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A Longitudinal Analysis of the Impact of Health Behavior Campaigns on HIV-Risk Behaviors and HIV Incidence in Eswatini

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Abstract

Between 2010 and 2015, Eswatini conducted mass media health behavior campaigns (HBCs) designed to avert new HIV infections. Using longitudinal data from the nationally representative Swaziland HIV Incidence Measurement Survey of 2011, we describe the impact of exposure to HBCs on selected HIV risk behaviors and HIV incidence among sexually active, HIV-negative adults (n = 11,232). Exposure to partner reduction HBCs was significantly associated with reporting fewer (i.e., 1 versus 2, or 2 versus ≥ 3) sexual partners in the prior 6 months at baseline among women (aOR = 3.02; 95% CI 1.38, 6.62); and at both baseline and at 6-months follow-up for men (aOR = 2.26; 95% CI 1.49, 3.44; aOR = 1.95, 95% CI [1.26–3.00], respectively). Despite these reported partner reductions, there was no association between HBC exposure and prospectively observed HIV seroconversions (n = 121). This analysis strengthens the evidence that HIV prevention at the population level requires integrated strategies.

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Fig. 1

Adapted from Stead et. al., [3])

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Data Availability

Information available at: http://shims.wcsitepreview.com and data available upon request.

Code Availability

Upon request.

References

  1. Centers for Disease Control and Prevention. Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. 2020. https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html.

  2. Sapiano TN, Moore A, Kalayil EJ, Zhang X, Chen B, Uhl G, et al. Evaluation of an HIV prevention intervention designed for African American Women: results from the SISTA Community-Based Organization Behavioral Outcomes Project. AIDS Behav. 2013;17(3):1052–67. https://doi.org/10.1007/s10461-012-0292-0.

    Article  PubMed  Google Scholar 

  3. Stead M, Angus K, Langley T, Katikireddi SV, Hinds K, Hilton S, et al. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. Public Health Res. 2019;7:8.

    Article  Google Scholar 

  4. DiClemente RJ, Salazar LF, Crosby RA, Rosenthal SL. Prevention and control of sexually transmitted infections among adolescents: the importance of a socio-ecological perspective–a commentary. Public Health. 2005;119(9):825–36.

    Article  CAS  Google Scholar 

  5. Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge: Harvard University Press; 1979.

    Google Scholar 

  6. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351–77.

    Article  CAS  Google Scholar 

  7. Figueroa ME, Kincaid DL, Hurley EA. The effect of a joint communication campaign on multiple sex partners in Mozambique: the role of psychosocial/ideational factors. AIDS Care. 2014;26(Suppl 1):S50–5. https://doi.org/10.1080/09540121.2014.907386.

    Article  PubMed  Google Scholar 

  8. Jana M, Letsela L, Scheepers E, Weiner R. Understanding the role of the OneLove campaign in facilitating drivers of social and behavioral change in southern Africa: a qualitative evaluation. J Health Commun. 2015;20(3):252–8. https://doi.org/10.1080/10810730.2014.925014.

    Article  PubMed  Google Scholar 

  9. Jung M, Arya M, Viswanath K. Effect of media use on HIV/AIDS-related knowledge and condom use in sub-Saharan Africa: a cross-sectional study. PLoS ONE. 2013;8(7):e68359. https://doi.org/10.1371/journal.pone.0068359.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kaufman MR, Rimal RN, Carrasco M, Fajobi O, Soko A, Limaye R, et al. Using social and behavior change communication to increase HIV testing and condom use: the Malawi BRIDGE Project. AIDS Care. 2014;26(Suppl 1):S46–9. https://doi.org/10.1080/09540121.2014.906741.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Myhre SL, Flora JA. HIV/AIDS communication campaigns: progress and prospects. J Health Commun. 2000;5(Suppl):29–45.

    PubMed  Google Scholar 

  12. Noar SM, Palmgreen P, Chabot M, Dobransky N, Zimmerman RS. A 10-year systematic review of HIV/AIDS mass communication campaigns: have we made progress? J Health Commun. 2009;14(1):15–42. https://doi.org/10.1080/10810730802592239.

    Article  PubMed  Google Scholar 

  13. Peltzer K, Parker W, Mabaso M, Makonko E, Zuma K, Ramlagan S. Impact of national HIV and AIDS communication campaigns in South Africa to reduce HIV risk behaviour. Sci World J. 2012;2012:384608. https://doi.org/10.1100/2012/384608.

    Article  Google Scholar 

  14. Sano Y, Sedziafa AP, Amoyaw JA, Boateng GO, Kuuire VZ, Boamah S, et al. Exploring the linkage between exposure to mass media and HIV testing among married women and men in Ghana. AIDS Care. 2016;11:1–5.

    Google Scholar 

  15. Bertrand JT, O’Reilly K, Denison J, Anhang R, Sweat M. Systematic review of the effectiveness of mass communication programs to change HIV/AIDS-related behaviors in developing countries. Health Educ Res. 2006;21(4):567–97.

    Article  Google Scholar 

  16. LaCroix JM, Snyder LB, Huedo-Medina TB, Johnson BT. Effectiveness of mass media interventions for HIV prevention, 1986–2013: a meta-analysis. J Acquir Immune Defic Syndr. 1999;2014(66 Suppl 3):S329–40.

    Google Scholar 

  17. Sweat MD, Denison J, Kennedy C, Tedrow V, O’Reilly K. Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990–2010. Bull World Health Organ. 2012;90(8):613–22. https://doi.org/10.2471/BLT.11.094268.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Quigley MA, Kamali A, Kinsman J, Kamulegeya I, Nakiyingi-Miiro J, Kiwuwa S, et al. The impact of attending a behavioural intervention on HIV incidence in Masaka, Uganda. AIDS. 2004;18(15):2055–63.

