Communication Skills and HIV Prevention
July 7, 2000
"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.'" (Communication expert Rick Zimmerman, quoted in The Invincible Ones by Rachel Solar-Tuttle, Harvard AIDS Review Spring/Summer 2000), about HIV prevention in adolescents. The full article is at: http://aids.harvard.edu/publications/har/spring_2000/spring00-4.html
I noted this quote because of a personal interest in communication. Last year I started a Web site, www.communicationpractices.org, on a certain approach to communication skills and training. While not AIDS-related, it might have uses in HIV prevention, and in drug-recovery skills as well.
I agree with Professor Zimmerman on the importance of role playing and rehearsals. But most such programs face a practical obstacle: the small amount of actual learning time, compared with assorted overhead. How many short programs can offer each participant as much as an hour or two of educationally successful role play? Yet that hour or two costs the time and expense to organize the program, travel time for participants, and the time at meetings spent being late, waiting around, getting the group started, being too embarrassed to participate, etc. And the great majority of those who need these programs will never have the opportunity, due to politics and resource constraints.
So I'm exploring another approach: organized, low-stress communication and relationship self-training that is completely integrated with everyday life, so it's available during all waking hours no matter what else we are also doing. This training requires no special equipment, resources, or permission, because it only uses everyday experience and human interaction, which we all have. Therefore rich and poor are equal here. And there's no overhead, no resource constraint.
The big question -- the one that stumped me for over 30 years in trying to put such a project together -- is how to format any kind of training or education to be used in this way. What works is to develop self-training "practices" for use in everyday life -- a kind of "scaffolding" for assisted-performance learning. Although we generally use these practices by ourselves, without having to wait for anyone else, we can developing them publicly, combining the talents and resources of many people to find or invent practices which work especially well for particular needs -- then test and improve them further, and make the best ones widely available.
See the Web site for some early examples of communication practices. My experience in experimenting with several of them is that certain lifetime interpersonal problems were unexpectedly gone in weeks. Why is this kind of education so effective? Because it's available any time so you can practice as much as you want, despite busy schedules; because all of it is low-stress, assisted-performance learning in exactly the setting where the skills will be used; and because the training program consists of independent modules which can be rationally developed and improved in advance.
My 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.
Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.
This article was provided by AIDS Treatment News. It is a part of the publication AIDS Treatment News.