Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
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Newsday - June 9, 1988
Laurie Garrett
The report said that while state and federal agencies disseminated information quickly at the outset of the AIDS epidemic out of a sense of urgency, they didn't create ways of evaluating how the public was receiving or using that information.
And while Americans have been deluged with messages about AIDS since the early-1980s, the author of the Office of Technology Assessment report, Jane Sisk, said, "It is astonishing the extent to which we do not know what works and what does not work in terms of actually affecting people's behaviors. Sisk testified yesterday before the Senate Governmental Affairs Committee.
According to Dr. Leonard Weiss, staff director of the Senate Governmental Affairs Committee, the U.S. government will spend more than $305 million this year on AIDS education, with that sum scheduled to double in the coming year.
"The key problem here," Weiss says, "is determining if that money has been well spent. The committee feels that there have to be systems built into education programs that allow us to evaluate their success."
Few AIDS campaigns have been evaluated to determine whether people were actually moved to change the behaviors that put them at risk for exposure to the HIV virus. In addition, the report found that:
It is difficult targeting heterosexuals who may be at risk for AIDS because no reliable information exists on their high-risk behaviors. Indeed, the report said no one knows exactly what constitutes high-risk behavior for heterosexuals or how many Americans may be participating in such activities.
There are no clear American examples of a group of people at high risk for AIDS changing their behavior because of a specific educational campaign. For example, it is impossible to tell whether heroin addicts were steered away from using the drug because of a government pamphlet, information from the mass media, the AIDSdeath of a friend or any of a number of other factors.
So many federal and state agencies are involved in AIDS education that there is massive duplication and interagency contradiction. "One thing is clear, that people in the federal government do not seem to know exactly what is going on, and there has not been a systematic approach to funding AIDS education or coordinating efforts between government agencies," the report said.
Nearly all federal AIDS education efforts are coordinated through the Centers for Disease Control in Atlanta. Fred Kroger, acting director of that effort, agreed with the bulk of the new report, saying that it is difficult to figure out how to build in evaluation mechanisms, given the confidential nature of most AIDS counseling efforts.
For example, said Kroger, the CDC runs a 24-hour AIDS hot line that receives about 70,000 calls a month. Because the callers remain anonymous, the CDC has no idea whether some of the callers are giggling teenagers phoning for a thrill or homophobic individuals who harass hot-line operators.
Another example is the U.S. surgeon general's mailer on AIDS, recently sent to 107 million households at a cost of about $17 million. Kroger says there is no way for the government to know what sort of reception it got.
Citing the British experience, the new report said there is good reason to be concerned about how the public absorbs information from mass mailings and government advertising campaigns. In 1986, the British government conducted a massive and, according to critics, alarming ad campaign.
Last year, British government studies revealed there were no changes in condom use patterns as a result of the campaign, and there may actually have been a backlash from some young people who felt the government was crying wolf.
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