    Article  Google Scholar 

  19. Ministry of Health Government of the Kingdom of Eswatini ICAP and CDC. Swaziland Incidence Measurement Survey 2 (SHIMS2) 2016–2017: Final Report April 2019. Mbabane, The Kingdom of Eswatini: Ministry of Health, Government of the Kingdom of Eswatini, ICAP at Columbia University, New York, NY, USA, US Centers for Disease Control and Prevention; 2019.

  20. UNAIDS. Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. Geneva, Switzerland: UNAIDS; 2010.

  21. UNAIDS. 2020 Global AIDS Update—Seizing the moment—Tackling entrenched inequalities to end epidemics. Geneva, Switzerland: UNAIDS; 2020.

  22. Swaziland Ministry of Health (MOH) ICAP and CDC. Swaziland Incidence Measurement Survey (SHIMS): First Findings Report November 2012. Mbabane, Swaziland and Atlanta, Georgia: Swaziland Ministry of Health and Center for Disease Control and Prevention; 2012.

  23. Bicego GT, Nkambule R, Peterson I, Reed J, Donnell D, Ginindza H, et al. Recent patterns in population-based HIV prevalence in Swaziland. PLoS ONE. 2013;8(10):e77101.

    Article  CAS  Google Scholar 

  24. Justman J, Reed JB, Bicego G, Donnell D, Li K, Bock N, et al. Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study. The Lancet HIV. 2017;4(2):e83–92.

    Article  Google Scholar 

  25. Government of the Kingdom of Eswatini. Swaziland HIV Incidence Measurement Survey 2 (SHIMS2) 2016–2017. Final Report. Mbabane: Government of the Kingdom of Eswatini; 2019.

  26. Kraft JM, Hill Z, Membe I, Zhang Y, Meassick EO, Monsour M, et al. Effects of the Gama Cuulu radio serial drama on HIV-related behavior change in Zambia. J Health Commun. 2012;17(8):929–45.

    Article  Google Scholar 

  27. Vaughan PW, Rogers EM, Singhal A, Swalehe RM. Entertainment-education and HIV/AIDS prevention: a field experiment in Tanzania. J Health Commun. 2000;5(Suppl):81–100.

    PubMed  Google Scholar 

  28. Bessinger R, Katende C, Gupta N. Multi-media campaign exposure effects on knowledge and use of condoms for STI and HIV/AIDS prevention in Uganda. Eval Program Plann. 2004;27(4):397–407.

    Article  Google Scholar 

  29. AVERT. HIV and AIDS in Eswatini. 2017. https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/swaziland.

  30. Swaziland Ministry of Health (MOH). Multiple Indicator Cluster Survey 2014. 2014.

  31. Swaziland Ministry of Health (MOH). 12th National HIV Serosurveillance Among Women Attending Antenatal Care Services in Swaziland Survey Report 2010. 2011.

  32. Greene WC. A history of AIDS: looking back to see ahead. Eur J Immunol. 2007;37(Suppl 1):S94-102.

    Article  CAS  Google Scholar 

  33. Iliffe J. The African AIDS epidemic: a history. Athens: Ohio University Press; 2006.

    Google Scholar 

  34. Stoneburner RL, Low-Beer D. Population-level HIV declines and behavioral risk avoidance in Uganda. Science. 2004;304(5671):714–8.

    Article  CAS  Google Scholar 

  35. NC Lo, A Lowe, E Bendavid. The Impact of PEPFAR Abstinence and Faithfulness Funding Upon HIV Risk Behaviors in Sub-Saharan Africa. Conference on Retroviruses and Opportunistic Infections (CROI); Seattle, Washington 2015.

  36. United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects The 2010 Revision Volume I: Comprehensive Tables. New York: United Nations; 2011.

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Acknowledgements

The authors would like to thank Dr. George Bicego for his contribution to this work. The authors would also like to acknowledge the Government of the Kingdom of Eswatini Ministry of Health, including the National Reference Laboratory, National AIDS Programme, and Central Statistical Office; and the SHIMS 2011 participants and research team, without whom this analysis would not have been possible.

Funding

The 2011 survey was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC) under the terms of Cooperative Agreement #5U2GPS002005. This analysis was supported through the National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (NIH) under Award Number 2R25GM62454-06 and the National Institute of Allergy and Infectious Diseases (NIAID) of the NIH under Award Number T32AI114398.

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, C/O ICAP, 722 W 168th St, New York, NY, 10032, USA

    Ivy Mushamiri & Jessica Justman

  2. Eswatini Ministry of Health, Mbabane, Eswatini

    Zandi Mnisi

  3. Eswatini National Emergency Response Council on HIV/AIDS, Mbabane, Eswatini

    Muziwethu Nkambule

  4. ICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY, USA

    Jessica Justman

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  1. Ivy Mushamiri
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  2. Zandi Mnisi
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  3. Muziwethu Nkambule
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  4. Jessica Justman
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Contributions

JJ and IM designed this study, IM analyzed the data and IM and JJ interpreted the data, IM drafted the manuscript and all authors reviewed and approved the manuscript for submission.

Corresponding author

Correspondence to Ivy Mushamiri.

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The authors declare that they have no conflicts of interest.

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All participants provided written consent to participate in the study.

Ethical Approval

The study was approved by the Institutional Review Boards (IRBs) at Columbia University, the U.S. Centers for Disease Control and Prevention, and the Swaziland Science and Ethics Committee.

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Mushamiri, I., Mnisi, Z., Nkambule, M. et al. A Longitudinal Analysis of the Impact of Health Behavior Campaigns on HIV-Risk Behaviors and HIV Incidence in Eswatini. AIDS Behav 25, 2767–2778 (2021). https://doi.org/10.1007/s10461-021-03316-7

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