HIV Testing and Codom Use Poster

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70
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Midterm
61.7
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Percent of Sample
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47.7
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35.6
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23.0
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15.3
16.7
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Never Tested
Tested more than 1 year ago
Tested in the last 12 months
Stastically Significant Increases from Baseline to Midterm
in Proportion of Sample that Reports Using a Condom
Most or Every Time
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Baseline
25
METHODS
15
10
Midterm
19.9
20
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A first-of-its-kind household-based longitudinal study was conducted in
December 2011 among 685 adults (56% female, average age=30.2 years,
SD=10.9), two years after they were first interviewed before the campaign
began. The longitudinal panel was selected on the basis of a stratified (by
intervention or control) random sample.
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Increases in HIV Testing from Baseline to Midterm
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Those who remained in the sample were less educated (p<.01) and poorer
(p<.05) than those who dropped out. Compared to baseline, there was a
25.8% increase in HIV testing (p<.001) and 5.9% increase in condom use
(p=.054) at midterm. Exposure to a key program component – the “Tasankha”
message – was associated with testing (r=.14, p<.001) and increase in
condom use (r=.10, p<.05). Exposure to the reality radio program “Chenicheni
Nchiti” was associated with condom use (r=.10, p<.05), but not with changes
in HIV testing.
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BRIDGE II is implemented by the Johns Hopkins Bloomberg School of Public
Health Center for Communication Programs in partnership with Save the
Children in Malawi, Pact Malawi, International HIV/AIDS Alliance and local
partners.
RESULTS
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Based on the stage of the epidemic, Malawi is in urgent need of theoretically
informed campaigns to promote behavior change. BRIDGE II is a
USAID-funded five-year HIV prevention program implemented in 11 districts
in southern Malawi. The project uses a research-based socio-ecological
behavior change model that includes mass media, interpersonal
communication and community mobilization. The Tasankha (We
Choose/Choices) mass media campaign encourages risk reduction and
strengthens individual/couple efficacy and collective efficacy. Linked to
Tasankha, a weekly radio program airing nation-wide, titled Chenicheni
Nchiti? (What is the reality?), examines HIV issues through various programs,
including the Radio Diaries, which are true personal stories about and told by
PLWAs. The mass media campaign has a potential national listenership of 70%
in more than 340 rural and semi-urban communities, targeting men and
women ages 18 years and above.
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AIDS is the leading cause of death among Malawians aged 15-49 (MOH,
2008), and HIV/AIDS has negatively influenced the average life expectancy,
which currently stands at 43 years (UNGASS, 2010). Although the national
prevalence is approximately 11% (UNGASS, 2010), the southern region has
been particularly hit hard by the epidemic, with a prevalence of 15%.
16.9
16.5
13.2
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8.7
5
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Men
Women
Overall
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CONCLUSIONS
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BACKGROUND
HIV testing and condom use significantly improved at midterm, in
comparison to baseline, and exposure to BRIDGE II was significantly
associated with these outcomes. Overall, mass media messages, coupled
with community activities, appear to show promise in the fight against AIDS.
B R I D G E
Although this evaluation focused on the “demand side” by promoting
condom use through mass media and community-based interventions,
Malawi has been suffering on the “supply side” – there is a severe shortage
of condoms in the country. Hence, changes observed in this assessment
have occurred despite an environment in which condoms have been
unavailable. Moving forward, a significant challenge for the intervention will
be to coordinate the demand promotion efforts with supply enhancement.
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Changes in HIV Testing and Condom Use in
Malawi: Longitudinal Findings at Midterm
from the Malawi BRIDGE II Program
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(In partnership with Save the
Children in Malawi, Pact Malawi,
Alliance and local partners),
This research has been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of 674-A-00-09-00024-00.
Presented at AIDS 2012 – Washington, D.C., USA
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BRIDGE II
Rajiv N. Rimal, PhD, Rupali J. Limaye, PhD, Glory
Mkandawire, MPH, Peter Roberts, Jane Brown, MPH
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