5 interrelated domains of context that should be the focus in developing future communications strategies for HIV/AIDS prevention, care, and support. These are:

1. Government Policy - the role of policy and law in supporting or hindering intervention efforts.
2. Socioeconomic Status - collective or individual income that may allow or prevent adequate intervention.
3. Culture - positive, unique or negative characteristics that may promote or hinder prevention and care practices.
4. Gender Relations - status of women in relation to men in society and community and the influence on sexual negotiation and decision making.
5. Spirituality - role of spiritual/religious values in promoting or hindering the translation of prevention messages into positive health actions.

1) Advocacy

Careful attention must be given to the fact that political and social advocacy affecting decision-making processes might be needed before any technical work (methodology), such as a communications campaign, is conducted. Political decisions often affect the types of messages that will be part of a communications campaign, which means that even if a communications campaign is methodologically sound, it may still be limited in impact, due to political issues and decision making.

• Advocacy is needed on different fronts throughout the region. For instance, issues of men who have sex with men tend to be ifnored in some countries. Thus, advocacy must be conducted at local and national, as well as at international levels.
• The need to strengthen support groups is increasing. Advocacy must play a critical role in this process. For instance, where necessary, access to basic health services must be advocated for people living with HIV/AIDS.
• Efforts must be made to develop strong partnerships among the media, government, and NGOs. However, this must be achieved through negotiation, sensitization of media owners, and proposal of sound communications strategies.
• UNAIDS must play a variety of roles in this process: as a facilitator of processes, to promote prevention, and to promote greater attention at the individual and family levels through advocacy before policy and decision-makers.
• The creation of a Latin American regional speakers' bureau is one way to strengthen education and prevention programmes. People living with HIV/AIDS might feel more comfortable sharing their experiences in countries other than their own, where there is little chance of being ostracized or discriminated against.
• At the ethical level, people involved in delivering HIV/AIDS programmes must be self-critical and look inward to asses whether there is personal and organisational commitment to the work. Advocacy must be made to all audiences so as to gain political will and commitment.
• Issues such as violence, cultural values, human rights, education, sprituality, and law must also be taken into account in communications. It is noted that "human rights" has a negative connotation in certain contexts. Thus, other terms such as "human dignity" and "citizenship" should be used to avoid resistance.

2) Involving HIV-Positive Persons in Communication Programmes

• Persons living with HIV/AIDS must be involved in the planning, implementation, and evaluation of communications programmes. In this regard, negotiation and consensus among government, international organisations, and other groups affected by the epidemic is crucial.
• HIV/AIDS has a close relationship to emotion and feelings. Behaviour change does not occur in any one particular way. Entertainment, music, and humor are central elements of Latin American and Caribbean cultures and must be used in education and prevention programmes.
• Communications campaigns are no longer limited to prevention messages, but should take into account the health continuum from prevention to care and support.
• Communications strategies must be localized, so specific groups and areas might be targeted (e.g., urban and rural populations and vulnerable groups. Programmes must guarantee plurality and diversity and promote consensus (by keeping AIDS in the media and on social agendas).

"Communications Framework for HIV/AIDS: A New Direction" pp. 59-65; A UNAIDS/PennState Project - 1999.Click here for the PDF version of the full document.