Our Approach for HIV/AIDS Education
TeachAids breakthrough curriculum, Prevention Begins With Me, educates youth on the prevention and treatment of HIV/AIDS
Step 1
Identify the problem
We work with our stakeholders to identify global health challenges to determine if they can be addressed through targeted health education.
In the history of global health issues, HIV has been one of the most pressing to address. Despite a substantial investment of international resources to mitigate this problem, challenges around virus mutations coupled with high levels of social stigma only complicated this further. With a highly transmissible virus, educating the public about prevention efforts is a critical first step.
When we began our research on ways to tackle the knowledge problem, we quickly discovered that the sources of the education gap differed vastly from region to region.
For instance, in 2009 we found that places like India experienced high levels of stigma. In fact, the fear around the topic was so prevalent that children across schools in Andhra Pradesh (pop. 84 million) were expelled for being HIV positive. And although India had the third largest nationally infected HIV population worldwide, sex education had been banned across multiple states, preventing basic knowledge from reaching young people.
In other parts of the world, like Botswana, where one out of four individuals were infected, experts revealed that the population had become “fatigued” from the repetitive messaging. Communities were exposed to a barrage of mass media campaigns — billboards, pamphlets, and TV commercials — that were limited by time and space to encompass basic HIV facts. Research demonstrated that this approach resulted in high awareness of HIV/AIDS, but a “superficial” understanding of HIV transmission and prevention.
These examples represented the two extremes of the “HIV Knowledge Gap Continuum”.
The investment of hundreds of millions of dollars around the world clearly indicated that stakeholders were working to solve the education problem, but the low levels of knowledge demonstrated that something about model was fundamentally broken.
Step 2
Embrace complexity
We seek to understand the socioeconomic, medical, and cultural influences impacting the problem.
Across all regions, we identified a myriad of complexities in providing comprehensive HIV education. These included the following, but were not limited to:
Awareness vs Knowledge: One of our initial discoveries was that although the “awareness” of HIV being a problem was high, the actual “knowledge” levels around prevention, transmission and treatment was low. Our challenge became how to provide comprehensive HIV education to communities that believed simply “knowing about” the issue (i.e. “having awareness”) was sufficient. But high levels of awareness was not enough.
For example, the approach to teaching math is not to raise “awareness about math” through billboards and TV commercials, but to systematically teach mathematical concepts. Being able to communicate the need for actual HIV education, beyond simply awareness, was the first step in solving the problem.
Existing Content: We analyzed existing education materials and surveyed affected communities to understand what was causing the disconnect between HIV/AIDS awareness and reduced transmission. We found that many materials were medically inaccurate, fragmented and incomplete, and profoundly biased by social stigma.
Language and Literacy: Further complicating the issues was the demographic diversity and language barriers that made existing materials inaccessible across communities. In Nigeria alone, there are over 520 languages spoken. In rural areas, where education is arguably needed most, low literacy rates hindered access to written materials
Step 3
Innovate solutions
We identify solutions that will resonate and thrive in complex and diverse communities.
To approach this issue, our research team performed a rigorous analysis that incorporated numerous factors — prevalence rates, incidence levels, population size, language demographics, and global predictions on hot zones. Based on these findings, we devised a strategy to tackle the problem systematically.
Through close collaboration with local stakeholders, community medical health facilities, and experts in the field, our aim was develop a transnational way to provide robust education while bypassing traditional social taboos.
Comfort and Clarity: Our research indicated fear-based education inhibited learning and increased stigma. We determined that comfort with the content was essential for retaining engagement. We sought to identify the perfect the balance between comfort and clarity to optimize learning.
We closely studied imagery to understand which types of graphics provided the most comfort to our audiences. We found that Disney-inspired 2D characters struck the balance we sought.
Breaking Through Stigma: To combat stigma, we employed two strategies. First, we reimagined the topic of HIV as a biologically-based issue versus a socially and politically-charged one. Using a scientific lens, we were able to provide learners with a fundamental knowledge base (e.g., what is a virus, infection, transmission).
Second, in order to address more nuanced tabooed topics, we incorporated euphemisms. Through extensive ethnographic research, we meticulously identified culturally appropriate ones and coupled these with the biology-based approach to provide comprehensive education in areas previously unapproachable.
Pedagogy: Utilizing best practices from the learning sciences, we used research-based analogies and mnemonic devices to simplify medical concepts and provide clarity. For example, we used an analogy relating the human body to a country, immune cells to soldiers protecting the country, and HIV to foreign invaders that enter the country in certain ways. This allowed our audiences to understand the mechanism of HIV infection and transmission more concretely as it related to a familiar topic.
