NO.
7 FEBRUARY 2007
Findings
www.healthlink.org.uk
What’s culture got to do with
HIV and AIDS?
Why the global strategy for HIV and AIDS needs to adopt
a cultural approach
INTRODUCTION
This paper reports the initial findings from HIV/AIDS: The
Creative Challenge, a project which is developing reflective
discussion with field practitioners and policy makers on the
value of cultural approaches to HIV and AIDS. The project
has been developed by Creative Exchange in partnership
with Exchange and UNESCO. It looks at how the cultural
dimension can be more effectively factored into HIV and
AIDS communication programmes, which are often the area
in which culture is most visible and effective.
Analysis of the first phase of HIV/AIDS: The Creative
Challenge suggests that cultural approaches to HIV and
AIDS prevention are currently limited by the wider strategic
environment, which:
promotes a biomedical approach to HIV and AIDS to the
exclusion of social and cultural approaches and
therefore misses opportunities to engage with local
communities;
focuses its cultural approach on behaviour change
communication and ‘message giving’, rather than on
building dialogue, participation and empowerment
through local cultures;
is not capturing or accepting evidence of wider
legitimate impacts (beyond behaviour change) which
flow from culturally-appropriate communication and
prevention and care activities.
There are, however, opportunities to engage with culture,
particularly through HIV and AIDS communication
programmes that seek to go beyond giving out messages
and instead focus on engaging with the cultural meanings
that people create for themselves.
www.healthlink.org.uk
KEY POINTS
Cultural approaches to HIV and AIDS have built
trust and engagement at community level,
increasing the likelihood of prevention.
Cultural approaches to HIV and AIDS are gaining
currency because they interact with the values,
beliefs, traditions and social structures – the
‘webs of significance’ – in which people live.
Culture is most visible in communication
programmes but some programmes are
culturally inappropriate and may contribute to
infection and stigma because of their focus on
behaviour change.
Where a cultural approach is used in HIV and
AIDS communication there is evidence of wider
impact on awareness and attitudes, of stigma
reduction, and of more inclusion of people living
with HIV and AIDS.
New forms of monitoring and evaluation are
required to capture the impact of cultural
approaches to HIV and AIDS beyond behaviour
change.
Culture can offer a real benefit to global strategy
for HIV and AIDS if it is re-cast as an opportunity
for action and engagement with communities,
rather than as a barrier to prevention and to
bio-medical approaches.
1
Findings
NO.? | MONTH YEAR
WHAT IS A CULTURAL APPROACH?
Development thinking is shifting towards acknowledging
the role of culture. But culture is notoriously difficult
to define. The starting point for HIV/AIDS the Creative
Challenge was the widely accepted definition which regards
culture as: “not only the arts and letters, but also modes
of life, the fundamental rights of the human being, value
systems, traditions and beliefs”
(UNESCO, 1982). This is a holistic If culture is a factor
definition of culture, which recognises
that there are many ways of living, in transmission and
being, knowing and expressing impact, it follows
ourselves.
that prevention and
It is impossible to negotiate any level of
human change without confronting
care require a cultural
culture. Human beings, says Professor approach.
Tim Gorringe (citing Clifford Geertz,
1993), are “suspended
in webs of significance they themselves have spun. Culture
is the name for those webs” (Gorringe, 2004). It has been
said that a failure of modernity – and this could also be said
of development – has been an inability to grasp how people
weave meaning from these webs in order to develop their
values, relationships, behaviour, social and political
structures (Gorringe, 2004).
CREATIVE EXCHANGE’S CULTURAL
FRAMEWORK
This framework evolved from research about how
development policy makers and practitioners relate to
culture (Gould and Marsh, 2004). It consists of four
levels at which culture intersects with development:
Culture as context factors specific to local life:
beliefs, value systems, history, geography, social
hierarchies, gender, faiths, and concepts of time.
Culture as content languages, practices, objects,
traditions, clothing, and heritage.
Culture as method, the medium or cultural forms
that projects will use to engage/communicate with
communities, eg drama, dance, proverbs, song,
music, video, radio or television.
Culture as expression of the intangible, creative
elements of culture that connect with our beliefs,
values, attitudes, feelings and ways of viewing the
world.
The research found that culture at all of these four levels
tended to be used either as a tool – pre-determined and
message-driven – or as a method of participatory
cultural engagement.
www.healthlink.org.uk 2
NO.7 FEBRUARY 2007
A cultural approach sets out to systematically engage
with the “webs of significance” that people create; it takes
account of the cultural context in which communities and
groups exist; it negotiates with local social hierarchies and
living patterns; and it draws on local forms of
communication and expression to engage people.
It stands to reason that a worldwide health crisis such as
HIV and AIDS, which is deeply rooted
in personal and social issues, is closely
linked to culture. Research has indicated
that culture is a factor in the social trends
that contribute to infection, and HIV and
AIDS in turn leave a footprint on people’s
social and cultural lives (UNESCO, 2000). If
culture is a factor in transmission and
impact, it follows that prevention and care
require a cultural approach.
HIV and AIDS strategies – at a global,
regional or national level – need to be viewed through what
is commonly described as “a cultural lens” (Duer, 1998;
