According to the Evidence

On World AIDS Day – I listened with mounting anger to a discussion on Joy 94.9 on Saturday Magazine, which epitomised everything that is wrong with our current responses to HIV.

First there was a whole panel of people with no real experience in the field telling us about what they think and believe. Prevention, people, is a science, and does not rely on belief but on evidence, and the impact of that evidence on programs or interventions.

This gets me going every time, because many of these ideas they think about and believe have been tried and failed. Mainly because no-one benchmarked them and measured their impact, or looked at the processes of implementation to see how they worked or failed.

Don’t get me wrong. I think we have done a good job with HIV prevention – it’s just not good enough, and part of the failure is that policy makers – including me till recently – took their eye off the ball. I clearly remember having to cajole and threaten and persuade change when I set up the HIV Prevention Task Force, and I think the Health Dept. would be well advised to ask me to reconvene the task force for another round, given the recent stats.

Next time I will be much more bolshy about demanding evidence-informed responses. And if I hear another broadcaster complain about VAC without really understanding the processes of community-led and implemented prevention. I swear I will strangle them. In fact that could be quite fun.

We have some big investments, but they need to be recalibrated. We need to learn from other areas of prevention, and not just bleat on about teaching young people in schools – a clear way from the evidence to fail in health promotion.  And its the same with the comments they all made about how we should target schools. That has been tried and evaluates incredibly poorly – it makes activists feel warm and fuzzy but it doesn’t work because its an irrelevant environment for most public health campaigns.

We have, after I gained a large funding increase in 2007, a major investment in rural sexual health prevention which now I would say is a fail, and needs to be refocussed and recharged with a new mission.

We have some great innovations from VAC and the Burnett in social media health promotion which need to be evaluated, and if the evaluation has a skerrick of positivity, expanded, because they point to the world where communication is evolving.

My immediate call is re-establish the HIV Prevention Task Force. Recommit to maintaining funding and support, and stop eyeing off HIV prevention resources for funding savings (and don’t be fooled, this is happening). The community must take back control of prevention, but the community must shoulder the responsibility to use evidence, and not belief, to frame new approaches.

This is too important to leave to bureaucrats with no experience of the community sector, or to broadcasters who get swayed by celebrity, which is what today’s broadcast sounded like to me.

Happy World AIDS Day to you all.

[James Rendell has also written about the failures in HIV prevention here. Ed]

Ben Rylan, the Producer of Saturday Magazine, responds:

The “panel of people with no real experience in the field” Jim refers to was a segment on the show called the Liberation Conversation. This is a regular segment on Saturday Magazine which involves a panel discussing a variety of topics on which they have an informed opinion.

The idea of the segment is to promote discussion, debate, and participation amongst listeners. Saturday Magazine, as well as many other programs across JOY 94.9, regularly feature experts on a wide variety of topics, including HIV/AIDS. While the Liberation Conversation panel on yesterday’s show may not have been “experts” in HIV/AIDS, to assume that their opinions are not worth hearing is, in my opinion, a complete misunderstanding of what the segment sets out to achieve.

Our hosts on Saturday were very mindful of allowing the panel to voice their opinions, and the questions were directed as such. The response we had via email, text message, and Twitter was far stronger than usual. Personally, I think the fact that we succeeded in igniting a lively conversation on the topic is a victory in itself.

In regards to the rest of Jim’s comments; he’s clearly got plenty to say on the topic and I think he’d make a great guest on Saturday Magazine. 

I’m not sure what Jim means by “swayed by celebrity”. The Lord Mayor perhaps? Regardless, Jim is more than entitled to disagree with anything we discuss on the show. Quite a bit of our content is talk-focussed, so disagreements are natural and expected. 

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About the author

Jim Hyde has a long history in Public Health and gay community advocacy. He was GM of VAC/GMHC and later Victorian Director of Public Health, when major new investments were made in HIV prevention. He has a rainbow award for leadership - what a has-been - and you can still occasionally see him around the traps. He is still single FYI :-)