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Most theories and models used to develop human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) communication are based on social psychology that emphasizes individualism. Researchers including communication and health scholars are now questioning the presumed global relevance of these models and thus the need to develop innovative theories and models that take into account regional contexts. In this paper, we discuss the commonly used theories and models in HIV/AIDS communication. Furthermore, we argue that the flaws in the application of the commonly used "classical" models in health communication are because of contextual differences in locations where these models are applied. That is to say that these theories and models are being applied in contexts for which they were not designed. For example, the differences in health behaviors are often the function of culture. Therefore, culture should be viewed for its strength and not always as a barrier. The metaphorical coupling of "culture" and "barrier" needs to be exposed, deconstructed, and reconstructed so that new, positive, cultural linkages can be forged. The HIV/AIDS pandemic has served as a flashpoint to either highlight the importance or deny the relevance of theories and models while at the same time addressing the importance of culture in the development and implementation of communication programs.

In response to the overwhelming burden of new cases of human immunodeficiency virus (HIV) in Africa, Asia, Latin America, and the Caribbean, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in 1997, initiated a project to examine the application of existing communication theories/models to HIV/acquired immune deficiency virus (AIDS) prevention and care in these regions. In the past 2 years, 103 leading researchers and practitioners from different parts of the world were invited by the UNAIDS to participate in one of five consultative workshops designed to review these theories/models and rethink their adequacy for Africa, Asia, Latin America, and the Caribbean. A new communications framework for HIV/AIDS was developed to move from a focus on the individual to a focus on five domains of "contexts" that influence behaviors: government policy, socioeconomic status (SES), culture, gender relations, and spirituality.

To invoke the primacy of culture in health education activities is not only to challenge approaches to health education that overlook or downplay this domain, but to also deepen and extend the possibilities of progressive approaches that focus on culture. Border pedagogy, which seeks to establish a countervoice to Eurocentrism and patriarchy, enhances and magnifies the possibilities that were opened up when critical pedagogy invoked the engagement of students in the production of knowledge. This process of engaging the teacher/interventionists and the students/audiences in the production of meaning, value, pleasure, and knowledge should be central to the mission of health education. It is only through such dialogue where varied cultural expressions are affirmed and centralized that the production of cultural identity can be legitimating and empowering relative to health promotion.

African-Americans have emerged as the "second wave" of the AIDS epidemic. Epidemiologic evidence indicates that African-Americans adults as well as adolescents have a disproportionately higher risk of AIDS and human immunodeficiency virus (HIV) infection. While programs designed to increase self-protective behaviors are urgently needed to avert a further increase in HIV infection among this population, there is little understanding of African-American sociocultural factors that may influence the acceptance of HIV information and the adoption of HIV-preventive behaviors. This paper describes African-American cultural values and mores which may be related to risk-taking behavior. Barriers to the effective dissemination of HIV prevention education are identified and strategies that may be effective in surmounting these barriers and implementing culturally-appropriate HIV behavioral modification programs are described.

Multicultural education is a necessary ingredient for promoting cultural diversity in the U.S. educational system. School health curricula should incorporate instruction about health problems among ethnic minorities. If we are to educate youth for what we want the future of society to be, educators must encourage and promote diversity. In school health curricula, diversity is critical to adequately promote health for all.