UNFPA, 2004). Relating to the lifestyles and realities of local
people has long been the argument of anthropologists and
participatory development theorists, but mainstream
development has been slow to acknowledge this: “We are
realising that building development solutions on local forms
of social interchange, values, traditions, and knowledge
reinforces the social fabric. We are starting to understand,
that development effectiveness depends in part, on
‘solutions’ that resonate with a community’s sense of who it
is,” wrote former World Bank President, James Wolfensohn
(Duer, 1998).
WHAT DOES A CULTURAL APPROACH LOOK LIKE?
Creative and artistic projects (culture as method and
culture as expression) are often the most immediately
visible example of cultural approaches in HIV and AIDS
programmes. Examples include: drama clubs with young
people in Ethiopia to discuss HIV and AIDS prevention;
participatory film projects in Kenya to draw out local
perspectives on HIV and AIDS; shadow puppetry plays
for street children and drug users in Cambodia; and radio
‘soap’ opera in Rwanda. Creative and artistic activities offer
a ‘way in’ to building relationships with local communities,
of tapping into the cultural undercurrent, of gauging the
thinking and experiences of different segments of the
community in relation to HIV and AIDS, and of building skills,
confidence and capacity to act (Marsh and Gould, 2003).
Creative and artistic methods are widely used across the
world – research among five UK development agencies
found evidence of 350 such projects in 40 countries over
two years, with a conservative cost base of £30 million
Findings
NO.? | MONTH YEAR
(Marsh and Gould, 2003). But these are by no means the
sum total of a cultural approach. To be effective, these
activities have to be rooted in an understanding of local
cultures (culture as context) otherwise there is a danger of
local cultural forms being abused as part of a didactic
process of social engineering.
Increasingly, donors are looking at how they can work with
other areas of the cultural ‘web’ to improve the impact of
work on the ground. United Nations Population Fund
(UNFPA) has documented its own efforts to engage culture
in programmes in nine countries in Culture Matters (UNFPA,
2004). Activities included working with elders in one
traditional clan structure to explore issues around ‘female
genital cutting’. UNFPA found that their broader cultural
approach (culture as content) helped achieve programme
goals more effectively, demonstrated transparency and
tolerance by the donor, which in turn built trust and greater
community involvement and ownership. Greater involvement
helped create a virtuous circle that helped expand
opportunities for UNFPA programmes.
THE ROLE OF CULTURE IN HIV AND AIDS
COMMUNICATION
The most powerful examples of a cultural approach to HIV
and AIDS can be seen in development communication
programmes. These include projects using radio drama and
soap opera to communicate health information; theatre-for-
development projects where audiences witness or
participate in performances; and film projects designed to
create compelling stories.
Because people are enmeshed in different cultural webs, to
be affected by a message, people have to hear it in a way
that has cultural significance for them, and which connects
with their experience of life. Culture has
the potential to connect with people Increasingly, donors
and affect them on many different levels.
However, communication programmes are looking at how they
have tended to focus largely on one
level – behaviour change.
can work with other
areas of the cultural
Behaviour change communication
models are criticised as being based
‘web’ to improve the
on Western assumptions about what impact of work on the
change is required, and for assuming
a degree of individual volition that does ground.
not exist in some societies (Marsh, 2004).
They have also tended to focus on giving information,
rather than building dialogue and sharing knowledge within
communities – influencing attitudes and behaviour through
telling, rather than by engaging and empowering people.
Singhal and Rogers (2003) have argued that: “Many
communication strategies are culturally inappropriate.” The
WWW.HEALTHLINK.ORG.UK 3
NO.7 FEBRUARY 2007
Panos Institute (2004) has concluded that the health
communication field has been “missing the message”
because it has concentrated on “putting out messages
[rather than] fostering an environment where the voices of
those most affected…can be heard.”
There are concerns that behaviour change communication
methodologies have also been corrupted by promotion of
moralistic messages. For example the message of “abstain,
be faithful, use condoms” – or ABC messaging – has made
little impact on prevention over 20 years (Panos, 2004). It
has been said that such approaches are not realistic and
may in fact contribute to infection, deepen stigma and
discrimination and result in “shame, lying and useless
values” (van Kampen, 2006). In Uganda, where the focus on
messages about abstinence and being faithful has
intensified in recent years, there has been a reported
increase in prevalence, after more than a decade of decline
(Sanders, 2005).
Examples of more sensitive communication modes include
drawing on the knowledge of traditional healers and local
communication methods – rites, dances, dramas and chants
(Somma and Bodiang, 2004); and working with participatory
cultural methods in group and community settings to explore
lifestyle change options, rather than imposing solutions for
change externally (Marsh and Gould, 2003). Other methods
have used minority languages, drawn on local customs,
traditions and technologies, or used prayer cards or
traditional clothing for communication.
Where cultural approaches have been used to benefit people
living with HIV and AIDS (PLWHA), research has indicated
that they can help PLWHA come to terms with their
experiences, reintegrate into society and become socially
