HIV Communication for MSM, PLHIV, and Sex Workers in Jamaica

This report describes and evaluates an approach developed by C-Change in Jamaica: a series of Action Media workshops in November 2010 with most-at-risk populations (MARPs) including men who have sex with men (MSM), sex workers (SWs), and community educators to inform the development of social and behaviour change communication (SBCC) resources to support and strengthen HIV prevention interventions with or by these populations.

An excerpt from the report follows:
"The current strategy for working with SW and MSM related to HIV prevention in Jamaica is primarily through outreach activities, supplemented in part by the availability of a limited number of safe spaces...

A need for a comprehensive toolkit (training and SBCC materials) for peer educators serving MSM and SWs has been identified, particularly with a focus on non-print based SBCC materials that are tailored for these populations and that address psychosocial and mental health needs. Print materials that may identify an individual as MSM or a SW can be dangerous given the wide-spread stigma, discrimination, and violence faced by these groups. Using social media as a channel for reaching MSM and SW has been identified as a way to address their needs while maintaining confidentiality and privacy.

...Towards developing SBCC materials for HIV prevention with SW and MSM, a series of participatory communication development workshops were held from November 1 - 17, 2010 in Kingston, Jamaica. The workshops employed the Action Media methodology and were conducted with groups of 15 - 20 SWs, MSM, and peer educators. The workshops were facilitated by a C-Change communication specialist consultant.

The overall objectives of conducting Action Media Workshops were to develop SBCC resources that contribute to the reduction of HIV among MSM and SW and that could be integrated into existing programming with these priority populations....Within the workshops, contextual challenges, gaps, and needs in relation to health were also explored. The 'Action Media' methodology was developed in the mid-1990s in South Africa in response to approaches to health promotion that approached communities as 'target audiences,' to whom messages and imperatives about health should be directed....[In contrast,] Action Media allows for integration of audience perspectives through a process of deep reflection around critical issues that affect their lives, while at the same time assimilating linguistic and cultural view perspectives...

C-Change conducted Action Media workshops for two days with each participant group (MSM, SW, and peer educators). One week later, each audience group attended an additional session for concept testing material/media concepts derived from their first Action Media workshop....

Participants worked in small groups to discuss their likes and dislikes related to the workshop process and were encouraged to make additional suggestions....Participants reported the facilitators were open-minded and that they liked learning about diverse risk populations. The inclusion of grassroots' perspectives in communication development was appreciated. By being taken out of their comfort zones, they were able to gain a deeper understanding of some of the topics covered...

The Action Media workshops with SWs, MSM, and peer educators allowed C-Change to gain information related to its priority audiences' perspectives on HIV, their vulnerability to the virus, and their communication preferences. The workshop also allowed SWs and MSM to play an instrumental role in the creation of future media directed to them by moving past information needs and engaging participants contextually to make meaning of HIV information in their own way. The Action Media methodology worked well with each participant group and participants appreciated the opportunity for open discussion and interaction on issues that directly affect them. Focus areas for communication coming out of the workshop went beyond condom promotion to include personal safely and knowledge of legal rights.

...During the workshop, a number of jingles were developed that could be refined into audio clips for dissemination. Participants also mentioned the potential for video clips, including testimonies and stories that could be disseminated in formats similar to You Tube, but also are available on DVD, flash drives, or via other electronic formats. The potential to screen video clips at clubs (with sub-titles) was also mentioned. Another option may be disseminating media created (e.g. screen savers, audio clips, etc.) via existing websites...There are also a number of blog spots and other websites that focus on lesbian and gay issues in Jamaica and the Caribbean...that participants reported accessing.

Peer educators raised the lack of teaching support materials and job aids as barrier in their work. While support materials can include flip charts, they also cited the potential to use items such as video clips and other formats for telling and sharing stories and testimonies. Peer educators also thought the use of role plays and picture codes were useful.

While not explored in great detail during the workshops, channels for message dissemination were highlighted briefly. These include tapping into resource organizations, peer educators, help lines, websites, and word of mouth...

The Action Media Workshops yielded a wide-range of ideas for content related to human rights, personal safety, and HIV prevention. Many of these ideas represent the language and codes specific to SWs and MSM. It was noted that Jamaican Patois was generally difficult to read, but in the short form of slogans and jingles, the local dialect is emphasized as a preferred language of communication than more formal English. Preferred slogans and message orientations are detailed in the report and should be referenced when selecting 'starting points' for communication development...

During the workshops, an experimental approach was taken towards understanding participant perspectives on material design. This included sharing and eliciting comments on existing resources as well as reviewing designs produced by a graphic artist over the course of the workshop. It was clear that uniformity of design was important to participants for all materials produced across the various types of media...

Although the examples presented in the workshop were drawn from other countries or the internet, any images developed need to be relevant to Jamaican audiences, representative of the Jamaican population, and need to ensure that copyright issues and image rights, are addressed. Some participants of the workshop indicated interest in appearing as models for communication materials that are developed or sharing stories/testimonies for video or audio clips.

Other branding considerations emerging from the discussions included use of sponsoring agencies or funders' logos...

...Findings from these workshops, along with additional research and input from organizations currently working with MSM and SWs in Jamaica will be used to inform the development of a package of SBCC materials for SW and MSM. The media developed will be appropriate for use by peer educators or other individuals conducting small group interventions with SWs and MSM. Additional materials/media created will aim to increase the reach of these smaller group interventions by appealing to a wider set of SWs and MSM (e.g. social media activities, word of mouth campaigns, etc.)...

It is recommended that as SBCC packages are produced, participatory processes that engage the priority audience continue to be followed. In addition to widely pre-testing any developed media with SWs and MSM themselves, those participants from the Action Media workshop will also be engaged in dialog for further concept testing of the developed materials..."

Click here for the 41-page report in PDF format.