Barcelona 2013
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| Abstract #615 - Social and Behavior Change Communication to Prevent HIV. Global impact. | ||||
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Session: 29.3: Social and Behavior Change Communication to Prevent HIV. Global impact. (Lunchtime) on Tuesday @ 13.15-14.15 in Raval Chaired by Michelle Kaufman Authors: Presenting Author: Dr Maria Elena Figueroa - Johns Hopkins Bloomberg School of Public Health, United States |
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| Additional Authors: Mr. John Miller, Ms. Kimberley Ibarra, Mr. Frank Wagner, | ||||
| Aim: For the last decade, HIV prevention programs have promoted reduction in sex partners, HIV testing and condom use as HIV prevention behaviors. Compared to condom use and testing behaviors, reduction of sex partners has been addressed the least in organized mass media campaigns. The asymptomatic nature of HIV, together with lack of trust about condoms and traditional norms that favor and expect men to have more than one sex partner at a time, may render some media messages ineffective. To have an effect on the intended population, communication programs need to address the intermediate factors underlying these prevention behaviors. The objective of this study was to evaluate an HIV prevention mass media campaign in Mozambique with the identification of several intermediate variables that are directly related to each of the three prevention behaviors. | ||||
| Method / Issue: Survey data was collected from 790 men and 876 women, aged 15-54 and 15-49 years, respectively, in four provinces in Mozambique with the highest HIV prevalence. The survey measured number of sexual partners in the last year; condom use at last sex (up to three partners reported); HIV testing in the last 12 months; attitudes and other intermediate variables related to multiple sex partners (MSP), HIV testing and condom use; sociodemographic variables and communication program exposure. | ||||
| Results / Comments: Structural equation modeling was used to assess the effect of the communication campaign on each of the three prevention behaviors. Results indicate the campaign had an indirect effect on reducing MSP behavior through the following intervening variables: 1) positive effect on knowledge and discussion with one?s partner of the risk of MSP [β=.14, p<0.001]; 2) a negative effect on having favorable MSP attitudes [β=.07, p<0.05]. The effect of the campaign on reducing favorable MSP attitudes was also indirect through knowledge and discussion of the MSP risk [β=.-10, p<0.001]. The campaign also had direct and indirect effects on condom use at last sex with any of the last 3 sex partners. The indirect effect worked through condom ideation [OR=1.3, p<0.001], a composite measure of condom self-efficacy and condom attitudes. Condom use at last sex was also higher among the youngest group [OR=2.9, p<001] compared to those older than 34 years. HIV testing was higher among men and women that discussed testing with partners and friends in the last 12 months. Those that talked to others about testing were 3.2 times as likely as those that did not to have tested for HIV in the last 12 months [p<0.001]. | ||||
| Discussion: The results of the analysis indicate the campaign was effective in changing the three prevention behaviors working through intermediate factors specific for each behavior. Research in Mozambique and elsewhere needs to continue to identify ideational variables like those measured in this evaluation, in order to improve program design and program impact. New qualitative research should explore additional variables related to HIV prevention behavior that have not yet been tested in sample survey research. | ||||
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