. We can also bring Journalism department of Dhaka University in our effort.

We UN bodies who work on HIV and AIDS would help you providing national expenditure assessment, infection evidences that we are getting , impact of AIDS related programmes so that we can build a formal channel of information.

We can talk to NISP that how can us formally engage media in National AIDS Congress.

Arthur Erken

I think media's role should be to remain impartial. In addition, impartiality would be compromised if media engages in any formal programme. They are here to report, to tell us the stories, to tell us what is happening, and how for instance funds for HIV and AIDS programmes are being used; in short, to be a watchdog.

If we want to have human story into the media, we have to bring the media to the human story, to the people at risk. How many people do know about the link between early marriage and AIDS? How many people do know about the link between migration and AIDS? You cannot ask a journalist to figure that out for him or herself. We should not think of media as a passive transmitter of information. I think we should work with the media in a symbiotic way. We have a need, getting the story of HIV and AIDS out; they have a need, capturing news! Let's work on a win-win situation.

Dr. Zeenat Sultana

Media can assist programme personnel. They can help us in shaping our programmes, particularly how to give the message related to HIV to the audience because they know audience better than us.

Media can portray some success story that how a HIV positive is living in a very positive way and thus breaks the stigma.

We sometime find reservation from programme people that they do not want to give some particular type of information to the journalists fearing that information will create social repercussions and hinder their programmes. We need to do some balance between programme and media reporting.

Sabir Mustafa

We should not treat the media as monolith. Bangladeshi media is vibrant and diverse. Each media has its own editorial policy. Some will be very please talk about religious issues; others would be very much reticent about doing that. You will have different approach from different people. When you take something to a media, you should put emphasis on its news value. Media people would not run with a story without news value. You have to bring a story, and HIV is an issue that has been covered in many different forms. It is a big story, and it should not be a problem to sell to a media. If you bring press releases and say please publish it, it will not get anywhere.

Brigadier Shahedul Anam Khan, Editor, Op- Ed & Strategic Issues

I think role of media in HIV prevention is a management information system issue. Media people have to prepare the strategy how to manage that information related to HIV and AIDS and present in an attractive way to their readers.

Every media house has its own agenda, and that is not a problem. We have to be careful that whether there is any hidden agenda.

There are constraints of time and space in the media. However, it should rise over the simple rubric of time and space, and dedicate its energy and resources to some very important issues such as HIV prevention.

Arthur Erken

From today's discussion, two things came out beyond what we usually think about the role of media. One, the media as watchdog for reporting on HIV and AIDS in Bangladesh; a role we have not seen much of in Bangladesh. The media has a huge role to play in holding our leaders and our development partners accountable. Media should follow up on the pledges of the government and development partners, and write on a regular basis whether the concerned authorities are doing enough to fulfill their pledges. We do not do enough investigative journalism on where the money of the development programmes goes? How much was actually spent on it? Do we write enough about our commitments?

For that, we have to build the capacity of the media. We have to train them so that they can do more investigative reporting on HIV and AIDS. In that respect, we should also not forget the role of social media, which is extremely powerful.

The second important point is that it is crucial to giving a human face to HIV and AIDS, and giving voice to the voiceless. It is not just giving information; it is also not just holding people accountable; it is knowing what it does for a person who is infected with HIV. Does the person has access to the right information and services? Does the person get a job or on the contrary is being thrown out of a job? What is the human story behind HIV and AIDS in Bangladesh? If we become the interface between the media and people who work with HIV infected persons, then journalists will learn more, and will probably run with the story, provided it has any real news value.

Our leaders should learn from what Princess Diana did, when she shook hands with a HIV patient; it destroyed the social stigma about HIV. I have not seen many leaders talking about AIDS, talking about men having sex with men, talking about and engaging the Hizra community. Media can play a strong role in that part.

The fight against HIV is not over today. It is and will continue to be a long fight. And it is already going on for 20-25 years. It will be with us for some time to come. The media is a strong ally and partner in the fight against HIV and AIDS. We need to team up with them so that we get the story of HIV and AIDS in Bangladesh in the media.