Live Drama May Be More Effective Than TV or Radio in Teaching About AIDS

Researchers have shown that when it comes to reducing the stigma of AIDS and explaining how the human immunodeficiency virus (HIV) is transmitted, live theater may be more effective than either the mass media or interpersonal counseling. The study evaluated audience knowledge and attitudes about HIV/AIDS both before and after performances of a locally produced drama in Madras, India, and found, for instance, that before seeing the play 61 percent of the audience members surveyed agreed with the incorrect statement that HIV is transmitted by sharing food with an infected person. After the play, only eight percent made that mistake. The study appeared in the June, 1999 issue of AIDS Education and Prevention.

Lead author Thomas W. Valente, PhD, associate professor, Population and Family Health Sciences, Johns Hopkins School of Public Health, said, "A community drama group is able to tailor its message to a local audience. And, unlike being counseled individually about the disease, watching a dramatic performance about AIDS and HIV may decrease the amount of discomfort associated with the subject."

The two-hour drama about HIV and AIDS was created by a local theater group and performed in inner-city slums in Madras, India. Most of those surveyed had already heard of HIV and AIDS from either TV (65 percent) or radio and newspapers (18 percent).

Before a performance, randomly selected audience members were asked a series of 12 true/false questions about HIV and AIDS. Six of the questions were accurate (i.e., "HIV/AIDS spreads by transfusion of unchecked infected blood") and six were inaccurate (i.e., "HIV/AIDS is transmitted by sharing food with an infected person"). After the performance, the same people were asked the same questions. Last, participants were queried about their income and education levels and were asked an open-ended question: "How would you treat a neighbor if you discovered she or he had AIDS?"

Overall, watching the drama about AIDS increased the audience's correct responses from an average of 71 percent to 97 percent for the true statements, and from 54 percent to 95 percent for the six false statements. Before the drama, for instance, 62 percent of those polled said they could tell if someone has AIDS by looking at them; after the play, only nine percent said this.

Changes in scores before and after the drama were not related to age or gender, but did depend on respondents' education and income. Before the play, those respondents with less formal education and income had lower levels of HIV and AIDS knowledge than their more educated and wealthier counterparts. After the drama, however, their test scores improved more than average, so that the knowledge gap was reduced.

The study also found that the drama increased the number of people who said they intended to treat HIV-positive individuals more kindly in the future. Before the play, 29 percent of respondents stated that if they discovered their neighbors had AIDS, they would shun the person; 7.5 percent said they would hand him or her over to police; and 18 percent said they would treat him or her the same as anyone else. After the performance, those percentages were 9.7, 0, and 50, respectively.

The researchers emphasized that, unlike mass media presentations, plays can be tailored to meet local tastes and education levels, and then can even be recorded and disseminated broadly. Further, because a mass media production does not afford the personal interaction of a play, the investigators speculated that a drama's person-to-person contact may help people get in touch with emotions they are feeling about HIV and the AIDS epidemic. The researchers also noted that while a play affords interpersonal contact, it is still a public, non-intrusive vehicle for communicating sensitive information. One-on-one counseling, on the other hand, may make people feel singled out or defensive about a topic.

Because of these strengths, Dr. Valente said, "It is hoped that future health promotion programs will consider street theater or drama as one means to inform their audiences."