active, which in turn helps combat stigma and gives voice to
anxieties (Robins, 2005). For example,
the Magic Threes initiative in Vietnam
shared the stories of existing PLWHA
through a leaflet containing art, personal
testimonies and insights into other
people’s experiences of the disease.
Newly diagnosed people and their
families were able to relate to these
experiences which helped them come to
terms with their own situation (Kaufman,
2005).
MAKING A CULTURAL
APPROACH TO HIV AND AIDS HAPPEN
Development policy makers are beginning to acknowledge
the need for a cultural approach to local, national and global
strategy. The Commission for Africa (2005) report notes that:
"Tackling HIV and AIDS requires a holistic response for
Findings
NO.? | MONTH YEAR
treatment, prevention and care that recognises the wider
cultural and social context and which is supported by well-
functioning health systems. Indeed, where cultural norms
have not been taken into account in HIV and AIDS
prevention strategies, prevalence rates continue to rise".
The Swiss Agency for Development Cooperation (SDC), has
argued that the benefits of a cultural approach stem from
revitalising local cultural forms of expression and channels
of communication. This builds solidarity and empowerment
within the community, and encourages self-reflection, which
in turn makes public health knowledge more accessible and
sustainable (Somma and Bodiang 2004).
Support is building for a cultural approach to
communication: the UNAIDS Communications Framework
for HIV and AIDS (1999) identified culture as one of the five
‘contexts’ affecting risk and health behaviour (alongside
government policy, socio-economic status, spirituality and
gender) and recognised that communication needs cultural
influence to have impact. The UK Department for
International Development (DFID) report on AIDS
Communication (Power and Skuse, 2005) stressed the need
for an approach that addresses the “economic, spiritual and
cultural dynamics” of the disease, and
identified participatory communication “Where cultural norms
methods such as video, theatre,
community radio, dance and
have not been taken into
oral testimony as helping with account in HIV and AIDS
communication and dialogue
building. prevention strategies,
prevalence rates
As well as opportunities, there are
a number of challenges to rolling out continue to rise.”
a cultural approach. There is limited
evidence of the efficacy of a cultural approach to HIV and
AIDS. It is only comparatively recently that some of the key
agencies in the UN-led partnership responsible for
implementing the global strategy have started researching
the cultural dimension of HIV and AIDS – notably UNESCO
and UNAIDS with their joint programme A Cultural Approach
to HIV/AIDS Prevention and Care; and UNFPA with its recent
programme on Culturally Sensitive Approaches to
Development Action (UNFPA, 2004). What knowledge is
available has yet to percolate more widely into policy and to
field level.
An additional challenge is a reluctance to take on cultural
arguments because the term ‘culture’ is complex and
contested – cultural approaches are often criticised for
reducing social behaviour to a set of cultural causes and
effects. Some anthropologists have argued that a cultural
focus can result in cultural practices being erroneously
blamed for transmission or credited for impact where other
social factors are at work (Vidal, 2003). This has led to a
WWW.HEALTHLINK.ORG.UK
NO.7 FEBRUARY 2007
switch to language which excludes reference to ‘culture’
by some agencies, in favour of terms such as ‘local
approaches’ and ‘social dimensions’ – though sadly
the expressive and creative dimensions lose out in this
transition.
There are also emerging concerns that the cultural approach
is being ‘hijacked’ to drive forward highly moralistic external
agendas for prevention of HIV and AIDS. Culture has been
used to justify the imposition of behaviour change on
vulnerable groups – particularly in some African countries.
For example there has been an attempt to describe
abstinence from sexual relations as a ‘cultural norm’ and
therefore as a culturally acceptable target for campaigns.
This re-casting of external agendas as ‘cultural’ may
generate distrust of cultural approaches among communities
and donors.
Then there is the simple fact that access to medical
treatment and care is the priority for donors. Culture is just
not on the agenda. UNESCO (2001c) has identified that
“institutional pressure prioritizing medical and cognitive
activity” and a lack of “training/sensitizing” are preventing
field staff from engaging with cultural issues. If a cultural
approach is going to be
mainstreamed, it needs simple
methods through which it can be
easily absorbed into donor processes.
WHERE DOES CULTURE FIT IN
INTERNATIONAL HIV AND AIDS
STRATEGY?
A cultural approach offers the chance
to improve the effectiveness of global
HIV and AIDS strategy and rebuild the trust of communities
through more sensitive modes of engagement. Insofar as a
cultural approach allows prevention and care methods to
come from within the culture, it “maintains socio-cultural
acceptability, local ownership and credibility” (Somma and
Bodiang 2004). Local, community-based approaches driven
by “community work” and “social activism” (Lynn, 2004) will
remain the most important means of reaching and
influencing people.
Approaches to tackling HIV and AIDS are driven by an
international, multi-institutional strategy led by the UN
consortium UNAIDS. This strategy emerged in 2001 from a
United Nations General Assembly (UNGASS) declaration
(UNGASS, 2001), which committed national and international
policy makers to a coordinated approach to combating HIV
and AIDS. The global strategy, however, has been devised
with very limited reference to cultural factors that may
influence transmission, prevention and impacts from HIV and
AIDS (Marsh, 2004). There has been a tendency to portray
4
Findings
NO.? | MONTH YEAR
NO.7 FEBRUARY 2007

