"The most effective prevention messages are those which help provide skills to be used interpersonally regarding refusal, delay, and negotiation: ability to say no when pressured to have sex, to put off sex if unwanted, and to negotiate to use condoms. Role plays, rehearsals, et cetera, are most critical. Unfortunately, politics, religion, and supposed values often get in the way of delivering the messages that would be most likely to succeed: 'remain abstinent if you can, but learn how to negotiate for condom use if you're already active.'" Our personal interest is to develop this activity as a social movement, outside the money system, outside of all institutional structures. Others could try different models. Here is a way we can work every day to build a better life for ourselves, and a better world for all people, through exactly the same actions.

How does this relate to HIV prevention? Some programs already recognize a critical synergy of appeals -- teaching skills not only for disease prevention, but also for personal autonomy, and also (most important to adolescents, and many others as well) for social success. We suggest adding another element: programs where most of the learning takes place not in a group meeting, or while reading a poster or otherwise receiving a public-service message, but through well-designed, low-stress communication practices to do on one's own within the social context of everyday life. Then these practices can be delivered to the community in many ways, especially through leadership that already exists, including celebrities, and also including the natural leaders of local (or Internet) social scenes. Also, new scenes could be created to address pressing needs.

Commercial Sex Workers
Men having sex with Men
Truck drivers and helpers
IV Drug users
Population
Sub-groups
Prisoners
Migrant Labourers
Street Children
Students
Clients to CSWs
Research Objectives

To assess the knowledge of STD/HIV/AIDS among population and specific population subgroups. To identify the actual target audience for communicating the messages related to STD/HIV/AIDS. To identify approaches and means of communication most effective for the target groups. Analyse the existing materials used in the state for STD/HIV/AIDS control and assess the acceptance. Assess the groups who will be helpful in preventing STD/HIV/AIDS among the high risk groups and suggest the best way of reaching this group and recommend suitable communication strategy. Evaluating the adequacy of the existing media and need for modification, if any.

Awareness of STD/HIV/AIDS
Awareness of cause of infection
Awareness of sources of infection
Knowledge on ways that the HIV/AIDS virus spreads
Ways to prevent STD/HIV/AIDS
Differentiation between STD, HIV & AIDS
Sources of knowledge
Appropriate perception of risk
Proportion of respondents with risk behaviour who perceive appropriately that they are at risk of contracting HIV/AIDS
Misconceptions with regard to spread of virus
Exposure to risk
The nature of disease
Attitude towards influencing groups (such as NGOs, Counselors, Doctors, Drama Artists, Peers etc.)Likeability of various groups
Credibility of various groups
Media related issues
Media exposure
Intensity of exposure to each Media

CSWs, truck drivers and helpers, migrant labourers, MSM, IV drug users, prisoners, students, street children, clients to CSWs. The study covered each of these population sub-groups in detail. The above categories were covered in both urban and rural centres.

Urban
Coimbatore Madurai Trichy Salem

Rural
Namakkal Villupuram Vellore

Sample Size
Population sub-groups covered
Commercial sex workers (CSWs)
Migrant Labourers
Truck Drivers
Students
Men having sex with men (MSM)
Prisoners
Street Children
Clients to CSWs
IV Drug Users

Cycle rickshaw pullers
Auto rickshaw drivers
Pimps
Hotel/Lodge owners
Policemen

After all the sites where CSWs operate were identified, the required number of sites were randomly selected. Around 20 interviews were conducted at each site.

The site fixation was done by physically identifying all the areas where the truck drivers/helpers congregate in the survey towns. After all the sites were identified, then the required number of sites were randomly selected. Here again, 20 interviews were conducted in each selected site.

After all the construction sites in the survey towns were identified, the required number of sites were randomly selected. In each site, 10 effective interviews were conducted. Further, migrant labourers belonging to both sexes were covered.

Both male and female students were covered. School students studying in class-XI & XII, as well as college students pursuing any discipline were covered. The institutes within each survey town were selected by ensuring geographical spread and adequate representation of that town. 10 interviews were done in each selected institute.

Since MSMs segment is difficult to identify by normal means, the respondent contact for this segment was done with the aid of NGOs (such as Prakriti, ICWO etc.) The required number of interviews was done through purposive sampling thereafter.

The sampling procedure followed for this segment was similar to that of MSMs since this segment is also difficult to identify by normal means.

The inmates of the main central jails in three key study centres were covered. The support of Inspector General of Police (Prisons) was taken for this purpose. The respondents were randomly selected based on the number assigned to them by the jail authorities. The total sample was proportionately distributed across the central jails in three study centres.

NGOs Municipal corporation / Government departments
The required number of sites was randomly selected. The actual respondent identification was done through snow balling method. Around 10 interviews were conducted in each selected site.
Clients to female CSWs

This segment was primarily identified at the pre-mapped sites where CSWs operate. Around 10 interviews were conducted in each site.

Findings Among Sub - Groups

1. Awareness and knowledge about STD is quite high

2. Awareness of HIV/ AIDS is almost universal

The main media from where HIV/ AIDS messages are recalled:

3. Majority feel that the Government needs to initiate and continue steps towards providing HIV/ AIDS related knowledge to people

With respect to expectation regarding the media that could be used for educating CSWs, the following media were mentioned prominently : -

4. Interestingly, only a small proportion of CSWs contacted, expected written material like books/ pamphlets to be given to them.

