Applying Value Expectancy Theory to a Potential HIV Prevention Program in Tanzania - Research Paper Example

Applying Value Expectancy Theory to a Potential HIV Prevention Program in Tanzania HIV and AIDS is one of the killer diseases around the world. Many people are either infected or affected in a way. This reflects a worrying trend, which in turn requires being resolved in the most appropriate manner to eliminate the threat posed by the disease. Every country all over the world has put in place strategies to fight this disease, and this article looks at such attempts made in Tanzania. This article will look into how women can be a potent weapon in the efforts to reduce the rates of new infections in Tanzania. It will also look into the challenges that these women may go through as they play this role. Introduction Human Immunodeficiency Syndrome (HIV) and Acquired Immune Deficiency (AIDS) together form a disease that has decimated a lot of people globally and has seen the productive people fall to it (Whiteside 2008). As of 2007/08, the HIV prevalence rate in Tanzania had fallen to 5.7% with women having 6.6% while men had 4.6%. This was a fall from 7.0% with 7.7% in the 6,000 women who were tested and 4.3% in men, 4,900 of whom were tested. This information was accessed from the United Nations Economic Commission for Africa, 2009. Behavioral outcome of the intervention As a result of this intervention, the women in Tanzania are anticipated to revolutionize in several ways. First of all, the women are expected to become more assertive in the households as far as sex is concerned. This translates that women being able to negotiate for sex with their partners and in effect increase the use of condoms. At the same time, the high risk category is projected to be knowledgeable on the benefits of using condoms. They are expected to start taking precautionary measures, as well as, educating their fellow women on the same. The high risk group in this case mainly encompasses commercial sex workers. The version of the value-expectancy model The value of assessing this behavioral intention is to allow the strategists redesign ineffective messages and also allow the formulation of more effective and up-to-date version. As Fishbein (2000) has stated, there is no need to formulate new theories of behavior change. The existing ones are effective when applied well. In that regard, as he has stated, targeting a specific behavior for change will effectively bring about the needed change. If the women can be well informed of the risks that they face through unprotected sex, they can then change for the better. Figure of the Integrated Model This figure displays the interrelationship of different factors in the shaping of behavior. This model, espoused by Fishbein (2000), indicated the way that behavior of women using condoms will be enhanced. According to this model, the strategy that will be implemented in Tanzania will be inclusive of all the above. This means that the environment around the women will be used to influence them to change. In the case of factors like individual biases, the women will be softened, and issues addressed to allow them understand the issues that surround the use of condoms. This will allow women to shape a favorable opinion towards condom use. Proposed model of intervention Cost-benefit Analysis This theory has its essence in looking at the success-failure elements of human, socioeconomic transformation (Dompere 2004). This theory in a sense juxtaposes the two effects. According to Dompere, decisions are deemed to have outcomes good or bad depending on the change agent. Acceptance to use condoms for women, for example, implies that there is the desired benefit of the reduction of new infections. On the other hand, there is the undesired effect of the women undergoing domestic violence from their sexual partners. This theory, therefore, involves the positive and negative aspects if adoption of a new behavior. Role of women in bringing down the rate of new infections HIV/AIDS is a killer disease that calls for a concerted effort to tackle. The women are better placed to tackle HIV/AIDS due to their unique position they hold in society. The applied cost-benefit analysis strategy is one valuable weapon in the fight against HIV. The reason is that it involves the exposing the women to the most efficient way to reach their target (Pardeck et al. 1998). In other words, it involves the rational process of choosing the alternative with the highest utility (Pardeck et al. 1998). There are several benefits for the use of the cost benefit analysis as was seen in a survey conducted in Tanzania, in the 1994-2001 periods. The findings were that, among others, the enrollment of more girls in schools was seen to have reduced rates of new infections as it made them more informed. This also led to the improvement of the quality of life as the girls were able to gain better jobs (Brent 2008). Though the benefits were not high considering the poor nature of the country, they, however, existed (Brent 2008). As a consequence, this article will strive to change women’s perceptions and empower them to negotiate during sex. This will allow them have a say in the process and, therefore, increase the use of condoms in many households. Traditionally, sex is more inclined in favor of men who determine when it will take place and how this will occur. Accordingly, there is a danger that women might face a backlash from their husbands and their sex mates for they may appear to suggest that they or their husbands are unfaithful and, as a result, may be infected. Looking to the cost benefit analysis, encouraging women to use condoms will mean that women will have to make some sacrifices real and perceived. Fishbein states that, while it may be behavior for men to use condoms, women must look to it as a goal. It has a number of benefits as espoused in the numerous adverts that normally encourage use of condoms. The two main ones are the prevention of unwanted pregnancies, and the other is the prevention of STIs. In a survey conducted in Nigeria, there were older sex commercial workers who held the belief that the seminal fluids produced during intercourse was healthy to their bodies. Others would not use condoms as they wanted to bear children of their sexual partners. Other women feared that they would retain condoms within