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Focusing on People's Cultural Beliefs and Social Influences: Soul City's Approach by Lebo Ramafoko

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I think the challenges that we have suggest that we need a social revolution to deal with the real drivers of HIV in South Africa. "¶

At a meeting in May in this year, the SADC countries in southern Africa identified the following as key drivers of the epidemic: unequal gender relations, concurrent sexual partners, sexual violence, intergenerational sex, transactional sex due to poverty and due to social inequality and alcohol misuse.

If one looks at concurrent partners as a key to the epidemic, as Dr. Wilson suggested, one begins to understand that on average Africans are not having more partners than people in Europe and North America. But what is particular about southern Africa is that people seem to be having more than one partner at the same time.

And these are often relatively stable and long-term relationships. This is fine if it is a closed system"¶ .

This [slide] shows how if one person in the network is, or becomes, positive, and is highly infectious, in the first six weeks what the implications are for everybody else in the network.

And that is why I'm suggesting that we need a social revolution.

But what is the social revolution? I think we need commitment at all levels of society"¶

I think we need to synergize our messages. At the very least, even if we are sending different messages, we should all be driving at all our participants, our target audience looking at the whole issue of concurrent partners and the other key drivers.

We need multiple levels of intervention"¶ We also need well thought out and evidence-based communication across all sectors of society and we need social mobilization.

At this point I will turn to what the rate of social change communication can be. Society acknowledges that while most communication is targeted at the individual, more often it is the sectors that influence that individual [behavior];  what is happening at a community level and at a broader social economic level are basically indicators on whether or not an individual can change [their] behavior.

"¶Several social scientists propose social influence as a key mechanism of change. Social influence, social comparison and convergent theories specify that the perceptions and behavior of peers or other types of reference groups influence one's perception and behavior.¬† Especially in uncertain or ambiguous situations, people rely on the opinions of others.

"¶Theories of social change and of social influence look at the importance of social networks and behavior change. [They] propose that the degree of social interconnectiveness determines the likelihood of exposure to new ideas and behavior"¶.

Many of these theories look at mass media as a significant social influence, able to shape and legitimize social norms and personal beliefs. Impacting on attitudes and beliefs is an important objective of communication for social change, interventionally. [This is] despite the fact that it is well documented that positive attitudes in themselves do not directly predict healthy behavior"¶ .

The BASNES model is a good example. "¶ BASNES stands for beliefs, attitudes, subjective norms and enabling sectors. According to this model an individual will take up a new practice when he or she believes that the practice has sufficient benefits, health or otherwise, and considers these benefits important.

He or she may then develop a positive attitude toward the change, influences, or subjective norms from others in the environment,[those] who are important to him or her will also influence his or her decision whether to try this new practice.

"¶ At Soul City, we analyzed our first series, which dealt with one topic that was also a norm in our society, which was domestic violence where the held belief was that domestic violence was a right. The woman needed to be controlled by the husband"¶; therefore, you will not intervene when a husband is beating up the wife.

An analysis of the Soul City Four Series examined the nature of the relationships between attitudes, beliefs and desired behavior. It suggests that beliefs play a role through a more complex causal pathway than often assumed in the literature. Although a direct association between positive personal beliefs and behavior may be inconsistent or weak, personal beliefs and interaction with perceptions of one's reference group's beliefs may play a significant role in impacting on positive behavior and intention through interpersonal discussions as an intermediate social process.

The analysis documents the influences of mass media communication of subjective norms, interpersonal communication and debate and, ultimately, on desired behavior. An evidence-based argument is made for using mass media to impact all social norms and individual beliefs as an important mechanism in bringing about the social change.

Exposure to Soul City Series Four, [was] associated with a significant positive shift in subjective norms. It associated with exposure to Soul City Series Four significant positive shifts.

Therefore, mass media communication interventions can and do impact on subjective norms, interpersonal communications, and debate and then, ultimately, desired behavior change through a number of mechanisms.

Through a drama series, you can model the desired behavior. You can show through story the choices and the consequences of [choices]. There is a parasocial interaction. There is deep emotional engagement that audiences have with the characters and through the legitimizing effects.

But what should the common message be? Whatever the message is, I want to argue that it must address gender inequality by focusing on male involvement, responsibility, accountability "¶ for HIV prevention.

I think as Dr. Madlala has indicated, it needs to address the fears that men have around the whole issue of gender equality and women's empowerment.

But how can we communicate this? I want to argue after a number of years of experience in doing mass media communication that pretesting is important. There is a big gap between research that understands that concurrent partnerships and/or gender inequality drives the epidemic and telling stories that resonate with audiences.

So whatever the messages are, we need to make sure that the audiences understand the message in the way that it was intended to be understood. In other words, we need to make sure that we do not blame the victim. 

We [at Soul City] understand where our audiences come from. We understand the stories that would resonate. We understand why women would stay in relationships where they know that their partners are having other partners.

And we tell stories or we give messages that would resonate [with] reality. Thank you.

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