Malawi BRIDGE Program: Effects on HIV Prevention Behaviors and Behavioral Predictors

Objectives. To determine the extent to which exposure to the Malawi BRIDGE project–a six-year, multi-channel HIV prevention campaign–was able to affect HIV prevention behaviors as well as behavioral determinants.

Methods. A household-level survey was conducted in Malawi (N=3843; 50% female; 34% youth) in 2008. Sampling was done at the Traditional Authority level (administrative unit below the district), stratified by level of BRIDGE activities. Primary variables measured were: demographics; perceived risk to HIV; exposure to the campaign; knowledge about HIV (percent correct response); self-efficacy to use condoms, reduce number of sexual partners, and talk about AIDS; HIV testing uptake; high-risk sexual behaviors; and condom use. Hierarchical regressions tested whether exposure to the program was associated with each of the study outcomes.

Results. Exposure to the BRIDGE program occurred through an average of 4 channels (range: 0-9; M = 4.0, SD = 2.1). Controlling for demographics and other predictors, exposure was associated knowledge (β=.13); self-efficacy to use condoms (β=.09), reduce number of sexual partners (β=.06), talk about AIDS (β=.08); HIV testing (β=.18); and high-risk sexual behavior (β=-.06); all Ps<.001.

Conclusion. After controlling for the effects of known predictors of HIV prevention behaviors, exposure to the Malawi BRIDGE program was associated with a number of positive outcomes, including knowledge about HIV transmission, HIV testing uptake, enhancement of self-efficacy, and reductions in high-risk behaviors. We will describe intervention components (which included radio, print, community events, and mobilization of local organizations) and the effects associated with the program.