their reproductive system (Benjamin 2011). These are some reasons why women must be educated about the myths that surround the condoms and the fact separated from the fiction. Criteria for behavior change Fishbein (2000) puts it that behavior changes will be more effective if it is specific; therefore, the aim is the drive that increases condom use. Fishbein has suggested four elements that inform behavior. These elements are; the action, in this case being adoption and use of condoms, the target in this case being the condom itself, the context where the condom’s use will be needed and finally, the timeline of the behavior’s adoption. These elements present a challenge to the implementation of an effective strategy due to reasons like the challenge of early adopter versus the late adopters. These two will lead to poor results as the gains made by early adopters will be watered down by those who adopt a wait-and-see attitude. Using these four elements, the strategy to have the women change their behavior will include a stakeholder meeting that will discuss both the positive and negative side of the strategy. Stakeholders will include healthcare providers, local opinion holders, the women themselves, as well as, the men (Minelli and Breckon 2009). There will also be target audience segmentation. This will include separating the high risk groups and low risk groups, as well as, establishing messages that will have the best effect on the target populace. In this regard, it is imperative to argue that in the spirit of cost-benefit analysis where the target audience has to be involved in preventing more infections; there will be comprehensive participation of women from the beginning to the end of this strategy. They will be involved mainly because they have to ‘own’ the process completely for it to achieve the desired goal. During monitoring and evaluation, for example, they will need to look at their own progress and gauge themselves on whether they are making any headway or are lagging behind (Minelli and Breckon 2009). The basis of the approach to bring about change in Tanzania will have to apply this approach. Since there is no cure or vaccine in sight, the main weapon in fighting HIV and AIDS infection will be to target their behaviors with the intention of changing them (Fishbein 2000). According to Fishbein, this is a disease that is highly influenced by behavior. There are several reasons as to why people will use condoms when engaging in sexual intercourse. According to Fishbein, the act of a man having sex with a commercial sex worker and that of having sex with his wife are very different. Accordingly, women will find it hard to have their husbands use condoms on them. Measuring the women’s behavioral intention Behavioral intention will be evaluated in a number of ways. One of the methods of measuring this will be through the number of condoms that are purchased or taken from the collection points. Another method of assessing this intention will be through the focus group discussions. These are groups that will be formed among the women from different regions. These groups will be formed to allow the women share amongst themselves with an outside evaluator to assess the progress. At the same time, the decline of the rate of new infections will be another means of assessment. Strengths, Weaknesses and Barriers to Targeting Women as Change Agents The progressive nature of educating women is one of the strengths. This has the effect of empowering the women through the understanding that it is within their rights to say no to sex if their request for condoms is turned down. At the same time, the women have focus groups that they can use to share their challenges thus help each other grow. This has the effect of allowing women to thereby feel that they are not the only ones suffering, but there is someone else going through the same (Minelli & Breckon 2009). The weaknesses, on the other hand, of using women are that they will be viewed as culturally inferior to men. This has the effect of degrading their voice in the household. Attempts to assert their rights will often lead to them being battered, a factor that worsens the prevalence rate. According to the United Nations Economic Commission for Africa (2009), domestic violence increases the rate of infection. This is because the women will experience wounds which may come into contact with an infected partner’s blood thus causing new infections. At the same time, sex is a weapon of domestic violence, which an infected husband or sexual partner can use to infect the wife or sexual partner. Other weaknesses are focussed on by Dr Benjamin (2011) who tackles issues like retention of the condom in the vagina. These are myths, which must be tackled to allow women to be effective ambassadors. Closely tied to the weaknesses are the barriers of using only women. These are matters such as culture. Culture is an impediment since a man has the final word as far as sex matters are concerned. At the same time, the need to attain more education indicates how great illiteracy is a barrier in the society. These challenges represent the resistance that the fight against HIV/AIDS that prevails and it must be surmounted if the war against HIV/AIDS is ever to be won. References: Brent, R. J. (2008). Applied Cost-Benefit Analysis. Camberley: Edward Elgar Publishing. Benjamin, A. (2011). HIV and AIDS: Knowledge Attitude and Practices Thirty Years On. Summerland: WSIC EBooks Ltd. Dompere, K. K. (2004). Cost-Benefit Analysis and the Theory of Fuzzy Decisions Identification and Measurement Theory. Washington D.C.: Springer Berlin Heidelberg New York. Fishbein, M. (2000). The Role of Theory in HIV Prevention. Philadelphia: Taylor and Francis Limited. Minelli, M. & Breckon, D. (2009). Community Health Education: Settings, Roles and Skills. London: Jones and Bartlett Publishers International. Pardeck, J. T., Longino, C. F. & Murphy, J. W. (1998). Reason and Rationality in Health and Human Services Delivery. New York: The Haworth Press, Inc. United Nations Economic Commission for Africa. (2009). African Womens Report 2009: Measuring Gender Inequality in Africa - Experiences and Lessons from the African Gender and Development Index. Addis Ababa: Economic Commission for Africa. Whiteside, A. (2008). HIV/AIDS: A Very Short Introduction. Oxford: Oxford University Press. . Read More