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WEPDC0203 - Poster Discussion Session
Changes in HIV testing and condom use in Malawi: longitudinal findings at midterm from the Malawi BRIDGE II Project
Presented by Rajiv N. Rimal (United States).
R.N. Rimal1, G. Mkandawire2, W. Dothi2, P. Roberts2, J. Brown3, R. Limaye3
1Johns Hopkins Bloomberg School of Public Health, Health, Behavior & Society, Baltimore, United States, 2Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Lilongwe, Malawi, 3Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, United States
Background: With 14.5% HIV prevalence, the southern region of
Malawi is in urgent need of theoretically informed campaigns to promote
behavior change. Since 2010, the BRIDGE II Project has run a mass
media campaign with a potential national listenership of 70% in conjunction
with community-based and interpersonal communication interventions that
facilitate behavioral choices around HIV prevention in over 340 BRIDGE II
communities in 11 districts in southern Malawi. We present midterm evaluation
results on two key outcomes promoted by the campaign: condom use and HIV
testing. Methods: 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. Results: 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” (“We have decided”) 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. Conclusions: HIV testing and condom use significantly
improved at midterm, in comparison to baseline, and exposure to the BRIDGE II
programs was significantly associated with these outcomes. Multiple sexual
partnerships, another intervention-targeted outcome, were too few to analyze in
this sample. Further analyses will explore the role of interpersonal discussion
and community mobilization activities in propagating intervention messages.
Overall, mass media messages, coupled with community activities, appear to show
promise in the fight against AIDS.
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