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Looking back, look forwards Ross Duffin, AFAO Educators Conference
Some impressions from coming back into the field <ul><li>Positive Life Project </li></ul><ul><li>Educators divided loyalti...
Some impressions from coming back into the field (cont’d) <ul><li>Two conversations </li></ul><ul><li>i) gay men – when an...
Then - The mythical golden age of prevention <ul><li>Extraordinarily rapid behaviour change </li></ul><ul><li>Gay organisa...
Now – A period of stasis <ul><li>Behaviour change going in the “wrong” direction </li></ul><ul><li>Public health, AIDS org...
This talk <ul><li>What lessons can be learnt out of 30 years of practice that lend themselves to practical recommendations...
1. Always focus on the big picture <ul><li>Example of TB versus HIV drug education in Sth Africa </li></ul><ul><li>Golden ...
2. Use core educational theory and practice <ul><li>Curriculum, pedagogy </li></ul><ul><li>Adult education principles </li...
3. There is an ethical obligation to convey information ‘without bias’ <ul><li>Oral sex and re-infection examples </li></u...
4. Try to work in the current conversations and practices – not in the past <ul><li>Gay men ‘when and where to give up con...
5. Find the balance between ‘professionalism’ and ‘personal experience’ <ul><li>1980s – sort of rejection of ‘professional...
6. A generalist or a ‘specialist’ <ul><li>A number of specialist disciplines and practices impact on HIV Education – educa...
7. Beyond social marketing <ul><li>Social marketing has become the most visible and talked about strategy of education – (...
8. Because we care <ul><li>Why do we still do HIV education? Does it matter?  </li></ul><ul><li>Not because of a commitmen...
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Looking back, look forwards

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This presentation was given by Ross Duffin at the AFAO HIV Educators Conference 2010.

Published in: Health & Medicine
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Looking back, look forwards