5. Certain gaps noticed with respect to knowledge about prevention of HIV/ AIDS
Therefore, the focus of education should be on methods to prevent HIV/ AIDS

1 Awareness of and knowledge about STD is quite high
2 Awareness of HIV/ AIDS is universal
3 Knowledge about prevention of HIV/ AIDS by using condoms and by not indulging in unprotected multi partner sex is quite high. There is some scope to increase the knowledge about HIV/ AIDS prevention through condom usage.

The main media from where HIV/ AIDS messages are recalled :

4 Vast majority feel that the Government needs to initiate more steps towards providing HIV/ AIDS related knowledge to people

With respect to expectation regarding the media that could be used for educating CSWs, the following media were mentioned prominently: -

Few other media also received significant mention in this regard: -

5 Certain degree of lack of awareness was noticed with respect to prevention of HIV/ AIDS. Therefore, increasing STD awareness and education on methods for preventing HIV/AIDS should be the focus of communication.

1 Awareness of STD is moderate
2 Among those who are aware, the knowledge about STD is quite good
3 Awareness of HIV/ AIDS is almost universal

The main media from where HIV/ AIDS messages are recalled:

4 An overwhelming majority of truckers feel that the Government needs to initiate more steps towards providing HIV/ AIDS related knowledge to people.

With respect to expectation regarding the media that could be used for educating truckers, the following media were mentioned prominently: -

5. On the whole, this segment also exhibits a reasonably high level of basic awareness and knowledge about both STDs and HIV/ AIDS.
Therefore, the need for communication per se is somewhat lower in this segment.

1 Awareness of and knowledge about STD is quite high
2 Awareness of HIV/ AIDS is almost universal
3 Knowledge about prevention of HIV/ AIDS by using sterilized needles / syringes is quite high. However, relatively lesser proportion seemed to know about condom usage as a possible method of prevention of HIV/ AIDS through sexual mode.

The main media from where HIV/ AIDS messages are recalled:

4 Majority of IV drug users feel that the Government needs to initiate more steps towards providing HIV/ AIDS related knowledge to people. However, the proportion of IV drug users who seek knowledge about HIV/ AIDS is much lesser than other high risk segments.

With respect to expectation regarding the media that could be used for educating CSWs, the following media were mentioned prominently: -

5. On the whole, the need for communication per se is much lower in this segment as compared to other segments. The possible area where some education could be provided is with respect to condom usage as a method for preventing HIV/AIDS (which is probably not a priority area of concern for this segment).

1 Awareness of and knowledge about STDs is quite high.
2 Awareness of HIV/ AIDS is almost universal.

The main media from where HIV/ AIDS messages are recalled :

4 An overwhelming majority of prisoners feel that the Government needs to initiate more steps towards providing HIV/ AIDS related knowledge to people.

With respect to expectation regarding the media that could be used for educating prisoners, the following media were mentioned prominently: -

6 Interestingly, only a small proportion of prisoners expected written material like books/ pamphlets to be given to them.

7 Certain gaps noticed with respect to knowledge about prevention of HIV/ AIDS- particularly with respect to condom usage as a preventive method against HIV/ AIDS.
Therefore, the focus of education should be on methods to prevent HIV/ AIDS

1 Awareness of STDs is moderate.
2 Among those who are aware, the knowledge about STDs is quite good.
3 Awareness of HIV/ AIDS is almost universal.
4 Certain degree of knowledge gaps noticed with respect to prevention of HIV/ AIDS- particularly with respect to condom usage.
5 None of the media received very high mention when migrant labourers were probed about the media from where they had received HIV / AIDS related messages. Only TV was mentioned prominently in this regard. A significant proportion also mentioned radio and cinema halls.
6 An overwhelming majority of migrant labourers feel that the Government needs to initiate more steps towards providing HIV/ AIDS related knowledge to people.

With respect to expectation regarding the media that could be used for educating prisoners, the following media were mentioned prominently: -

1 Awareness of and knowledge about both STDs and HIV/ AIDS is quite low in this segment
2 Significantly, majority of the street children are unable to make up their mind with respect to Government initiating more steps towards providing HIV/ AIDS related education to street children like them. This could possibly be caused due to the inability to articulate their needs that is normally observed in many of the children below 15 years.

1 Awareness of both STDs and HIV/ AIDS is quite low in this segment
2 However, among those who are aware about these diseases, the knowledge levels are quite high
Therefore, the focus of education should be to increase the awareness about STDs and HIV/ AIDS
The main media from where HIV/ AIDS messages recalled are as follows: -

3 Significantly, majority of the students are unable to make up their mind with respect to Government initiating more steps towards providing HIV/ AIDS related education to students like them. This inability to articulate their needs could be the possible reason.

When the respondents were probed on from which media they would like to get educative information on HIV/AIDS, some interesting responses were obtained apart from the expected response related to mass media such as TV, Radio, Cinema and print ads. Significant proportion of respondents mentioned direct contact with health workers / social workers, doctors and hospital staff as possible routes for spreading HIV / AIDS related messages.

Interestingly, the data clearly shows that personal attention actually increases the depth of knowledge related to the spread and prevention of HIV/ AIDS, which is very important.

Television is the most preferred media, followed by Radio.
Awareness on HIV/AIDS is higher than the awareness on STD/RTI.
Major source of information on HIV/AIDS was through TV, radio, panels and newspapers.
Awareness level varies from group to group, not uniform.
Knowledge levels are higher in the high risk behavior groups than the low risk population.
Knowledge levels are high in individuals who are interacted with social workers.
Majority feels that the government should provide HIV/AIDS related education on a constant basis.