How do news media frame the issue of male circumcision for HIV prevention? A content analysis of international media coverage

Background

While published research has shown male circumcision (MC) to provide partial protection against HIV infection, there is significant anecdotal evidence in media sources that suggests opposition to MC-based intervention. Since the media's framing of an issue can greatly influence public opinion, policy, and programmatic uptake, we performed a systematic analysis in order to examine prevailing messages about MC circulating in global media, and to inform strategies that public health groups can use to address potential sources of opposition.

Methods

Our content analysis sampled global news and opinion pieces in English between December 2006 and March 2008. We coded each article for quantitative and qualitative data, including geographical information, tone, and major themes.

Results

Articles published in the United States all had either a positive or a neutral tone. The majority of negative coverage appeared in Kenyan and Ugandan sources, and was highly concentrated in editorials, columns and letters to the editor. Articles most frequently focused on the logistics of mass circumcision efforts or the effectiveness of MC in preventing HIV.

Conclusions

Those promoting MC for HIV prevention would be best served by focusing on Kenyan and Uganda media environments, and devoting particular attention to opinion pages. Further, health program managers should closely monitor discussions in such opinion pages and prepare to respond to objections to MC and potential inaccuracies or misconceptions. Since media sources serving international audiences frequently turn to multilateral and government organizations when writing about health, well-crafted, evidence-based policy statements from such sources are of vital importance.