National communication for social change program in Nicaragua successful in improving HIV-related attitudes and behaviors on a population level

"Somos Diferentes, Somos Iguales" (SDSI) is a communication for social change strategy to encourage youth empowerment and prevent HIV in Nicaragua. The strategy focuses on promoting social norms that foster sexual responsibility and gender equity, and that reduce HIV-related stigma. Intervention activities include a national ‘telenovela', a weekly call-in radio show, and various community-based activities, such as alliance-building with local NGOS, and youth training camps. Survey data were collected at baseline, one year, and one year after that, from a random, representative sample of male and female youth aged 13-24 in 3 major cities in Nicaragua (n=4,567 at baseline, with a 70% response rate at round three.) Qualitative data collection complemented the survey data. Baseline findings indicated that HIV-related knowledge was relatively high, yet risk behaviors were also substantial (e.g., more than two-thirds did not use condoms consistently with occasional partners). Follow up data demonstrated various significant, positive changes associated with exposure to the intervention (p<.05). A significant reduction in stigmatizing, as well as gender inequitable attitudes, was found. Interpersonal communication about HIV prevention, violence, and sexual behavior had all significantly increased. Knowledge and use of HIV-related services had increased. Survey findings indicate that this national communication for social change program focused on HIV prevention led to positive changes in both HIV-related attitudes and behaviors on a population level. Qualitative findings indicate that SDSI played an important role in promoting community-based dialogue on key topics, strengthened youth leadership, and fostered alliances between local actors relevant for health promotion.