Effects of the Malawi BRIDGE Radio Diaries on HIV-related stigma in Malawi: An experimental design in the field

Background: Few studies on HIV/AIDS stigma have manipulated exposure to mass media messages to study their effects. This study used an experimental design to evaluate the effects of a radio program featuring men and women with HIV (Radio Diaries program) on HIV-related stigma in Malawi. Methods: Thirty villages with 10 participants each were randomized to one of three study conditions: intervention (listened to Radio Diaries), intervention plus discussion (listened to Radio Diaries followed by a moderated formal discussion) and control (listened to a radio program unrelated to HIV). Post-intervention interviews assessed stigma indicators such as fear of casual contact, shame related to HIV, blame and judgment, and disclosure of HIV status. Results: The intervention group reported significantly lower levels of fear of casual contact and shame than the control group. The intervention + discussion group reported significantly lower levels of fear of casual contact and blame/judgment than the control group but significantly higher levels of shame than the intervention-only group. Interactions indicated that the intervention reduced blame/judgment for men and not women and for participants age 18-24 and not older participants. The intervention had a greater effect on shame in participants who did not report having a close friend or relative with HIV, as participants who did report knowing someone had significantly lower levels of shame across groups. Conclusions: Including people living with HIV/AIDS in communication interventions has strong potential to reduce various aspects of HIV-related stigma. Future studies should look at gender and age differences in stigma.