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  

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.    

Evalua+on  

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).      

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Conclusion  

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.    

Thank  You!  

•  The  Government  Hospital  for  Thoracic  Medicine,  Tambaram  

•  Dr.  David  Gere,  UCLA  Global  Health  Center  •  Mr.  Rajeev  Verma,  Make  ART  Stop  AIDS  •  The  Elizabeth  Taylor  AIDS  FoundaLon,  Los  Angeles