  1. 1. Looking back, look forwards Ross Duffin, AFAO Educators Conference
  2. 2. Some impressions from coming back into the field <ul><li>Positive Life Project </li></ul><ul><li>Educators divided loyalties </li></ul><ul><li>Constant demand for more “prevention education” </li></ul><ul><li>Professionalism and the loss of gay / HIV-positive voices </li></ul><ul><li>Dominance of thinking that social marketing as the core strategy </li></ul><ul><li>Generational shift – transfer of knowledge </li></ul>
  3. 3. Some impressions from coming back into the field (cont’d) <ul><li>Two conversations </li></ul><ul><li>i) gay men – when and under what circumstances can we stop using condoms </li></ul><ul><li>ii) educators – how do we encourage gay men to stick to persistent condom use </li></ul>
  4. 4. Then - The mythical golden age of prevention <ul><li>Extraordinarily rapid behaviour change </li></ul><ul><li>Gay organisations seen as incredibly effective and gay men as ‘good’ and incredibly good at prevention education </li></ul><ul><li>The confluence between government, public health and gay community </li></ul><ul><li>Being sex-positive in a sex-negative era </li></ul><ul><li>Mass media coverage </li></ul><ul><li>The threat that HIV/AIDS was seen as to the emergent (and recently legal) gay community (cf sex work and IDU) </li></ul><ul><li>Everyone was involved in the same conversation about HIV/AIDS (which soon began to splinter) </li></ul>
  5. 5. Now – A period of stasis <ul><li>Behaviour change going in the “wrong” direction </li></ul><ul><li>Public health, AIDS organisations, Gay men and their collectivities, and Governments all have different interests – many masters and confusion from targets </li></ul><ul><li>Hard to get traction and program participation </li></ul><ul><li>The more usual situation for prevention education – much more difficult task </li></ul><ul><li>Sexual caution instead of pro-sex </li></ul>
  6. 6. This talk <ul><li>What lessons can be learnt out of 30 years of practice that lend themselves to practical recommendations </li></ul>
  7. 7. 1. Always focus on the big picture <ul><li>Example of TB versus HIV drug education in Sth Africa </li></ul><ul><li>Golden era (and the myths it created), Post-AIDS </li></ul><ul><li>Now – normalisation, Internet, individualism, HIV infection endemic, no AIDS epidemic, HIV and Ageing </li></ul><ul><li>Practice recommendations </li></ul><ul><li>i) Reflective spaces focussed on the big picture </li></ul><ul><li>ii) Plenaries / conference sessions on broader culture and contexts </li></ul>
  8. 8. 2. Use core educational theory and practice <ul><li>Curriculum, pedagogy </li></ul><ul><li>Adult education principles </li></ul><ul><li>Curriculum </li></ul><ul><ul><li>How HIV is transmitted (less?) </li></ul></ul><ul><ul><li>How HIV is treated (less) </li></ul></ul><ul><ul><li>What characterises HIV disease (less) </li></ul></ul><ul><ul><li>Technologies of HIV prevention (condoms, biomedical, testing) (variable) </li></ul></ul><ul><ul><li>The lived experience of being HIV+ (less) </li></ul></ul><ul><ul><li>An ongoing conversation about appropriate ways to use this information (problematic) </li></ul></ul><ul><li>The invisible curriculum </li></ul><ul><ul><li>Ways of being / doing gay </li></ul></ul><ul><ul><li>Normalisation versus sexual cultures </li></ul></ul><ul><li>Recommendations </li></ul><ul><li>Promote and use HARM more (and/or NAM) </li></ul><ul><li>Regular basic information production </li></ul><ul><li>Training </li></ul><ul><li>Strategies to make public the modern lived experience of HIV+ </li></ul>
  9. 9. 3. There is an ethical obligation to convey information ‘without bias’ <ul><li>Oral sex and re-infection examples </li></ul><ul><li>Gatekeepers? HIV and Ageing, Undetectable viral load </li></ul><ul><li>Spin – and HIV statistics </li></ul><ul><li>Recommendations </li></ul><ul><li>Make public information on HIV and Ageing </li></ul><ul><li>Produce a regular ‘state of the epidemic’ report </li></ul>
  10. 10. 4. Try to work in the current conversations and practices – not in the past <ul><li>Gay men ‘when and where to give up condoms’ versus ‘how to keep gay men wearing condoms’ </li></ul><ul><li>1984 – one conversation, 1987 – divergence – testing , negotiated safety – educational response 7 years later. Late 1980s – people using HIV status in sexual negotiations (still no effective response) 1996 – new treatments, gonorrhoea returns, risk reduction outside of regular relationships 1999 – syphilis returns. Education had a decade long struggle with incorporating risk reduction education. </li></ul><ul><li>Research documents the past – handing over too much to research (eg syphilis action plan) </li></ul><ul><li>The need to take risks in the absence of perfect knowledge or data </li></ul><ul><li>Recommendations </li></ul><ul><li>Set up professional spaces to talk about the current conversations / issues </li></ul><ul><li>Develop and document collaborative response to these issues </li></ul>
  11. 11. 5. Find the balance between ‘professionalism’ and ‘personal experience’ <ul><li>1980s – sort of rejection of ‘professionalism’ – dominant mode – activism (overlap with Ottawa Charter) </li></ul><ul><li>2010 – ‘health professional’ dominant mode – lack of a ‘gay voice’ or ‘positive voice’. </li></ul><ul><li>Original reason for funding CBOs (still exists with government) was personal experience </li></ul><ul><li>Relationship between connection with constituency and professionalism? </li></ul><ul><li>Making the constituency ‘other’ and increasing stigmatisation </li></ul><ul><li>What a gay voice brought to the table (oral sex) and its absence didn’t (syphilis) </li></ul><ul><li>Recommendations </li></ul><ul><li>Practice appropriate places to speak with a gay voice (eg here) (gay men as ‘other’ in the program) </li></ul><ul><li>Incorporate personal experience into professional practice </li></ul><ul><li>Organisational policy in regards to disclosure of personal experience </li></ul><ul><li>‘ Community development’ projects - reconceptualisation </li></ul>
  12. 12. 6. A generalist or a ‘specialist’ <ul><li>A number of specialist disciplines and practices impact on HIV Education – education, personal experience, biological sciences, psychology, sociology, social marketing, epidemiology, health promotion, cultural studies…(the scope of what an HIV educator is expected to do and does is way too large) </li></ul><ul><li>My experience is that people who pick and choose the appropriate application of these knowledges to particular problems do best at working in the current moment </li></ul><ul><li>Recommendations </li></ul><ul><li>Reality is only a few people with have the skills, ability and knowledge to work across many disciplines – find them, support them and use them </li></ul><ul><li>Management / organisational role to better define some jobs </li></ul>
  13. 13. 7. Beyond social marketing <ul><li>Social marketing has become the most visible and talked about strategy of education – (mainly because in the sector it is used as a vehicle to talk big picture). Our reliance on it comes at a time when it is harder and harder to get attention and because of its familiarity / brand no matter what it actually says is usually read as ‘wear condoms’. </li></ul><ul><li>The purpose of social marketing is to create social spaces to talk about relevant issues </li></ul><ul><li>A whole set of the ‘toys’ in the health promotion toolbox have been deprioritised </li></ul>
  14. 14. 8. Because we care <ul><li>Why do we still do HIV education? Does it matter? </li></ul><ul><li>Not because of a commitment to the past and the ghosts we walk with </li></ul><ul><li>Why HIV still matters </li></ul><ul><li>Individualism versus a ‘culture of care’ </li></ul><ul><li>The stuff we don’t talk about in regard to living with HIV being endemic – trust, disclosure, fear…. </li></ul>

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