culture as a problem and a barrier to change (and therefore a IMPLICATIONS OF A CULTURAL APPROACH
barrier to prevention), rather than an opportunity for
Changing donor culture
engagement. The UNESCO review of cultural approaches to
Donors need a greater degree of confidence in using a
HIV and AIDS concluded that: “The largest breach between
cultural approach rather than falling back to arguably less
existing programmes and projects and field realities is due to
effective mass media campaigns. In his review of 50 case
the almost complete absence of consideration of people’s
studies of participatory communication, Alfonso Gumucio
cultural references, except as obstacles to a logically built
Dagron (2001) highlights a donor preoccupation with the
prevention and care action” (UNESCO, 2001d).
need for scale, visibility and short-term successes, despite
the fact that “30 or 40 years of failures” have shown that
Global strategy has “had the effect of promoting a universal
these models often backfire.
set of HIV and AIDS discourses, including the dissemination
of many Western concepts of prevention, treatment and care
Improving monitoring and evaluation
to Southern societies that have been derived from scientific
Moving beyond the behaviour change mode of
medical models, rather than from humanistic social-cultural
communication will require a change to current monitoring
models” (Altman, 1998). Subsequent implementation of the
and evaluation processes, which are structured to collect
strategy has reinforced the ‘biomedical’ approach, and often
data on behaviour change. Other outcomes may be more
alienated societies with different concepts of health,
realistic such as changes in: “knowledge, skills, awareness,
wellbeing, life and death. Indigenous health knowledge is
attitudes, beliefs, emotions and interpersonal relationships”
often treated as secondary to biomedicine (Vincent, 2004).
(Gould and Marsh, 2004). Current monitoring and evaluation
Yet traditional knowledge and healers are often an
does not capture the full array of impacts from
opportunity for outreach and are trusted by communities.
communication. For example a participatory drama project in
Africa inspired hope among participants, encouraged people
The Swiss Agency for Development Cooperation (SDC)
to develop income generation activities, which in turn
points out that 80 per cent of people in developing nations –
improved incomes, nutrition and quality of life, and extended
particularly in sub-Saharan Africa – use traditional healers as
and improved the lives of people living with HIV and AIDS
a primary source of care. These healers “think, express and
(Gould and Marsh, 2004). The evaluation systems of donor
act illness experience ‘inside’ the same cultural framework
agencies are not geared up to accept these “softer”
as their patients” (Somma and Bodiang 2004). SDC cites
qualitative, process-based outcomes as evidence of impact.
examples where programmes have drawn on the knowledge
This challenge and the need for more subtle measures are
of traditional healers in developing ‘common sense’ solutions
recognised by DFID (2005).
and prevention practices that will work locally. Locally
derived prevention information was then incorporated into
Linking local, national and international strategies
traditional communications methods – rites, dances, dramas
It is a priority for all agencies working on HIV and AIDS to
and chants (Somma and Bodiang, 2004).
start addressing the cultural dimension of the pandemic
through practical action in country strategies and at field
Failure to engage with the local, cultural context of HIV and
level. To do this, it will be necessary to build a dialogue
AIDS has led to a mistrust of global strategy: there appears
about the role of cultural issues in each country, and start
to be cynicism about political and corporate, moral and
weaving culturally appropriate prevention into regional
medical/scientific agendas overwhelming human and cultural
strategy. One starting point may be a system of Cultural
aspects of the pandemic; there is widespread concern, too,
Assessments proposed by UNESCO (2001a) to gather data
that funding, even for the biomedical approach, will barely
on the cultural specifics, resources and processes of
be sufficient to reach one in five of infected people.
countries and communities and link these into HIV and AIDS
strategy and implementation. In taking forward a cultural
Despite limited formal evidence it appears that where a more
approach to HIV and AIDS communication, UNESCO has
local or cultural approach has been used to generate public
proposed an approach which is based on two-way
awareness and engagement, there has been success in
information exchange between field workers and
tackling HIV and AIDS. For example, in Uganda in the 1990s
communities. It requires cultural analysis of the community;
prevalence declined by around two-thirds. Where
commitment from key ‘cultural’ groups; and processes which
community-level responses have been backed up by HIV
develop local participation in preparation and
prevention policy, it is said that their success “has been
implementation. The approach helps communities to focus
greater than biomedical approaches or methods introduced
on their priorities and supports local cultural processes of
from outside. It represents a social vaccine for HIV” (Low-
change.
Beer and Stoneburner, 2003).

