HIV and Aids is a major health problem with a wide ranging impact on employment, the economy, security and human rights. In the military environment HIV can cause loss of continuity at command level and within the ranks, increased costs with regard to recruitment and training for replacements, a reduction in military preparedness, increased costs with regard to health care, loss in productivity and a reduction of internal stability.

Since it's discovery, HIV has continued to cause large scale morbidity and mortality, and with the exception of a few successful programs, continue to infect and affect communities all over the globe. Some of the most identifying characteristics of the epidemic has been that it can occur under any socioeconomic condition, and that the virus establishes itself in communities by means of sexual transmission. These two characteristics combine to form one of the few successful preventative responses, that of behavior change programs.

Due to the wide variety of environmental impacts on behavior, and the myriad of social taboo's that influence sexual choice and sexual expression, every program has to be developed within a specific community or group to ensure a common understanding. This severely limits copying successful interventions, and is the cause for failure of the majority of unsuccessful attempts at transferring programs that seem to be working.

The Masibambisane program of the Department of Defense is an excellent example of such a prevention program, and is based on the existence of a common identity and closed community found in the military environment. According to Masibambisane:

"... soldiers operate within a strict military code of conduct which leads to a controlled environment where your life and well-being depends on following orders and the support of your fellow comrades."
Since the effectiveness of such programs have been scientifically proven, not much further research has been done in the field of HIV Prevention, but what has received a lot of attention is research on perception, awareness, reasoning and consciousness. Research that has changed the way we look at emotions, feelings, attitudes and choices. Research that is changing how we look at the world around us, how that change influence the choices we make, and how we think about consciousness itself. According to LiveScience:
"It wasn't that long ago that the study of consciousness was considered to be too abstract, too subjective or too difficult to study scientifically. But in recent years, it has emerged as one of the hottest new fields in biology, similar to string theory in physics or the search for extraterrestrial life in astronomy."
According to the Stanford Encyclopedia of Psychology, the problem of consciousness is arguably the central issue in current theorizing about the mind. 
"Despite the lack of any agreed upon theory of consciousness, there is a widespread, if less than universal, consensus that an adequate account of mind requires a clear understanding of it and its place in nature."
In HIV Prevention, where the success of most interventions are measured by the subject making conscious and well informed, healthy choices, it is important that recent scientific research in this area be noted and incorporated into any planned health intervention. If we consider the current level of discourse on consciousness and examine our expanded knowledge and understanding of behavior, it is necessary that we re-evaluate existing behavior change programs. More so in the case of new interventions being planned for funding.

I am convinced that a better understanding of perception, awareness and consciousness will radically change the way we look at HIV Prevention, and will result in a fresh approach to combating the scourge of HIV, and my experience in Masibambisane has left me convinced that any successful program is built on a shared objective. The more people that share in that objective, the greater the chance to succeed.

I believe that the reward of a review that highlight some of the recent discoveries about our mind, what we believe and how we think will not only invigorate the jaded view on HIV prevention, but will foster some well needed discussion between the different authorities involved in the planning and execution of health prevention policies and programs. 

Please let me know what you think.


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