268663 Social Amplification of Intervention Effects for HIV Prevention: The Role of Interpersonal Communication and Community Vibrancy in Malawi

Tuesday, October 30, 2012

Rajiv N. Rimal, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Peter Roberts , Center for Communication Programs, Johns Hopkins University, Baltimore, MD
William Dothi , Center for Communication Programs, Johns Hopkins University, Lilongwe, Malawi
Rupali Limaye , Center for Communication Programs, Johns Hopkins University, Baltimore, MD
Glory Mkandawire , Center for Communication Programs, Johns Hopkins University, Lilongwe, Malawi
Jane Brown , Center for Communication Programs, Johns Hopkins University, Baltimore, MD
Background. HIV prevalence in southern Malawi, 14.5%, highlights the need for prevention-oriented interventions. Through interpersonal communication, mass media, and community mobilization, the BRIDGE 2 Project focused on increasing the uptake of protective behaviors, including HIV testing, condom use, and reducing number of sexual partners. This presentation asks whether interpersonal communication amplifies intervention effects and whether community-level engagement plays a role in promoting preventive behaviors.

Methods. Longitudinal data (N=685) spanning two years (2009 to 2011) were collected from the same individuals through a representative survey in all 11 southern districts where BRIDGE 2 operates. Sampling was stratified by intervention status (low, medium, and high); individuals from baseline were randomly selected for inclusion. Community vibrancy was assessed as two dimensions: unity in the community and involvement of community organizations.

Results. There was a significant association between exposure and organizational involvement (p<.001) but not between exposure and community unity. In a multivariate model, predictors of increase in HIV testing were: decreased organizational involvement, increase in community unity, exposure to the primary campaign theme, and discussion about the campaign; predictors of increase in condom use were: improvements in community unity, exposure to the primary campaign theme, and discussionXexposure interaction (all p's<.05). Multiple sexual partnerships were too few to warrant analysis.

Conclusions. Perceptions that one's community is vibrant are critical predictors of improvement in HIV testing and condom use. Interpersonal communication appears to have further augmented intervention effects. Integrating an approach that involves interpersonal communication and community engagement is critical in the fight against AIDS.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Social and behavioral sciences

Learning Objectives:
1. To identify intervention characteristics that can affect health behaviors 2. To apply concepts from health behavior change theory in an intervention setting 3. To identify features of interpersonal communication and mass media campaigns that enhance intervention effectiveness

Keywords: HIV Interventions, Assessments

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal researcher and I wrote the bulk of the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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