The empirical investigation was conducted on news media in two parts of the world that are economically, politically, and culturally different. The two European countries, Britain and Sweden, belong to the affluent part of the world and share a common Judeo-Christian heritage. The two African countries, Kenya and Uganda, belong to the economically developing part of the world, and have a common colonial heritage.
If we compare the African countries, Uganda officially recognized AIDS earlier and has taken measures to fight the epidemic. In Kenya, the government denied reports of the disease, fearing it would hurt its tourist industry.[2] Yet, the prevalence and severity of AIDS in the two African countries is higer than in Sweden and Britain.
I chose Britain and Sweden as countries with a free press and defined AIDS policies. Both have free access and availability to data and materials in a setting and language I easily understand. Besides, Britain's long contacts with the two African countries in the study makes her the most likely candidate for a comparative study of an issue of AIDS alleged to have long existed on the African continent.[3]
The study begins in the 1980's because it was then that the studied media started to report on AIDS. For example, The Times of Britain had its first report in April 1983. The Swedish paper, Dagens Nyheter, started reporting on AIDS in December 1982. The study continues through 1990 to see if the reporting pattern has stayed the same through the beginning of another decade.
A public health risk, such as AIDS, clearly shows how a perception and understanding of risk can influence a nation's policy debates and resource allocation. The transmission and rapid spread of AIDS has required people to enquire about their sexual behavior. Unquestioned or tolerated behaviors and life styles have been put in question. The AIDS risk has brought out old scapegoating cliches. The risk is seen at the individual, as well as the societal level
To discern the news media's role in risk communication, and AIDS risk communication in particular, the first part of the paper briefly answers the following: What is the media's role and significance in risk communication? Does the media have any role in risk communication while relaying public health news of the AIDS? The second part attempts to present and analyse empirical findings of the study.
Risk and disaster news communication's diffusion rate is known to be rapid. It also has a high audience interest as some American studies like the 1973 survey of the American Newspapers Publishers Association indicated.[7] Health risk communication, like any disaster news, diffuse rapidly; notwithstanding the probable confusion and ambiguity it might entail among the recipients.[8]
Public perceptions of a risk communication can vary from person to person, despite constancy of the message.[9] This is clear from different public reactions to the AIDS risk message. Some thought it did not concern them as they perceived AIDS to be the disease of "others" -- homosexuals, Haitians, etc. This reaction is exemplified by young American college students who did not exercise preventive behavior since they consider themselves to be not at risk.[10] Moreover, targeting the risk messages to others -- who happen to be the "target audiences" -- might bring about unexpected adverse results like leading the target audience to stigmatization.[11]
Existence of risk of disease and protective measures is better communicated via available and expedient media. If the risk is high where any member of a society has an equal chance of being touched, then the use of the mass media is preferred. Society learns what to expect and what has happened regarding a risk or disaster mainly through the mass media.[12] All sexually transmitted diseases and AIDS that call for a restraint from unprotected sex are communicated via different types of media, of which the mass media are the mostly used. For example, Rogers et al. mention that in the U.S.[13]
by April 1983, 81 percent of a national sample reported that they had heard or read about a disease called AIDS; this figure increased to 92 percent by mid-1983, then increased slowly to 98 percent by early 1986.... Almost all of these individuals first learned about AIDS from the mass media.... [Emphasis added.]
The mass media, according to "most scholars" has the responsibility of communicating risk.[14] Since the mass media is an important carrier of risk communication, the lay audience as well as experts depend on them.[15] However, according to Klaidman, health risk reporting by what he calls "elite news media" is treated by a different logic that fits the media's "core middle class constituency."[16] For example, as Klaidman noted, AIDS news initially was not worth covering as the media's constituency was not perceived to be at risk as opposed to the homosexuals, hemophiliacs and Haitians who were perceived to be the only ones affected.