www.healthlink.org.uk 5
Findings
NO.? | MONTH YEAR
NO.7 FEBRUARY 2007

CONCLUSION Duer K (1998) Culture and sustainable development: A

framework for action, World Bank, Washington
Approaches to the HIV and AIDS over the past 20 years
have not reached people effectively enough to stem the tide
Gould H and Marsh M (2004) Culture: Hidden Development,
of HIV transmission. Wherever a cultural approach has been
Creative Exchange, London
used – whether it is finding ways of negotiating social
hierarchies, or methods of communicating creatively which
Gorringe T (2004) Furthering Humanity: A Theology of
makes people listen and respond – it would appear that
Culture, Ashgate Publishing Ltd, Aldershot
there has been a response.
Gumucio Dagron A (2001) Making waves: stories of
We don’t know enough about that response to lay great
participatory communication for social change, Rockefeller
claims to a direct causal link between cultural approaches
Foundation, New York
and prevention. But the emerging evidence indicates that
credible, locally owned, culturally appropriate HIV and AIDS
Lynn O J (2004) AIDS – the lucrative disease.
programmes are important to effective treatment and could
Email Community-Research@eforum.healthdev.org
be critical to prevention.
Kaufmann P (2005), from interview/project materials for
There is a need for better evidence gathering on the value
HIV/AIDS the Creative Challenge, Creative Exchange,
and impact of cultural approaches to prevention and care.
London (forthcoming)
This must go beyond behaviour change to consider what
other impacts cultural approaches deliver and how useful
Low-Beer and Stoneburner (2003) cited in Court J (2004)
that is to HIV and AIDS prevention, treatment and care.
Draft Uganda Country Note, Bridging Research and Policy in
HIV/AIDS, ODI, London
Accepting more participatory and inclusive cultural
approaches requires a cultural shift among development
Marsh M (2004) HIV/AIDS The Creative Challenge Literature
policy makers and donors, towards “a culture of partnership
Review: Engaging with culture in HIV/AIDS communications,
and mutual learning with countries” (Rao and Walton, 2004).
Creative Exchange, London
But also towards a new system of developing change which
is based on respect for different ways of seeing and living in
Marsh M and Gould H (2003) Routemapping Culture and
the world, on valuing cultures, cultural expression and
Development, Creative Exchange, London
identity and their fundamental role in people’s lives. Cultures
and communities will remain unceasingly diverse and
Panos (2004a) Missing the message: 20 years of learning
complex. The donor response has to change so that HIV and
from HIV/AIDS, Panos, London
AIDS strategies are effective and meaningful in these cultural
realities.
Panos (2004b) HIV/AIDS communication and treatment
scale-up: promoting civil society ownership and integrated
approaches to communication, issues and challenges
REFERENCES emerging from the integrated AIDS communication, meeting
Altman D (1998) ‘Globalization and the AIDS industry’, report, Geneva 29-30 April 2004
Contemporary Politics, Vol 4 (3)
Robins S (2005) Rights Passages from ‘Near Death’ to ‘New
Ayvalikli D, Brown J C and Mohammad N (2004) Turning Life’: AIDS Activism and Treatment Testimonies in South
bureaucrats into warriors: Preparing and implementing multi- Africa, Working Paper 251, Institute for Development
sector HIV-AIDS programs in Africa. A Generic Operations Studies, Brighton
Manual, World Bank, Washington
Rao V and Walton M (2004) Culture and Public Action,
The Commission for Africa (2005) Our Common Interest: Stanford University Press, Stanford, California
report of the Commission for Africa, The Commission for
Africa, London Sanders E (2005) Uganda Takes Up Abstinence Campaign,
Los Angeles Times, Los Angeles
Clemmons L, and Coulibaly Y (2000) Turning the Ordinary
into the Extraordinary: The Green Pendelu and Maternal Sen A (2004) ‘How Does Culture Matter?’ in Rao and Walton
Health in Mali, BASICS II Project and USAID, Arlington (2004)

Singhal A and Rogers E M (2003) Combating AIDS:

