AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #184 - Changing attitudes and behavior towards cross-generational sex through mass media: evaluation of the Fataki campaign in Tanzania
Authors: Presenting Author: Dr. Michelle Kaufman - Johns Hopkins University
Additional Authors: Mr. Deo Ng'wanansabi, Dr. Adiel Mushi, Dr. Susan Mlangwa, Dr. Benjamin Kamala, Ms. Anna McCartney-Melstad, Mr. Robert Karam,
Aim: This study explores the impact of a nationwide mass media campaign in Tanzania addressing “Fataki”—older men who have sexual relationships with girls and young women. In Tanzania, cross-generational sex (CGS) is a driver of the HIV epidemic for women because these relationships often involve power imbalances and transactional sex. The Fataki Campaign, running nationwide since 2008, has attempted to stigmatize these relationships and to encourage families and community members to “protect their loved ones from Fataki”. This study looks at the impact of the campaign by evaluating exposure as it relates to prevalence of intervening actions and sexual risk behavior of young girls and older men involved in such relationships. Hypotheses for this study were as follows: 1)exposure to Fataki spots are associated with a greater level of communication with family and community members about HIV and the risks of CGS; 2)there is a mediating relationship between communication, social norms about CGS, and engaging in CGS behavior such that interpersonal communication about CGS is associated with perceptions that social norms oppose CGS, and perceptions that social norms oppose CGS is associated with less engagement in CGS relationships; and 3)a higher level of social support, socio-economic status, education and exposure to the Fataki campaign are predictors of women’s negative views of CGS and reduced likelihood of engaging in such relationships.
Method / Issue: A nationwide cross-sectional household-based survey was conducted with a total of 2,400 men and women ages 15 and above in Tanzania. In addition, a series of 40 interviews and 12 focus group discussions were completed in high HIV prevalence areas within the country to gain in-depth understanding of the specific actions people have taken to stop such relationships as a result of the campaign.
Results / Comments: Initial analyses show that our hypotheses are supported. Results show that exposure to the campaign was wide-reaching and that about 35% of those exposed have personally intervened in a CGS relationship. Further analyses will use regression analyses and causal modeling to look at exposure to the campaign as it relates to attitudes towards CGS and sexual risk behavior. Regression analyses will look at predictors for girls engaging in relationships with Fataki, such as their level of social support, SES, education level, and exposure to the campaign. This presentation will also include qualitative data from the interviews and focus groups to provide examples of how families and communities have intervened in CGS relationships as a result of the campaign, as well as stories from informants about their engagement in CGS relationships.
Discussion: The Fataki campaign uses mass media to intervene with one of the drivers of the HIV epidemic in Tanzania, particularly for girls and women. Such a wide-reaching campaign could serve as a model for changing sexual risk behavior on a large scale by stigmatizing relationships where risky behavior is so prevalent.
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