Trusted Voices: Building on existing research and using an iterative feedback process with our diverse populations, we found that youth preferred to learn about sensitive topics like HIV from individuals they trusted most. The range of trusted and influential players varied significantly across regions. For instance, in India, youth wanted to learn from Bollywood and Tollywood actors. In regions within Africa, learners preferred reputable music artists. And, for the Tibetan population, they felt most comfortable learning from the personal physician of His Holiness the Dalai Lama to impart critical health knowledge. As a result, our team engaged widely-respected cultural icons and integrated their voices and characters into the interactive animated films.
In order to address the significant gender gap in knowledge amongst males and females, our team paid special attention on ways to optimize learning. Our research further demonstrated that with sensitive subjects, young girls preferred to learn from female doctors while young boys felt most comfortable learning from male doctors. Given the strong preference for this, our team designed and produced separate male and female versions for each language.
Cultural Customization: We ensured that the animated films were localized for each language version. Our research teams utilized a rigorous iterative design process to hyper-customize each animation, taking into consideration details such as decorative elements in cultural artifacts, clothing, and customs.
Using IRB-approved research from Stanford University, our education product was shown to be more effective than other HIV/AIDS education products tested. They demonstrated a 98% acceptance and comfort level, which was unheard of for a topic as controversial and stigmatized as HIV/AIDS. Through 500+ iterations and over five years of research, we designed and produced animations in 13 languages impacting over half-a-billion learners.
Below are some of the publications produced on this research:
Sorcar, P., Strauber, B., Loyalka, P., Kumar, N., & Goldman, S. (2017, May). Sidestepping the elephant in the classroom: Using culturally localized technology to teach around taboos. CHI ‘17: Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems. https://doi.org/10.1145/3025453.3025958
Bowen, K., Forssell, K., & Rosier, S. (2020). Theories of change in learning experience (LX) design. In M. Schmidt, A. A. Tawfik, I. Jahnke, & Y. Earnshaw (Eds.), Learner and user experience research: An introduction for the field of learning design & technology. EdTech Books.
Sorcar, P., & Nass, C. (2010). Teaching taboo topics through technology. In M. S. Eastin, T. Daugherty, & N. M. Burns (Authors), Handbook of research on digital media and advertising: User generated content consumption (pp. 393-436). IGI Global.
Sorcar, P. (2009). Teaching taboo topics without talking about them: An epistemic study of a new approach to HIV/AIDS prevention education in India. [Doctoral dissertation, Stanford University.]
Other publications that feature TeachAids include InsightOut by Tina Seelig, Made with Creative Commons by Paul Stacey and Sarah Hinchliff Pearson, The Startup Star by Matt Cook and Jon Zhang, and Health Communication in the New Media Landscape with editors Jerry C. Parker and Esther Thornson.
Step 4
Engage nations
We secure strategic partnerships with prominent national and community partners.
Combining efforts with influential celebrities, governments, nonprofit partners, and corporations, we built a united effort to tackle issues around HIV. Our approach was region-specific, taking into account political, social, and economic factors. For instance, in India, we partnered with the central government as well as each individual state government. In Botswana, we engaged the two leading education forces: UNICEF and the Ministry of Education. For the Tibetan population, we partnered with the Central Tibetan Administration.
Step 5
Distribute products
Our mission is to provide access to our lifesaving health education to as many people as possible.
The TeachAids Multiplier Effect guided our distribution strategy. First, grants, sponsorships, and donations funded research and design of the highest quality HIV education products for a region. Then, under a Creative Commons License, all entities were able to access the interactive animated films for free via the Internet and computer media; organizations continue to replicate and distribute to each other in peer-to-peer fashion. The production of Prevention Begins With Me led to a dramatic, lasting cost reduction throughout the value chain, realized for all stakeholders. Examples of distribution efforts include:
- In India, despite the ban on sex education, our animated software was formally approved and are now accessible to more than half a billion people. The materials incorporate the voices and caricatures of 22 Bollywood icons and have already been viewed in 30,000 schools, hospitals, and on national TV.
-
His Excellency, Former President of Botswana, Festus Mogae, Special Advisor to TeachAids, at his compound in Phakalane Golf Estates, Botswana, with Dr. Piya Sorcar (Founder & CEO, TeachAids) and Lila Pavey (Ministry of Education, Botswana) In Botswana, with the support of Former President Festus Mogae and the UN, we convinced the national government to disseminate the TeachAids software into every public school in the country. Botswana named June 15th their “National TeachAids Day”.
- Inbound interest continues to grow — with a 17-fold increase in HIV rates amongst the Tibetan diaspora, we responded to their Health Minister’s plea to us and developed customized software. With the support of the Dalai Lama and their Prime Minister, our materials are now being distributed to 30 nations with large refugee populations.
Prevention Begins With Me interactive education products have been provided to millions of learners across hundreds of organizations, for free. To date, we’ve engaged with more than 250 partners in 82 countries to provide the most effective culturally-appropriate HIV education to learners around the globe.