www.healthlink.org.uk 6
Findings
NO.? | MONTH YEAR
Communication strategies in action (abstract), Sage
Publications, New Delhi
Skuse A (Ed) and Power F (2005) AIDS Communication,
DFID, London
Somma D B and Kessler Bodiang C (circa 2004) The Cultural
Approach to HIV/AIDS Prevention, Swiss Agency for
Development and Cooperation/Swiss Centre for International
Health,Swiss Tropical Institute, Geneva
UNDP (2004) Human Development Report 2004: Cultural
liberty in today’s diverse world, UNDP, New York
UNGASS (2001) Political Declaration on HIV/AIDS [online],
UNAIDS, Geneva
http://data.unaids.org/pub/Report/2006/20060615_HLM_Poli
ticalDeclaration_ARES60262_en.pdf#search=%22UNGASS
%20political%20declaration%22 accessed 15 June 2006
UNFPA (2004) Culture Matters, Working with Communities
and Faith-based Organizations, New York
UNESCO (1982) Mexico City Declaration on Cultural Policies,
from the World Conference on Cultural Policies Mexico City,
26 July - 6 August 1982, UNESCO, Paris
UNESCO/UNAIDS (2000) A cultural approach to HIV/AIDS
prevention and care: Summary of country assessments and
project design handbook, UNESCO, Paris
UNESCO/UNAIDS (2001a) A cultural approach to HIV/AIDS
prevention and care, Methodological Handbook 1:
Appropriate Communication for Behaviour Change, (2001b)
Methodological Handbook 2: Strategy and Policy Building,
(2001c) Methodological Handbook 3: Fieldwork: Building
Local Response, (2001d) Methodological Handbook 4:
Project Design, Implementation and Evaluation Division of
Cultural Policies, UNESCO, Paris.
UNESCO/UNAIDS (2002) A cultural approach to HIV/AIDS
prevention and care: summary of country assessments,
Division of Cultural Policies, UNESC0, Paris
Vidal L (2003) ‘The Shortcomings of Culturalism and
Relevance of the Social Dimension in the Approach to AIDS
in Africa’, in HIV/AIDS Stigma and Discrimination: An
Anthropological Approach, UNESCO/UNAIDS Project: A
cultural approach to HIV/AIDS prevention and care, Studies
and Reports Special Series, Issue No 20, Division of Cultural
Policies and Intercultural Dialogue, UNESCO, Paris
Van Kampen J (2006) ‘The ABC Disaster’, The Drum Beat
[online], No 345 www.comminit.com/drum_beat_345.html
accessed May 2006
Vincent R (2004) ‘What do we do with culture? Engaging
www.healthlink.org.uk
NO.7 FEBRUARY 2007
culture in development’, Exchange Findings, No 3,
Exchange, London
World Faiths Development Dialogue (WFDD) (2001) Cultures,
Spirituality & Development, World Faiths Development
Dialogue (WFDD), Oxford
UNAIDS (2005) Expanding access to HIV treatment through
community-based organisations: A Joint publication of
Sidaction, the Joint United Nations Programme on HIV/AIDS
(UNAIDS) and the World Health Organization [UNAIDS Best
Practice Collection], UNAIDS, Geneva
UNAIDS Inter-Agency Task Team (IATT) on Education (2006)
HIV and AIDS Treatment Education: A Critical Component of
Efforts to Ensure Universal Access to Prevention, Treatment
and Care [forthcoming], UNESCO, Paris
UNESCO/WHO (2006) Report on the HIV Treatment
