HIV and Aids Social Marketing among the Injectable Drug Users - Essay Example

?HIV AND AIDS SOCIAL MARKETING AMONG THE INJECTABLE DRUG USERS 1 Background Kotler and Zaltman (1989) were the first to use the term social marketing in 1971 in reference to marketing application to social and health problem solution. Social marketing is defined as "the design, implementation and control of programs calculated to influence the acceptability of social ideas and involving considerations of product planning, pricing, communication, distribution and marketing research". Marketing has been a successful strategy in encouraging the public and individuals to buy products for instance Coca-Cola and Nike. So they believed social marketing strategy can be used to encourage people to adopt behaviours that enhance their lifestyles. The spread of HIV and AIDS is mainly caused by social and health problems, therefore social marketing offers mechanisms for solving such problems through encouraging people to live healthier lifestyles. According to Kotler & Roberto (1989); Rogers (1995), the idea of diffusion and social marketing has been transformed to form strategies for use by the public throughout Asia, Africa, North America and south America. According to the United Nations, in the past two decades 60 million people have been infected by HIV/AIDS and reportedly 20 million deaths have been reported. Ninety-five percent of the infected population presently live in developing countries. The report on the Global HIV/AIDS Epidemic, UNAIDS (2002) warned that unless prevention and treatment measures are put in place and followed diligently, over 68 million people would die in the next 20 years. Established cases of HIV/AIDS infection have increased in occurrence throughout different region and numerous countries report severe HIV epidemics amongst injecting drug users (IDUs). The countries with high frequency of HIV infections among IDUs are Myanmar, Thailand, Indonesia, Nepal, Malaysia, Vietnam, China, India and Iran. Justification One of the major HIV/AIDS epidemic accelerants is the drug abuse and misuse. The major barrier in the fight against new HIV infections, recent drug use and emerging responses is the limited up-to date information on the magnitude of the problem. Reports across several countries on the number of HIV infection cases show drastic increase among IDUs. Countries in transition and especially developing countries are extremely susceptible to drug abuse and the risks associated therewith, piling serious burden on already frail health and social facilities. UNAIDS (2002) and WHO (2004) state that there was and still is the potential for a main outbreak of HIV among the IDUs particularly in Russia and bordering countries in the Eastern Europe and in other numerous countries especially across Asia. In some countries with high HIV frequency among the IDUs, HIV prevention measures have been implemented however reports of low effective impact ability upon epidemic among the IDUs is due to their limited availability and thus receive few drug users. On the other hand some assessed countries are yet to enact policies that specifically address HIV/AIDS issues affecting the IDUs. Some countries rarely address the issue before it becomes an epidemic and therefore the policy makers and programs tasked with the drug use and HIV are deemed unnecessary. Across the world over, HIV and AIDS response in Australia is recognised as a success. The national prevalence is lower compared to other high income countries. Through peer education and community based organisations the IDUs, gay communities, and sex workers in Australia on a national gesture prepared early and efficient on the embryonic crisis such as providing support, care and education on the importance of safe sex and drug injecting practises. Initially, the government and healthcare professionals established sturdy leadership program, across the affected communities and the epidemic at large. Australia continues to utilize and gain from the good leadership foundation and the level of the policy innovation. For instance, the implementation of needle and syringe programs (NSPs) that prevented extensive HIV epidemic among people who inject drugs. There is approximately 13.2 million IDUs the world over, with more than 10 million (78%) living in developing and transitional countries. Aceijas & Stimson et al., (2004) estimates propose that about 3 million (30%) out of them are infected with HIV. Furthermore, in communities worst affected slightly more than 80% drug users are infected. Injecting drug users in 2002 was estimated to account for 10% of all HIV new infected (UNAIDS 2002). 1.2 Campaign purpose and intended impact or benefit The social campaign seeks to maintain Australia HIV response, long-standing accomplishment among the IDUs and the sex workers. In 2002 the intervention began in Dagou and in Luzhai on the needle social marketing strategies conducted in detoxification centres and also the wider community. In the intervention site the population targeted was IDUs. The activities made use of the local recourses including hospitals, pharmacies, and clinics to reach the IDUs. The wide variety of interventions used in the detoxification centres in order to reduce HIV related cases among the IDUs comprised of needle and syringe exchange programmes, a range of outreach work, voluntary counselling and testing (VCT), peer education, treatment programmes, and substitution maintenance therapy for opioid dependence. According to Stimson & Donoghoe (1997), there is considerably high and increasing body of proof, mostly but not solely from developed countries, to prove that IDUs are able to and are motivated to alter their behaviour to decrease own risk of HIV infection, thus lessen degree of the risk to others. This is encouraging for those working in the HIV prevention field. 