Bekalu Mesfin Awoke, Eggermont Steven, Viswanath K Vish
a Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Harvard University.
b Leuven School for Mass Communication Research , University of Leuven.
Health Commun. 2017 Jun;32(6):685-694. doi: 10.1080/10410236.2016.1167999. Epub 2016 Jul 1.
Three-and-a-half decades on, no cure or vaccine is yet on the horizon for HIV, making effective behavior change communication (BCC) the key preventive strategy. Despite considerable success, HIV/AIDS BCC efforts have long been criticized for their primary focus on the individual-level field of influence, drawing on the more reductionist view of causation at the individual level. In view of this, we conducted a series of studies that employed a household survey, field experiment, and textual content analysis, and explored the macro-social-level effects of HIV/AIDS-related media and messages on HIV/AIDS cognitive and affective outcomes in Ethiopia. Against a backdrop of epidemiological and socioecological differences, urban versus rural residence has emerged as an important community-level factor that impacts HIV/AIDS-related media and message consumption processes and associated outcomes. The central thread crossing through the six studies included in this paper demonstrates that urban and rural people in high HIV prevalence contexts differ in their concern about and information needs on HIV/AIDS, HIV/AIDS-related media use, and HIV/AIDS-related cognitive and affective outcomes, as well as in their reaction to differently designed/framed HIV prevention messages. This paper proposes that HIV prevention media and message effects in high epidemic situations should be considered from a larger community-level perspective and calls for a socioecological approach to AIDS communication in the hard-hit sub-Saharan Africa. With a number of concrete recommendations to current and future HIV/AIDS BCC efforts in the region, the study joins an emerging body of health communication literature and theorizing that suggests the need to consider media and message effects from a macro-social perspective.
三十五年过去了，针对艾滋病毒的治愈方法或疫苗仍未出现，这使得有效的行为改变沟通（BCC）成为关键的预防策略。尽管取得了相当大的成功，但艾滋病毒/艾滋病的行为改变沟通工作长期以来一直受到批评，因为它们主要关注个人层面的影响领域，采用的是个人层面较为简化的因果关系观点。有鉴于此，我们开展了一系列研究，采用了家庭调查、实地实验和文本内容分析，并探讨了与艾滋病毒/艾滋病相关的媒体和信息在埃塞俄比亚对艾滋病毒/艾滋病认知和情感结果的宏观社会层面影响。在流行病学和社会生态差异的背景下，城市与农村居住情况已成为一个重要的社区层面因素，影响着与艾滋病毒/艾滋病相关的媒体和信息消费过程及相关结果。贯穿本文所包含的六项研究的主线表明，艾滋病毒高流行环境中的城市和农村居民在对艾滋病毒/艾滋病的关注和信息需求、与艾滋病毒/艾滋病相关的媒体使用、与艾滋病毒/艾滋病相关的认知和情感结果，以及对不同设计/框架的艾滋病毒预防信息的反应方面存在差异。本文提出，在高流行情况下，应从更大的社区层面视角考虑艾滋病毒预防媒体和信息的效果，并呼吁在受影响严重的撒哈拉以南非洲地区采用社会生态方法进行艾滋病沟通。该研究针对该地区当前和未来的艾滋病毒/艾滋病行为改变沟通工作提出了一些具体建议，加入了新兴的健康传播文献和理论研究，这些研究表明需要从宏观社会视角考虑媒体和信息的效果。
