AIDS and Behavior

, Volume 13, Issue 6, pp 1213–1221 | Cite as

Keep Talking About It: HIV/AIDS-Related Communication and Prior HIV Testing in Tanzania, Zimbabwe, South Africa, and Thailand

  • Ellen Setsuko Hendriksen
  • Daniel Hlubinka
  • Suwat Chariyalertsak
  • Alfred Chingono
  • Glenda Gray
  • Jessie Mbwambo
  • Linda Richter
  • Michal Kulich
  • Thomas J. Coates
Original Paper


Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members’ uptake of voluntary counseling and testing. Drawing from Noelle-Neumann’s spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication, prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.


HIV AIDS Communication VCT Public opinion 



NIMH Project Accept is funded as a National Institute of Mental Health (NIMH) Cooperative Agreement (grants 5U01MH066687, 5U01MH066688, 5U01MH066701, and 5U01MH066702) involving the NIMH and several US and international institutions. The HIV Prevention Trials Network (HPTN) is also providing support to the project (HPTN 043)); support has also been provided by the Office of AIDS Research of the National Institutes of Health. E.S.H. conceptualized the paper, contributed to the analysis, and drafted the paper. D.H. performed the statistical analysis. S.C. was principal site investigator in Chiang Mai, Thailand and oversaw the data collection at that site. A.C. was principal site investigator in Harare, Zimbabwe, and oversaw the data collection at that site. G.G. was principal site investigator in Soweto, South Africa, and oversaw the data collection at that site. J.M. was the principal site investigator in Dar Es Salaam, Tanzania, and oversaw the data collection at that site. L.R. was the principal site investigator in Vulindlela, South Africa, and oversaw the data collection at that site. M.K. provided major support for the statistical analysis T.J.C. was the principal investigator of the overall project and oversaw the study team. All authors reviewed the manuscript. We would like to thank the many Project ACCEPT staff, both in-country and in the US, who have made this work possible.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Ellen Setsuko Hendriksen
    • 1
  • Daniel Hlubinka
    • 2
  • Suwat Chariyalertsak
    • 3
  • Alfred Chingono
    • 4
  • Glenda Gray
    • 5
  • Jessie Mbwambo
    • 6
  • Linda Richter
    • 7
  • Michal Kulich
    • 2
  • Thomas J. Coates
    • 8
  1. 1.Behavioral Medicine Service, Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonUSA
  2. 2.Department of Probability and Statistics, Faculty of Mathematics and PhysicsCharles UniversityPragueCzech Republic
  3. 3.Research Institute for Health SciencesChiang Mai UniversityChiang MaiThailand
  4. 4.Department of Psychiatry, School of MedicineUniversity of ZimbabweHarareZimbabwe
  5. 5.Perinatal HIV Research UnitChris Hani Baragwanath Hospital/University of the WitswatersrandJohannesburgSouth Africa
  6. 6.Department of Psychiatry, College of Health SciencesMuhimbili UniversityDar Es SalaamTanzania
  7. 7.Human Sciences Research CouncilDurbanSouth Africa
  8. 8.Division of Infectious Diseases, David Geffen School of MedicineUniversity of California Los AngelesLos AngelesUSA

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