HIV education for youth: the importance of social consensus in behaviour change

Most theories of health education focus on change in the knowledge, beliefs, and skills of individuals as causes of behaviour change. We argue that this neglects the important contribution of the social environment in supporting healthier behaviour, and we describe a model of social consensus that allows alternative routes for educational influence at both individual and social levels. This model assumes that basic knowledge and skills for avoiding health threats may not be sufficient for behaviour change unless socially-mediated influences that can inhibit behaviour change are addressed. This is especially crucial given the nature of HIV infection and the controversy surrounding its discussion. We illustrate the potential for social influences to have played a role in inhibiting the adoption of safer sexual behaviour in young people, and use our model to analyse young people's responses to the epidemic as documented in available research. The analysis also suggests possible educational strategies to overcome social obstacles in the future.