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Aids and Behavior: An Integrated Approach
In addition to the dissemination of essential information about the HIV virus, provision of health care and support services, and changes in government practices regarding access to experimental drugs, other equally important but relatively uninvestigated effects that result from such successful community organization include greater recognition of responsibility for one's behavior and identification with and pride in one's community (Kayal, 1993). Thus, community organization may not only be an efficient conduit for the provision of information to a broader group, but may also serve as an agent of change and a source of inspiration, pride, and identification for individual members.
The greatest rate of increase of AIDS cases is among racial and ethnic groups and women—HIV is spreading fastest among African American and Hispanic/Latina heterosexual women and African American and Hispanic/Latino injection drug users (Singer, 1991). It is a commonly held belief that HIV informational campaigns and prevention and treatment services will not be effective unless they are carefully tailored to take into account the beliefs and practices of diverse cultural groups. This is especially so because the behaviors involved in HIV transmission are of such a highly sensitive, private, and potentially controversial nature. Communities differ in such things as their ability to organize, the extent of financial and other resources available to them to support HIV prevention efforts, and other dimensions such as religiosity, literacy, and privacy needs. This means that the skills, resources, personnel, and procedures needed to organize African American and Hispanic/Latino injection drug users may differ markedly from those employed successfully among the predominantly white gay community (Friedman et al., 1992). This leads many to believe that community leaders must be carefully identified and intimately involved, and that members of the target population must be consulted in the formulation and organization of any informational campaign or intervention strategy.
However, others argue that, as important as it is in crafting meaningful community messages and programs, cultural sensitivity itself may be inherently problematic for HIV prevention. As Bayer (1994) points out, modification of those behaviors responsible for HIV transmission often entails endorsement of a political and moral agenda unacceptable to the communities involved. For example, racial/ethnic community leaders in New