1.3 Focus The focus is on the social marketing on HIV and AIDS prevention campaign among people who inject drugs (IDUs). Most HIV/AIDS campaigns tend to strongly focus on prevention messages and treatment information, so social marketing assistance typically entails procuring and distributing pharmaceuticals, over-the-counter drugs, and condoms. Consequently due to increased accessibility of successful antiretroviral therapies, the yearly number of AIDS diagnoses in Australia has remained moderately constant in 2001-2007 at just about 240. The sole biggest HIV/AIDS national donor assistance comes from US. In most regions the non-government organisation (NGOs) sectors leads in responding to HIV and drug use. Nevertheless, bearing in mind the problem size, the number of non-government organisations (NGOs) operational in this region is relatively small. A number of studies have pointed out the significance of not only needle syringe sharing exercises in transmission of HIV but also sharing of cotton wool, drug containers, and other injection paraphernalia (Chitwood, McCoy & Comerford 1990). Moreover, the use of contaminated syringes according to Chitwood et al (1990) may not involve sharing, in the sense of the communal act of passing a just used needle to a waiting partner, but somewhat pooling of used needles. 2.0 Analysis 2.1 Internal Strengths The internal strength of the project is that already the IDUs programmes such as NSPs has been experimented and proven to be efficient. Thus, the fight on HIV among the IDUs is a competitive edge to its competitor. 2.2 Internal Weaknesses The internal weakness of the programme is the financial constraint as very few if any governments and non -governmental organisation have put measure in the fight against HIV among the IDUs. 2.3 External Opportunities With the success of the fight against HIV/AIDs among the IDUs in countries such as Australia and other high income countries, it is a great opportunity for other countries to emulate such programmes to fight the epidemic. 2.4 External Threats The continued spread of HIV/AIDs among the IDUs, especially in the developing countries is a major threat to the fight against HIV. Consequently, the increase in the number of people taking drugs increased globally. 3.0 Target market The target markets include governments, non-governmental organisations of different countries in different regions, and individuals whether affected or infected. The market will be targeted with the help of marketing mix which entails product, price, place and promotion. Product refers to the set of benefits related to the desired behaviour or service usage (Kotler et al. (2002). For example, supply of safe needles and syringes to IDUs, and condoms for their protection when having sex. Price refers to the cost or sacrifice exchanged for the promised benefits. The benefit for not using infected needles and syringe is to be HIV/AIDS free (Hastings & Donovan 2002). Place refers to the distribution of goods and the location of sales and service encounters for instance in actions or exhibitions where goods and services can be easily accessed (Kotler et al. 2002). Promotion includes the type of influential communications marketers use to put across product benefits and related tangible objects and services, pricing strategies, and place components (Kotler, Roberto & Lee 2002) 3.1 The target group The target group are; IDUs, homeless, sex workers (Male and Female), transvestites, truck drivers, hospital and blood bank workers, women, professional blood donors, and the youth (Hanan 2003). In Australia HIV prevention among the IDUs has been highly successful. The success is due to the timely and early foreword and upholding of NSPs and the peer education base and drug users organisation in the HIV prevention. Nevertheless in spite of the early achievement, injecting drug users are the population mainly concerned because the rates of HIV among the group are responsive to the slightest change in the accessibility of injecting apparatus. 3.2 Barriers Primarily, there is limited access of basic healthcare infrastructure in many developing countries. These facilities are needed to offer counselling and testing, observing the progress of patients and making sure compliance with drug regimes. The alternative of recruiting and training large numbers of new healthcare workers tends to be expensive both at an individual, non-governmental or government level bearing in mind that the US is the major donor on the fight against HIV infection. Other challenges include improving women’s access to services due to some cultural tradition that bar women from empowerment in some countries yet women now account for almost three fifths of all HIV infections in sub-Saharan Africa. Another significant factor is stigmatisation, which is a setback in several developing countries. For instance, the fear of family and friends’ rejection to a positive HIV diagnosis is a influential cause in deterring people from going to VCT centres for HIV tests. 3.3 Benefits Benefits of the campaign include a reduced burden of HIV, hence a better general health status of people, particularly IDUs. Increase in private and public savings in health spending, through direct and indirect costs on the HIV infected patients. For instance, through the NSP strategies the IDUs are able to minimise the chance of being infected. By rising the way for lowering the threats of HIV contagion among the utmost-risk groups, the plan will augment the possibilities of IDUs people reducing own infection. Normally, women, men, and children will benefit equally from better admission to health care. The social marketing is a community intervention targeting behaviour change programs. The main beneficiaries would be the IDUs and their partners and others such as sex workers, truck drivers to mention but a few. 3.4 Objectives The main objective of the research is to ensure people with injecting drug users are well educated and informed of HIV and AIDs infection in relation to their social behaviour. Specific objectives To reduce the occurrence of HIV among the IDUs To decrease the risk behaviours linked with the spread of HIV among the IDUs and other related social behaviours. To prevent mortality related cases to drug use among the IDUs. To provide other social behaviour and measures to ensure reduction in the HIV transmission 4.0 Competition Hastings (2003) termed competition in commercial marketing as companies and/or products that put an effort to gratify comparable needs and wants as the item for consumption being endorsed. In social marketing, competition refers to the behavioural options that compete with public health recommendations and services. The phrase refers to the behavioural alternatives that battle with public health services and recommendations. 