Definition of the Prevention Area
Mass media interventions aim to prevent HIV by increasing knowledge, improving risk perception, changing sexual behaviors, and questioning potentially harmful social norms. Campaigns may utilize radio, television, and other outlets and ideally operate as part of multi-level efforts, in which mutually reinforcing messages are offered through interpersonal, community, and national channels. Mass media interventions are a critical part of an effective prevention approach.
Epidemiological Justification for the Prevention Area
Mass media interventions offer a cost-efficient way to reach large numbers of people, including people who may be difficult to reach through interpersonal approaches, such as migrants and people living in remote areas. These interventions have the potential to influence social norms, engendering productive dialogue at the population level.
Core Programmatic Components
Mass media programs should be implemented through multiple channels with mutually reinforcing messages. Radio and television, the most commonly used mass media, have been used creatively to target various populations through formats such as dramas, serials, and diaries. “Edutainment,” a combination of education and entertainment, can be used to model and demonstrate behavioral patterns that affect people’s risk of HIV, such as partner communication.
Studies also show that promoting branded products and programs as well as specific service delivery points are more likely to achieve the intended outcome as opposed to generic messages. Small media (posters, pamphlets, and flyers) that are typically distributed locally may enjoy a long shelf life. However, mass media is most effective when it is reinforced with community interventions.
The development of a communications campaign must be strategic and aligned to the achievement of specific and measurable outcomes. Critical elements to a campaign’s success include understanding the target audience, including the most efficacious media to reach them; pre-testing messages; modifying the campaign, if needed, based on post-test results; and measuring the cost-effectiveness of the media used. Principles for HIV and AIDS communication campaigns include realistic goals; behavior substitution rather than elimination; environmental support for behavioral change; cost-effectiveness; program accessibility to the target audience; and attention to legal and socio-cultural obstacles to change.
Current Status of Implementation Experience
Although a growing body of evidence supports the effectiveness of mass media interventions on many of these outcomes, systematic reviews suggest that the size of the effect can be small to moderate. The effects of mass media may be short term, and reinforcement of messages is needed to sustain behavior change. A dose-response effect to mass media messages has been demonstrated: higher exposure to mass media resulted in increased positive behavioral change. Moreover, individuals need to be exposed to a variety of prevention messages, because risk factors for HIV change over an individual’s lifetime.