Messages having a risk communication component are communicated in a format to an audience for the purpose of informing, warning, and bringing about protective and/or preventive measures, etc. The mass media and journalists, based on their professional working rules of valuing news, treat risk events as news once they find them newsworthy. Accidents and tragedies that are part of a risk event are oftentimes considered newsworthy, and a human interest story of the type that talks about a cure AIDS is newsworthy too.[17]
News happens to be among the many and varied forms of communication used by the mass media. The media news is known to give meaning to a "news event, by interpreting the event for the media's audience"[18] Nevertheless, according to Klaidman, any disease or health risk gets good media coverage as long as it is not perceived "as a threat to everyone, or to `us' and not `them'."[19] Therefore, coverage of any health risk news item must pass the litmus test of news value where rigorous selection and presentation work is done. The organizational constraints of news work force journalists to rely on authoritative sources in the form of press releases, press conferences etc.[20] The news media's dominant use of authoritative sources, such as officials and experts, has been confirmed by a recent doctoral study. In the study, officials and experts were found to be present more than 60% of the times as the main actors in AIDS news during the 1980's in four European and African prestige dailies.[21] Nevertheless, it remains a fact that risk communication is still conducted mostly through the mass media, despite some problems like ones discussed above. It is the mass media which is proving again that some masses of people are able to be contacted quickly with the same message at the same time.
The empirical investigation on the coverage of AIDS news as risk communication was conducted on the AIDS news reporting of The Times of Britain, Dagens Nyheter of Sweden, The Daily Nation of Kenya, and The New Vision of Uganda. A random sample of the four prestige dailies starting from the first week of 1983 and ending in the last week of 1990 was taken searching for AIDS news items. The AIDS news was examined from all the four papers based on a random selection of one day per week during the studied years.
An aim was to discern the trend of reporting risk messages in the AIDS coverage and then compare between the studied years. By so doing, the AIDS risk communication activity undertaken in the different prestige papers through the years will also come to be known. When was the risk communication messages of AIDS news high on the media agenda? When was it at its lowest? What was the trend in reporting AIDS risk communication messages through the studied years? These are questions this part of the paper attempts to answer.
A schedule was prepared to code the data from the studied AIDS articles. This coding schedule was prepared based on prior inspection of some of the study materials. While reading the different AIDS stories in the studied papers, it was observed that the coverage of AIDS had discussed the management of the AIDS risk in various ways ranging from vaccine development to banning AIDS carriers from a public swimming pool. The study was able to see that AIDS coverage was tinted with risk prevention and protection measures meant to curb the rapid spread of the AIDS pandemic.
AIDS stories were investigated to see if they contained discussion of risk prevention and/or protection activities. The news items were read and analyzed if they contain a discussion of the risk prevention and/or protection activities outlined in the coding schedule. In the coding schedule there were five items to choose and code under the category of risk prevention/protection activities. The items were: information campaign, public education, counselling/therapy; screening, registering, isolation, new laws; condom usage; avoiding multiple sexual partners; and other. The first group of items, i.e., information campaigns, public education, counselling/therapy, represent the prevention aspect of risk communication. The second group point to operational measures such as legal actions; and finally, the practice of sexual abstinence which is reflected by the item, avoiding multiple sexual partners, stands for the protection aspect of risk communication.
In one item found in the coding categories, i.e., Other, activities vary from one newspaper to another and even within a newspaper. For example, in Daily Nation activities found under "Other" include, prosecuting an AIDS patient for deliberately spreading disease, evacuating American AIDS sufferer from China, and testing potential vaccine on humans. In The Times, "other" includes refusing to conduct post-mortems for fear of catching AIDS, vaccine development, cleaning communion cups after every use and use of protective clothing. In Dagens Nyheter, activities such as closing bath clubs, teaching lab technicians to perform HIV tests, and research on AIDS patients and blood transfusion are found. Finally, in The New Vision, deportation, informing AIDS victims after they have been screened, and AIDS research are among the activities coded. It ought to be mentioned that in the studied papers one or more risk prevention and/or protection activity may be present in an article.
