This document provides an overview of the discussions at the Joint United Nations Programme on HIV/AIDS (UNAIDS) technical consultation on social change communication on August 2–3 2007. The meeting explored the role of social change communication in achieving the ends of matching HIV/AIDS epidemic responses at the country level to the social drivers prevalent in each country, such as gender inequality, HIV-related stigma and discrimination, and human rights abuses, through activities that are effective, measurable, and can be taken to scale. Challenges to achieving those ends within the field of health communication and social change communication include a lack of coordination, investment, and consensus on key issues.

As stated in the document, there is knowledge and consensus on the need for HIV/AIDS prevention in a range of population "who are key to the epidemic dynamic"; hence, there is a call "for more operational guidance... on how to influence the social drivers that make many of these groups vulnerable. [There is a] need to gather, synthesize, and simplify concrete advice on [social change communication] methods for different audiences, along with their costs, expected outcomes, and indicators that can be tracked and reported both for learning and accountability."


Key issues in social change communication described in the document include:

• Participation and the limits of participation - Participatory communication, participatory monitoring and evaluation, and local ownership were cited as central to good health communication; but the knowledge, skills, and technical capacities required for social change communication are not always resident within a community. Also, there may be local aversion to tackling the topic of sexual transmission of the virus.
• Building the body of knowledge - Using the example of social marketing of condoms, the report suggests that the lack of investment in generating good baseline information before interventions is now hindering development years after the first social marketing interventions took place.
• Civil society’s role - The experiences of participants highlighted the fact that any effort to place communication solely within the hands of national governments would possibly jeopardise the initiative, innovation, and energy within civil society.

The participants recommended the use of UN General Assembly Special Session on HIV/AIDS (UNGASS) accountability frameworks, which are international frameworks providing benchmarks and incentives for national governments. The group consulted on a UNAIDS definition of social change communication and principles, contained in the document. The participants worked on recommendations for applying social change communication to three social drivers: gender inequality, stigma and discrimination, and human rights violations. They suggested mapping the local situation to develop a baseline of information before making any intervention and then monitor the changing trends in virus spread and instances of gender inequality as a project progresses. Guidance documents at a conceptual level on each driver were seen as valuable - for example, a resource on stigma from the Panos Institute. Capacity building at the local level was a recurring theme. The document includes case studies on each of the drivers.


Participants discussed challenges of scaling up when social change communication is developed in a location-specific manner. Flexible guidelines were emphasised for taking effective projects to scale regionally or nationally. Several evaluation models were presented in the evaluation discussion: a socio-ecological model, participatory monitoring and evaluation, and a multilevel communication for social change initiative. Another kind of evaluation, a large-scale qualitative and quantitative analysis, demonstrated how meta-analysis of programmes can give evaluators a broad overview, as well as how the quantitative and qualitative data could be made to interact in such a way as to give a good level of understanding of the contextual factors and rationale of sexual behaviour. This broader country analysis can show programme synergies that programme-level evaluations cannot.

In conclusion the document reviews next steps in taking social change communication to scale:

1. Review and understand different approaches to social change communication.
2. Synthesise research reports and the existing frameworks to provide a practical overview that is useful and accessible to national AIDS programme managers.
3. Include consideration of what practical steps and tools are available and recommended to plan and monitor activities to address the social determinants behind “the next 1000 infections”.
4. Develop a technical framework that can demonstrate how countries can assess their local epidemics and select from a variety of social change communication methods that focus on the appropriate levels of social context with the appropriate levels of participatory
   methodology.
5. Develop an accompanying matrix that shows how different solutions can address the different elements necessary for HIV prevention.
6. Develop simple promotional information about social change communication for policymakers. Begin with a consultant who can approach policymakers with a persuasive flyer or short ten-page introduction to explain social change communication.
7. Establish a database of experts.
8. Develop leadership within UNAIDS to ensure that national strategies respond to local epidemic scenarios and to coordinate the many communication resources, projects, and programmes among the cosponsors.

UNAIDS website.