Education Consultation co-organized by UNESCO and WHO
[forthcoming], UNESCO, Paris
UNGASS (2006) Political Declaration on HIV/AIDS [online],
UNAIDS, Geneva http://data.unaids.org/pub/Report/2006/
20060615_HLM_PoliticalDeclaration_ARES60262_en.pdf#se
arch=%22UNGASS%20political%20declaration%22
accessed 15 June 2006
Vincent R (2006) Facing up to HIV and AIDS – effective
communication for prevention treatment and care, for a
sustained response, Panos, London
WHO (2003) ‘Case study. Perspectives and practice in
antiretroviral treatment’ in Antiretroviral therapy in primary
health care: experience of the Khayelitsha programme in
South Africa, WHO, Geneva
WHO (2005a) Progress on Global Access to HIV Antiretroviral
Therapy: an update on “3 by 5” [online] WHO/UNAIDS,
Geneva http://www.who.int/3by5/ fullreportJune2005.pdf
accessed 15 June 2005
WHO (2005b) ARV Toolkit: a public health approach for
scaling up anti-retroviral (ARV) treatment WHO; International
HIV/AIDS Alliance; PharmAccess International; and GTZ,
Geneva
7
Findings
NO.? | MONTH YEAR
NO.7 FEBRUARY 2007

ACKNOWLEDGEMENTS
This Findings paper was written by Helen Gould of Creative ABOUT FINDINGS PAPERS
Exchange based on research prepared by Marsh Marsh and
Findings papers are snapshots of key areas of health
Judy El Bushra for the international research project
communication to inform development practitioners
HIV/AIDS: The Creative Challenge.
and policy makers and to stimulate critical reflection.

Thank you to the reviewers: Manilee Bagheritari, Ailish Byrne,

Findings papers were orignally produced by Exchange
Andrew Chetley, Helena Drobna, David Finer, Colette Harris,
– a networking and learning programme on health
Fiona Power, Pat Norrish, Ross Kidd, Ben Ramalingam,
communication which was hosted by Healthlink
Robin Vincent, Paul Zetter.
Worldwide. Exchange has been integrated into a
Communication, Networking and Learning programme
This paper is complemented by HIV/AIDS: The Creative
at Healthlink Worldwide, which will continue to produce
Challenge Literature Review: Engaging with culture in
Findings papers.
HIV/AIDS communications (Marsh, 2004).
We welcome your feedback on this paper.
The second stage of HIV/AIDS: The Creative Challenge will
draw out stories of cultural practice from selected cluster
regions with the aim of stimulating a process of engagement
with policy makers and practitioners. Creative Exchange
welcomes readers’ own examples.
Key list
www.asksource.info

CULTURE AND HIV & AIDS

A list of key organisations, articles, newsletters, books
and websites on this topic is available from Source
International Information Support Centre.

See the Creative Exchange website for more details

www.creativexchange.org or contact
Creative Exchange,
56-64 Leonard Street,
London EC2A 4JX,
United Kingdom
Tel: +44 (0) 207 065 0980

Healthlink Worldwide T: +44 207 549 0240

56-64 Leonard Street F: +44 207 549 0241
London EC2A 4LT info@healthlink.org.uk
United Kingdom www.healthlink.org.uk

www.healthlink.org.uk 8