An empirical examination of AIDS articles as summarized in Figure 1 gives a positive answer to our initial query; stories did carry risk prevention and/or protection activity items. A closer examination of the number of risk prevention and protection activities in the newspapers shows all the papers covered a relatively high amount of risk prevention/protection activity messages in 1987. Besides, the study exhibits that between 1984 and 1987 there is a general trend of covering more risk prevention and protection activities in both the European papers. This trend was true for the two African papers before 1987. Then, there was a general drop in coverage between 1987-89 in all the studied papers. This trend was reversed in the two European and the Kenyan dailies in 1990. The highest number of risk prevention and/or protection activities was communicated by the studied prestige dailies in 1987, as it was then that the highest number of AIDS news stories were reported.[23]
Table 2 shows that Dagens Nyheter which is one of the European papers, carried a higher number of risk protection activities such as screening, registering, isolation and new laws. The table also shows that African dailies and one of the European newspapers, i.e., The Times, carried a high number of risk prevention items such as information campaign, public education, counselling/therapy, and several risk prevention and/or protection activities that are included in the item "other". Overall, the single most risk prevention or protection activity message was the preventive aspect, i.e., information campaign, public education, counselling/therapy, of risk communication that was reported most. When the different risk prevention and protection activities found in the coding schedule are grouped under the general items of either prevention or protection aspects of risk, the empirical results show more risk protection activities (i.e., screening, registering, isolation, new laws, condom usage and avoiding multiple sexual partners) are discussed by all papers than risk prevention activities (information campaign, public education and counselling/therapy).
Coverage of different risk prevention activities in each paper has shown a varying trend and rate during studied years. For example, in The Times there were a large number of risk prevention activities such as information campaign, public education and counselling/therapy discussed in 1983 and 1986. Incidentally, 1983 is the first year of coverage of AIDS by the Times and was among the initial years of the epidemic. Further in Britain, the public health education campaign with regard to HIV/AIDS was launched in 1986.[26] The protection aspect of risk messages was widely discussed in The Times in 1985, 1987 and 1988 along with "other" risk prevention and protection activities. In sharp contrast to the Swedish paper in the study, Dagens Nyheter, the London Times' discussion of risk protection activity, i.e avoiding multiple sexual partners, was scant. This reflects the attitude both societies (as reflected by the papers presentation) have on open discussions of sex. In the case of Sweden, it seems there are no inhibitions or societal pressure to prevent discussing sex openly, while in Britain the opposite is true.
In Dagens Nyheter, there were more risk protection activities discussed concerning screening, registering, isolation, new laws; condom usage, and avoiding multiple sexual partners in the years 1983-86, 1988 and 1990. Especially during the early year of reporting, i.e., 1983, the discussion on the protective aspect of risk communication was more on avoiding multiple sexual partners. Furthermore, the protective aspect of risk communication, i.e., screening, registering, isolation, new laws were covered most in 1984-86. At this juncture, one ought to note that the Swedish AIDS Delegation was set up in 1985 and HIV infection was regulated as a venereal diseases.[27] The preventive aspect of risk communication, i.e., information campaign, public education and counselling/therapy were covered more in 1987, which incidentally was the year the Swedish AIDS information campaign began. Further, in Dagens Nyheter, the different risk prevention and/or protection activities that are lumped in the item "other" peaked in 1985 and 1988-90.
In 1985 and 1987, the Daily Nation discussed more risk protection activities. Risk prevention activities such as information campaign, public education, counselling/therapy were the more frequent risk communication messages in 1986 and 1989.
The New Vision frequented risk protection activities in its risk communication messages reported in 1986. Risk prevention activities were the risk messages most commonly communicated in 1988 and 1990. In 1987 the risk prevention activities and risk protection activities were largely covered along with other risk prevention and protection messages that could be grouped under the item "other". In 1989, risk prevention activities and other risk prevention and protection activities were discussed most.
In general, the risk prevention and protection activities were dominantly discussed in the AIDS news stories reported by all the studied papers and years. Further, when all coded risk prevention and protection activities are grouped under either a protection or a prevention activity and the empirical results scanned, the results show that, through the studied years, risk protection activities dominated AIDS news reporting of the two European and the Kenyan prestige dailies in the study (Table 2). The Ugandan prestige daily showed that risk prevention activities were discussed most through the studied years (Table 2). The original study leading to this paper has empirically shown that more than half (i.e., 59%) of the AIDS news reported by the Daily Nation in the studied years was foreign news.[28] Besides, the study has demonstrated that AIDS news reported by the Reuters news agency used a large share of the news space in the studied Kenyan daily.[29] Therefore, it may be one of the reasons the Kenyan Daily Nation had some homogeneity in reporting with the European papers, and not with the Ugandan daily.
Finally, this study has shown that health risk communication is not an undertaking left only to consciously organized information campaigns and/or other public education forums. The news, which is the professional and institutional product of mass media organizations, can also carry health risk messages in reporting and discussing AIDS. AIDS has been found newsworthy and covered for many years, with news carrying health risk messages informing, warning and bringing about risk prevention/protection measures. The studied news media have clearly shown the mass media as a major vehicle of risk communication[30] when they imparted risk prevention/protection information alongside AIDS news stories. They reminded us that they will keep the issue of AIDS alive and active every time they transmit news of it.
