stantial attention from external institutions may mean some loss of control of messages. If Oprah Winfrey and Peter Jennings are to address an important health issue, they will not permit campaign planners to write their scripts. Great sensitivity to diversity in campaign planning may be feasible with regard to messages diffused directly by a campaign. In contrast, when social mobilization around an issue is the goal, and it requires working indirectly through other institutions, the goals and working routines of those other institutions may determine the outcome. Scarce campaign resources may be best spent on efforts to encourage institutional actors, including mass media, to focus on an issue. Resources spent on meticulous calibration of messages may prove less relevant to such social and institutional mobilization.

One example of the tradeoffs between diversity-focused versus generalized campaigns comes from the history of HIV/AIDS campaigns. It was an epidemiological fact that some behaviors put people at greatest risk of HIV infection. These behaviors were more common in some identifiable subgroups of the population, particularly men who have sex with men. There could have been an argument that the majority of campaign efforts should have focused on communities where many individuals’ personal behavior put them at risk. Indeed, many efforts focused on gay men. However, in most countries, this was only one component of a more broadly focused HIV campaign, one that declared all members of society as at risk. This strategy may have reduced infection incidence, but whether it would have done so more effectively than a campaign that focused on those at highest risk is still a question. Nonetheless, it seems clear that framing risk as broadly present in society, rather than only belonging to certain marginalized subgroups, was associated with a broadened policy concern: more health research dollars, more legislation outlawing discrimination based on HIV status, and perhaps lessened stigmatization of people living with HIV. Indeed, absent the broad policy concern, resources for an alternative focused campaign might have been missing entirely.



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