The pen-3 model was developed for culture centralization in promoting health interventions. It is presented for prevention of HIV\AIDS, support and care in Africa. Its domains include; culture empowerment, expectations and relationship, and cultural identity. These domains are used for assessment of culture. The domains help the practitioner of public health, in identifying the entry point of intervention in the community (Campinha-Bacote, 2002).
Culture has negative and positive effects on behaviors of health. As a feature that is central in gaining insight to behavior of health by behavioral and social scientists cultural study is new both by the provided representations and approach taken. HIV has threatened many positive responses that are traditional to prevention of the disease in cultures of Africa .failure in the adoption of new behavior and practices is considered as retrogression of culture.
The domain of cultural identity determines the intervention point of entry. When the critical issues are agreed upon, a decision is reached according to focus and nature for the intervention on the basis of the domain of cultural identity. This domain focuses on similar behavior characteristics basing on how the role of persons and community and family relationship are defined by culture.
The behavior interpretation and construction usually are based on the family influence and friends in behavior nurturance, interaction and the interaction between our perception of that habit, forces of the institution that disenable or enable actions and the resources. The categories of expectations and relationship include;-perception, enablers and nurturers.
Perception involves knowledge, values and beliefs in making decisions focusing on groups or individuals or emotional complementarily and cues, rational to behavioral deeds. Enablers are institutional support and resources, and economic status, as power and resource measure, and services availability like HIV drugs. Nurtures are discouraging and supportive family influence and it includes; soul and spirituality, events and community and healing tradition (Campinha-Bacote, 2002).
The domain of cultural empowerment is categorized in to three;-positive; these are relationships and values promoting health behavior of interest Existential; are beliefs and values practiced but are health friendly. Negative; are relationships and values that examine behavior context including communities and societies, the societal women’s position, in relation to sexuality decision making and the health behavior spiritual context in question.
Application of the pen model
First a 3-3table is developed by crossing the domain components of cultural empowerment (negative, positive, and existential) with relationships and expectation domain.(nurture, enabler, perception).the categories are; Positive perception; is the attitude, beliefs and knowledge that affect, positively, decisions concerning prevention of HIV\AIDS support and career. in these case HIV is seen as an impact of one`s behavior opposed to identity (Culhane, 1996).
Existential perception is the knowledge beliefs and attitude influencing decisions concerning prevention support and care in a unique way. As such they help in explaining some values concerning people (Culhane, 1996). On the other hand Negative perception; is attitude belief and knowledge that has a negative affect decisions pertaining to support, care and prevention about prevention of HIV\AIDS. It often represents the focus of intervention of behavior excluding others.
Positive enablers; refers to acceptability, affordability, accessibility and availability of the needed resources in supporting preventive health actions positively. Open discussions concerning HIV\AIDS reduce stigma. Also Existential enablers are the affordability and availability of the traditionally available resources of society to support preventive health measures. Evidently, Senegal healers have successfully developed HIV treatment.
Negative enablers; is the absence of affordable, available and accessible resources in promoting positive health preventive actions. The religious leaders’ reluctance to openly discuss about HIV promotes stigma. Existential nurturers are the significant influences in making health choices within specific traditional practices. While negative nurturers; are negative influences that negatively shape health choices contributing to spreading of HIV\AIDS.
Stigma, a negative nurturer does not promote HIV testing. It promotes risky sex practices (Goode, 1997). According to researchers and interventionists conduct a culturally based research which develop interventions that combat the disease HIV/AIDS in the sub-Saharan Africa. It is accompanied by human rights abuses and the discrimination leading to stigma whereby PEN-3 can be used to address the situation. Moreover, it also address culture in development, evaluation and implementation of health promotion programmes.
To conclude, the programmes implemented should be basing on cubing and eradicating HIV/AIDS from Africa and the rest of the world for it has proved to be a disaster that requires attention.