莫桑比克联合宣传活动对多个性伴侣的影响:心理社会/观念因素的作用。

The effect of a joint communication campaign on multiple sex partners in Mozambique: the role of psychosocial/ideational factors.

作者信息

Figueroa Maria Elena, Kincaid D Lawrence, Hurley Emily A

机构信息

a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs , Baltimore , MD , USA.

出版信息

AIDS Care. 2014;26 Suppl 1:S50-5. doi: 10.1080/09540121.2014.907386. Epub 2014 Apr 22.

Abstract

Mozambique is one of the countries in sub-Saharan Africa most affected by the HIV epidemic. Multiple and concurrent sexual partnerships (MSP/CP) have been recognized as one of the key drivers in the rapid spread of HIV in the region. Though HIV prevention programs have been successful in increasing condom use and HIV testing, reducing the practice of MSP/CP has been more difficult. Grounding their interventions in social and behavior change theory, four organizations in Mozambique joined efforts to implement a year-long, multimedia national campaign for HIV prevention with emphasis on the reduction of MSP/CP. Evaluating its impact and identifying the factors that hinder or contribute to its success are critical to building effective programs in the future. With data from a 2011 population-based survey of 1427 sexually active women and men, multivariate causal attribution (MCA) analysis was used to estimate the impact of the campaign in the four regions of Mozambique with the highest levels of HIV prevalence. The analysis tested the psychosocial pathways through which the campaign was expected to affect MSP. The results indicate that exposure (recall) was high; 81.2% of the respondents could recall one or more of the communication campaign components. The campaign had a significant indirect impact on MSP through its negative effect on attitudes that favor MSP, and its positive effect on knowledge and discussion of MSP risk with sex partner. This study demonstrates the value of identifying appropriate psychosocial factors and using them to design the campaign communication strategy, and evaluate the causal pathways by which it has an impact. The campaign was successful in changing MSP behavior by working through two psychosocial variables.

摘要

莫桑比克是撒哈拉以南非洲受艾滋病疫情影响最严重的国家之一。多重并发性行为伴侣关系(MSP/CP)被认为是该地区艾滋病迅速传播的关键驱动因素之一。尽管艾滋病预防项目在增加避孕套使用和艾滋病检测方面取得了成功,但减少MSP/CP行为却更加困难。莫桑比克的四个组织以社会和行为改变理论为基础,共同努力开展了为期一年的多媒体全国艾滋病预防运动,重点是减少MSP/CP。评估其影响并确定阻碍或促成其成功的因素对于未来建立有效的项目至关重要。利用2011年对1427名性活跃男女进行的基于人群的调查数据,采用多变量因果归因(MCA)分析来估计该运动在莫桑比克艾滋病流行率最高的四个地区的影响。该分析测试了该运动预期影响MSP的心理社会途径。结果表明,曝光度(回忆率)很高;81.2%的受访者能够回忆起该宣传运动的一个或多个组成部分。该运动通过对支持MSP的态度产生负面影响,以及对与性伴侣讨论MSP风险的知识和讨论产生积极影响,对MSP产生了显著的间接影响。这项研究证明了识别适当的心理社会因素并利用它们来设计运动传播策略,以及评估其产生影响的因果途径的价值。该运动通过两个心理社会变量成功地改变了MSP行为。

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