4.1 The competing alternative behaviours Education and Prevention Programs such as raise awareness and promote prevention of HIV/AIDS. First, it raises awareness through such programmes as; Peer Education, De-stigmatizing the Disease, Getting the Message Out, Going-Beyond the Workforce and Training. Secondly, it promotes prevention programmes including; Prevention of Mother-to-Child Transmission, Prevention and Treatment of STDs, Voluntary HIV Counselling and Testing (VCT), Condom Distribution and use, Review Occupational Health and Safety Procedures and Abstinence-based programmes. Thirdly, it monitors effectiveness; monitoring programmes helps the concerned parties to measure the progress against the stated goal of the behaviour for effective intervention and cost of the programme. Through reporting to the chain of command effective measures can be taken on time. Care and Treatment Programs Beyond awareness and prevention activities, care and treatment programmes on HIV/AIDS and/or other opportunistic diseases include Treatment of tuberculosis: The primary opportunistic infection is tuberculosis (TB). The most frequent cause of death among people leaving with HIV is TB. Anti-retroviral care: Anti-retroviral treatments, a generic phrase describing medications, and HAART (Highly Active Anti-Retroviral Treatment) have significantly boosted life expectancy among AIDS patients and made AIDS a manageable disease. Support system: Follow-up and moral support is extremely important to people living with HIV/AIDS. 4.2 Benefits audience associated with the behaviours With the care and treatment programme the audience understood the need to seek treatment early, the importance of the use of anti-retroviral drug to prolong life and a well established support system to help those infected by HIV/AIDS. The audience understood the procedure followed; hence they were assured of an effective monitoring of their progress by several programmes. Accessibility of healthcare facilities and services such as condoms, VCT, training on proper use of syringes, the place, price and the product required is made available. 4.3 Costs audience associated with the behaviours The cost of the products and services such as anti-retroviral drug, high quality condoms for men and women and counselling are expensive and can only be accessed by the wealthy members of the population. Some programmes such as sex abstinence till marriage is viewed unrealistic and also abstinence from drug is not easily attainable as the young people are mainly associated with IDUs. 5.0 Positioning statement IDUs and associated HIV/AIDS are spreading swiftly and influences most parts of the world. There is evidence that HIV epidemics among IDUs in both developed and developing countries can be prevented, slowed and even reversed through specific programs. Reference list Aceijas, C & Stimson, GV et al, 2004, ‘Global overview of injecting drug use and HIV infection among injecting drug users’ AIDS, vol 18, pp. 2295-2303 Chitwood, DD, McCoy, CB & Comerford, M 1990, Risk behavior of intravenous users: Implications of intervention. In: Leukefeld, C.; Battjes, R.; and Amsel, Z. eds. AIDS and Intravenous Drug Use: Future Directions for Community-Based Prevention Research. National Institute on Drug Abuse Research Monograph, U.S. Govt. Print. Off., Washington, DC. Chitwood, DD, McCoy, CB, Inciardi, JA, McBride, DC, Comerford, M, Trapido, E, McCoy, V, Page, JB, Griffin, J, Fletcher, MA & Ashman, MA 1990, ‘HIV seropositivity of needles from shooting galleries in South Florida’, American Journal of Public Health, vol. 80, no. 2, pp. 150- 152. Donovan, RJ & Henley, N 2003, Social Marketing: Principles and Practices, IP Commun, Melbourne. Gordon, R, Wilks, L & MacAskill, S 2009, Mapping Exercise Report on Social Marketing, Institute for Social Marketing, The Open University & University of Stirling, UK. Hanan, MA 2003, MARCH- media awareness related campaign for HIV, project Proposal, York University, Canada. Hastings, G & Donovan, RJ 2002, International initiatives: introduction and overview. Social Marketing Quarterly, vol. 8, pp. 3–5 Hastings, G 2003, ‘Competition in social marketing’, Social Marketing Quarterly, vol. 9, pp. 6–10 Janean, M 2004, Corridors of Hope Regional HIV/AIDS Cross-Border Prevention Program Secondary Analysis and Document Review, USAID/Washington Office of HIV/AIDS, Washington. Kotler, P & Roberto, EL 1989, Social marketing: Strategies for changing public behaviour, Free Press, New York. Kotler, P, Roberto, N & Lee, N 2002, Social Marketing: Improving the Quality of Life, Sage, Thousand Oaks, CA. Rogers, EM 1995, Diffusion of innovations (4th ed.), Free Press, New York. Stimson, G, & Donoghoe, M 1997, Health promotion and the facilitation of individual change. In Rhodes, T & Hartnoll R (Eds.), AIDS, drugs and prevention, Routledge, London. UNAIDS 2002, Report on the Global HIV/AIDS Epidemic, UN AIDS, Geneva, Switzerland. UNAIDS/PennState Project, 1999, Communications Framework for HIV/AIDS: A New Direction, UN AIDS, UK. WHO, 2004, Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users, WHO, Geneva, Switzerland Read More