* This article is based mostly on Part Three of the author's dissertation, Reporting a Pandemic: A Comparative Study of AIDS News Coverage in African and European Prestige Dailies, Göteborg University, Sweden, 1995.
** Dr. Tassew received his Bsc. (Biology) from Addis Ababa University, Ethiopia, a Post-Graduate Diploma (Journalism) from the Indian Institute of Mass Communication, New Delhi, his MA (Mass Communication) from the University of Leicester and his PhD (Journalism and Mass Communication) from Gteborg University.
[1]National Research Council, Improving Risk Communication (1989).
[2] Peter Gould, The Slow Plague: A Geography of the AIDS Pandemic (1993); Alfred J. Fortin, The Politics of AIDS in Kenya, 9 Third World Q. 906 (1987).
[3] See Christian Anderson, AIDS I Afrika-en Epidemi I Historia och Samhalle, 2 Sociologisk Forskning 46 (1988).
[4] NRC, supra note 1.
[5] Id; see also, Paul Slovic, Perception of Risk, 236 Science 280 (1987).
[6] Dennis S. Mileti and Colleen Fitzpatrick, Communication of Public Risk: Its Theory and its Application, 2 Soc. Prac. R. 20 (1991).
[7] Rahul Sood et al., How the News Media Operate in Natural Disasters, 37 J. Comm. 27 (1987).
[8] Nancy Signorelli, Television and Health: Images and Impact, in Mass Communication and Public Health (Charles Atkin & Lawrence Wallack, eds., 1990).
[9] Mileti, supra note 6.
[10] Everett M. Rogers, Science Communication about Risk (1988)(on file with author).
[11] Roy Widus et al, The Management of Risk in Sexually Transmitted Diseases, 119 Daedalus 177 (1990).
[12] E. L. Quarantelli, The Social Science Study of Disasters and Mass Communications, in Bad Tidings: Communication and Catastrophe (Lynne Masel Walter et al, eds., 1989).
[13] Everett M Rogers et al., AIDS in the 1980s: The Agenda Setting Process for a Public Health Issue, 126 Journ. Monographs 21 (1991).
[14] Lee Wilkins & Philip Patterson, Risk Analysis and the Construction of News, 37 J. Comm. 80 (1987).
[15] Dorothy Nelkin, Communicating the Risks and Benefits of Technology (1988)(on file with author).
[16] Stephen Klaidman, Roles and Responsibilities of Journalists, in Mass Communication and Public Health (Charles Atkins & Lawrence Wallack eds. 1990).
[17] Nelkin, supra note 15.
[18] Rogers, supra note 10, at 20.
[19] Klaidman, supra note 16, at 64.
[20] Rogers, supra note 10; Sood, supra note 7; Nelkin, supra note 15.
[21] Admassu Tassew, Reporting a Pandemic: A Comparitive Study of AIDS News Coverage in African and European Prestige Dailies 106 (1995)(Unpublished Ph.D. dissertation, Göteborg University).
[22] Id. at 22; 1985 copies of the Ugandan newspaper are not included as they were not available.
[23] Tassew, supra note 21, at 78.
[24] Tassew, supra note 21, at 184.
[25] Tassew, supra note 21, at 185; all 1985 copies of the Ugandan newspaper are not included, as they were not available.
[26] Ivana Markova & Kevin Power, Audience Response to Health Messges about AIDS, in AIDS: Communication Perspective (Timothy Edgar et al, eds., 1992); J.M. Wober, Informing the British Public about AIDS, 3 Health Educ. Res. 19 (1988); Chris Brewin & Barrie Gunter, Media Professional's Views of the Government's 1987 AIDS Campaign, 47 Health Educ. J. 111 (1988).
[27] Claes Herlitz, Studies on the Social Impact of AIDS (1992)(Unpublished Ph.D. thesis, Uppsala University); Birgit Westphal Victor, AIDS in a Caring Society (1991)(Unpublished Ph.D. dissertation, Nordic School of Public Health).
[28] Tassew, supra note 21, at 99.
[29] Id., at 102.
[30] Wilkins, supra note 14; Nelkin, supra note 15.