Exposure to BRIDGE project & its effect on self-efficacy among Malawians

Background: As the search for a vaccine continues, behavioral prevention is currently the only effective way to stem the further spread of HIV. One barrier in averting new infections is lack of self-efficacy; research shows that self-efficacy is a consistent predictor of HIV prevention behaviors. The Malawi BRIDGE project used a multi-dimensional strategy focused on enhancing self-efficacy to prevent HIV/AIDS through abstinence, faithfulness, condom use, and discussion. The objectives of the program were pursued through interpersonal, mass media, and community mobilization activities. Methods: A household survey of 14-86 year-olds (n=3,843) was conducted in eight districts in May 2009 to assess the impact of the project on self-efficacy and a variety of psychosocial variables. Multiple linear regressions tested the associations between exposure to the project and personal self-efficacy. A number of self-efficacy domains were tested: faithfulness, abstinence, condom use, discussion of condom use, partner reduction, and HIV/AIDS communication. Principal component analysis resulted in two composite self-efficacy factors: condom use and HIV communication self-efficacy. All tests controlled for age, gender, marital status, and education. Results: Exposure to the project was associated with efficacy to use condoms (β=0.08, p<0.001), but exposure was not associated with efficacy to talk about HIV/AIDS (p>0.05). Conclusions: Exposure to the BRIDGE project likely played a role in enhancing condom self-efficacy, but the intervention appears not to have affected discussion efficacy. The presentation will explore the underlying reasons. Focusing on efficacy improvement continues to be a pertinent method to increase condom use, which in turn can reduce new infections.