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Health Education Research Advance Access published online on July 17, 2006
Health Education Research, doi:10.1093/her/cyl036
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© 2006 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received December 16, 2004
Accepted April 14, 2006

Original article

Systematic review of the effectiveness of mass communication programs to change HIV/AIDS-related behaviors in developing countries

Jane T. Bertrand 1 *, Kevin O'Reilly 2, Julie Denison 3, Rebecca Anhang 4, and Michael Sweat 3

1 Johns Hopkins University, Bloomberg School of Public Health, Center for Communication Programs, Baltimore, MD 21202, USA
2 Department of HIV/AIDS, The World Health Organization, Geneva, Switzerland
3 Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21202, USA
4 PhD Program in Health Policy, Harvard University, Cambridge, MA 02138, USA

* To whom correspondence should be addressed.
Jane T. Bertrand, E-mail: jbertran{at}jhuccp.org


  Abstract

This review systematically examined the effectiveness of 24 mass media interventions on changing human immunodeficiency virus (HIV)-related knowledge, attitudes and behaviors. The intervention studies were published from 1990 through 2004, reported data from developing countries and compared outcomes using (i) pre- and post-intervention data, (ii) treatment versus control (comparison) groups or (iii) post-intervention data across levels of exposure. The most frequently reported outcomes were condom use (17 studies) and knowledge of modes of HIV transmission (15), followed by reduction in high-risk sexual behavior (eight), perceived risk of contracting HIV/acquired immunodeficiency syndrome (AIDS) (six), interpersonal communication about AIDS or condom use (six), self-efficacy to negotiate condom use (four) and abstaining from sexual relations (three). The results yielded mixed results, and where statistically significant, the effect size was small to moderate (in some cases as low as 1-2% point increase). On two of the seven outcomes, at least half of the studies did show a positive impact of the mass media: knowledge of HIV transmission and reduction in high-risk sexual behavior. Further rigorous evaluation on comprehensive programs is required to provide a more definitive answer to the question of media effects on HIV/AIDS-related behavior in developing countries.


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