AIDS 2012 - Turning the Tide Together

Changes in HIV Testing and Condom Use in Malawi: Findings at Midterm from the Malawi BRIDGE

II Program

Rajiv N. Rimal, Glory Mkandawire, William Dothi, Peter Roberts, Jane Brown, & Rupali Limaye

Johns Hopkins University Bloomberg School of Public HealthCenter for Communication Programs

Program Context

• HIV prevalence in Malawi – 10.6% (in 2010), a decrease from 12% (in 2004)

• In the southern Malawi, prevalence is 14.5%• The Malawi BRIDGE II Project (2009 – 2014)– Mass media– Community mobilization– Interpersonal communication– Targeted interventions

• Key outcomes: Condom use, HIV testing, reduction in # sexual partners

Description of Intervention

• Intervention components:– Mass media (Tasankha (Choices) + reality radio programs)• More than 265 programs aired• Collective reach of 40%

– Community mobilization efforts • more than 340 communities reached at Midterm and

550 by September 2012

Data Collection

• Baseline: random sample of households in all 11 districts• Midterm: – Stratified (by treatment or control communities) random sample of households in all 11 districts– Cross-sectional component (N = 1,338)– Longitudinal sample (N = 685)

Characteristics of Those Retained

Lost at midterm Retained at midterm

p

Age: M (SD) 27.4 (10.7) 28.1 (10.9) n.s.

Years of education: M (SD)

6.4 (3.4) 6.0 (3.3) P < .05

# Household possessions: M (SD)

3.6 (1.5) 3.5 (1.3) P < .05

Results

Condom Use

Exposure Effects

• Exposure to Tsankha (“We have decided”) radio program associated with – Increase in testing (r = .14, p < .001)– Increase in condom use (r = .10, p < .05)

Conclusion

• Exposure to mass media and community interventions – Impact on HIV testing and condom use– Multiple partnerships: too few to analyze

• Further analysis: the role that interpersonal communication plays in disseminating campaign messages

• Effects seen despite shortage of testing kits and shortage of condoms

Acknowledgements

• PEPFAR for funding the project• Implementing partners• Collaborating partners– Ministry of Health– National AIDS Commission

Thank You