Reducing S+gma and Improving Knowledge about HIV/ AIDS Adherence Through Cable Radio and Role Plays
Rajendran Jeevanandham, U#ara Bharath Kumar, Nithya Balaji,
Muthuvelan Sampath, Palaniyappan Oyyavandhan
SBCC Summit Addis Ababa, Ethiopia
February 8-‐10, 2016
Background
The NaLonal AIDS Control OrganizaLon (NACO) in India, most recently esLmates (2010) the number of people living with HIV at around 2.4 million. In the south Indian state of Tamil Nadu, where the first Indian AIDS case was diagnosed in 1986, there is a prevalence of 0.34% 2005-‐2006 Na)onal Family Health Survey (NFHS)
Background
The Government Hospital of Thoracic Medicine (GHTM) in the state is the largest for HIV and TB treatment in India since 2004. Up to 700 new paLents arrive daily for treatment. Approximately 500 of them outpaLents (90% of them PLWHA) while others get admi#ed for iniLal treatment that oben includes treatment of opportunisLc TB.
Background -‐ Challenge
The medical, psychosocial, and informaLon-‐related needs of this large number of paLents (and their caregiver populaLon) is an admi#ed challenge to already overburdened staff.
Nalamdana [Tamil]: Are you well?A non-profit based on the principle that entertainment more
effectively motivates and persuades people to adopt better health practices than traditional public health campaigns.
Interven+on Cable radio to the wards, live role plays at various parts of the GHTM hospital, full-‐length dramas (evening entertainment) and support group meeLngs
IntervenLon In 2004, Nalamdana partnered with the UCLA Art & Global Health Center and its India affiliate, to create the Are You Well? Project based at the GHTM. This project features parLcipatory theater, full-‐length dramas, and a novel radio program to: • Educate people living with HIV about the disease
• Increase treatment adherence • Reduce self-‐s+gma
IntervenLon The success of Are You Well? over the past decade stands as a powerful testament to the transformaLve power of art.
Monthly Stage Plays Monthly dramas explain and clarify issues of HIV/AIDS transmission, prevenLon/ risk reducLon and partner discordance, improve adherence to medicaLon, address sLgma (self and from others).
InteracLve Role Plays Use role plays, group mee+ngs and interac+on with posi+ve living groups to help care givers and family members come to terms with health and other issues relaLng to their HIV affected loved ones
Cable Radio ParLcipatory programs on the cable radio staLon called Thendral (A light breeze) that reaches all wards. The capLve audience of paLents and their caregivers listen to entertaining music, programmes and get criLcal informaLon about HIV.
EvaluaLon
A team of external researchers led by Dr. Devaki Nambiar has evaluated the program model in 2010. Exposure to the programmes was associated with significantly higher HIV -‐related knowledge (15-‐20%), lower levels of sLgma (2-‐7% lower), and over four Lmes the adjusted odds of asking doctors quesLons about HIV.
(2010) KNOWLEDGE, STIGMA, AND BEHAVIORAL OUTCOMES AMONG ANTIRETROVIRAL THERAPY (ART) PATIENTS EXPOSED TO NALAMDANA’S RADIO AND THEATER PROGRAM IN TAMIL NADU, INDIA -‐ Devaki Nambiar1, Vimala Ramakrishnan2, Paresh Kumar2, Rajeev Varma3, Nithya Balaji4, Jeeva Rajendran4, Lore#a Jhona4, Chokkalingam Chandrasekar5, David Gere6
EvaluaLon
Higher dose of exposure was associated with lower felt sLgma (21% reducLon per message recalled) and greater odds of: • Consistent condom use (AO raLo : 1.12) • Doctor-‐paLent communicaLon (AOR: 1.20) • Peer advice-‐giving (AOR: 1.18) • HIV-‐related advocacy (AOR: 2.35).
Conclusion
• In an world with exploding digital media, there is sLll a role for old-‐world communicaLon
• This innovaLve programme has received conLnued funding from a variety of sources -‐ public and private. Similar programmes may improve paLent outcomes in HIV treatment senng.