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C-Channel Issue 2

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Depending on your geographical location, visit Developing World or Industrialized World.
C-Channel header  October 2008

Dear Colleagues,

This issue of C-Channel highlights research on the role of behavior and social change communication in HIV prevention. Research topics include understanding the importance of building knowledge and skills about HIV and alcohol in reducing risky behavior, better knowledge of the social norms related to sexual partner concurrency among African-American men, and the positive effects of media exposure and interpersonal communication within networks to gauge social norms and increase levels of HIV disclosure. The Global HIV Prevention Working Group issued a report in conjunction with the International AIDS conference in Mexico City in August 2008 titled Behavior Change and HIV Prevention: (Re)Considerations for the 21st Century, which reviewed hundreds of studies and stated in the first sentence, "Recent results from clinical trials of potential new HIV prevention interventions underscore what we have known for decades: Wider delivery of effective behavior change strategies is central to reversing the global HIV epidemic." The report notes that "the HIV prevention effort must confront several challenges of perception to be more effective in the 21st century: misplaced pessimism about the effectiveness of behavioral HIV prevention strategies; confusion between the difficulty of changing human behavior and the inability to do so; and misperception that because it is inherently difficult to measure prevention success, prevention efforts have no impact."

This issue also looks at research on family planning behaviors, including the role of men in decision making in contraception and the use of systematic outreach to rural areas to increase knowledge and demand for contraceptive services; and at research on community-based responses to malaria control and the training of community health workers to use rapid diagnostic tests (RDT) for malaria.

To continue receiving subsequent monthly issues of C-Channel, you must subscribe using our simple subscription system. To subscribe, please click: Developing World or Industrialized World. If your colleagues or affiliated institutions have e-mail access and would like to receive C-Channel, please have them contact c-channel@healthnet.org.

We welcome your feedback and ideas that can be sent to c-channel@healthnet.org.

Thank you,
The Knowledge Management Team at C-Change


To view archived issues, visit http://c-changeprogram.org/c-channel


 

HIV/AIDS

1. Skills-building behavioural interventions advocated for reducing alcohol-related HIV risk in South Africa

2. Mass media, stigma, and disclosure of HIV test results: multilevel analysis in the Eastern Cape, South Africa

3. Urban African-American men speak out on sexual partner concurrency: findings from a qualitative study
 

FAMILY PLANNING/REPRODUCTIVE HEALTH

4. Fertility-limiting behavior and contraceptive choice among men in Nepal

5. Family planning and safer sex practices among HIV infected women receiving prevention of mother-to-child transmission services at Kitale District Hospital

6. Can family planning outreach bridge the urban-rural divide in Zambia?
 

MALARIA

7. An exploratory study of community factors relevant for participatory malaria control on Rusinga Island, western Kenya

8. Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training
 

COMMUNICATION FOR BEHAVIOR AND SOCIAL CHANGE

9. Radio role models for the prevention of mother-to-child transmission of HIV and HIV testing among pregnant women in Botswana
 


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HIV/AIDS

1. Skills-building behavioural interventions advocated for reducing alcohol-related HIV risk in South Africa

Authors: Cairns, Gus; Safreed-Harmon, Kelly
Source: AIDSmap, 2008 August 07

This study assesses the benefits of skills-building risk-reduction interventions for people whose alcohol consumption puts them at a higher risk for unsafe sex and HIV infection. The study participants were 353 men and women recruited at informal bars in Cape Town, South Africa who were identified as having a drinking problem (using the WHO AUDIT score). The men and women were assigned to participate in either a three-hour behavioral skills training workshop on sexual negotiation and condom use, or in a one-hour control intervention that consisted of an HIV education session. Participants were followed up three and six months after their workshops. Compared to the control group, those who participated in the behavioral skills building workshop showed more significant declines in unprotected intercourse, alcohol use before sex, numbers of sex partners, and partners met at drinking establishments. The workshop attendees also reported increased condom use. The success of the workshop depended on the level of a person’s alcohol use, however. Light drinkers showed more significant improvements than did heavier drinkers. The researchers determined that additional HIV prevention interventions should be targeted to drinking establishments

To link to the abstract of this article, click here

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2. Mass media, stigma, and disclosure of HIV test results: multilevel analysis in the Eastern Cape, South Africa

Authors: Hutchinson, PL; Mahlalela, X; Yukich, J
Source: AIDS Education and Prevention, December 2007;19(6): 489-510

This study examines how interactions with social networks and mass media influence HIV-related perceptions, attitudes and behaviors, including disclosing one’s HIV status to a partner. Using data from a household survey of adults in rural areas of the Eastern Cape Province of South Africa, the effects of these influences were measured using a multilevel framework that accounts for the social context in which people access information and make decisions. Results showed that media exposure and social networks reinforced overall knowledge about HIV and reduced stigma. Because increased knowledge and reduction of stigma are factors that can lead to actual behavior change, the study’s results lend support to the use of mass media channels and interpersonal communication through social networks to change behaviors such as condom use and disclosure of HIV status.

To link to the abstract of this article, click here

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3. Urban African-American men speak out on sexual partner concurrency: findings from a qualitative study

Authors: Carey, Michael; Senn, Theresa; Seward, Derek; and Vanable, Peter
Source: AIDS and Behavior, 2008 May 16

To learn more about sexual partner concurrency among low-income African American males, focus group discussions were held with 20 urban African American men recruited from a public STD clinic. The group agreed that it is normal and acceptable for men to have concurrent partners, but disagreed about whether the same was true for women. They also discussed the motives for their actions, and some men described negative consequences related to having concurrent partners. The study findings can help to inform future risk-reduction efforts for low-income, African American men and their partners.

To link to the abstract of this article, click here

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If you find these articles on communication for behavior change and social change useful and would like to receive subsequent monthly issues of C-Channel, please click Developing World or Industrialized World to complete the subscription information.


 

FAMILY PLANNING/REPRODUCTIVE HEALTH

4. Fertility-limiting behavior and contraceptive choice among men in Nepal

Authors: Dahal, Govinda; Padmadas, Sabu; Hinde, P.R.Andrew
Source: International Family Planning Perspectives, 2008,34(1):6-14

Analyzing data about men’s contraceptive use and fertility intentions from the 2001 Nepal Demographic and Health Survey couple data set, this study examined the contraceptive choices of 1,041 married men 20 years of age or older who had at least one living child, but who reported wanting no more children. Study findings detailing contraception use found variations by age groups, residence, occupation and education. Twenty-four percent of these men who wanted no more children were not using any method of contraceptive at the time of the survey. Thirty percent reported that their wives were sterilized, 12 percent had a vasectomy, 7 percent were using condoms, and 27 percent were using other temporary methods. The men were more likely to use permanent methods if they had at least two living sons. They were less likely to use a contraceptive method if they had only daughters.

To link to the abstract of this article, click here

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5. Family planning and safer sex practices among HIV infected women receiving prevention of mother-to-child transmission services at Kitale District Hospital

Authors: Bii, SC; Otieno-Nyunya, B; Siika, A; Rotich, JK
Source: East African Medical Journal, 2008 Apr;85(4):156-61 [PubMed]

The objective of this study was to explore the use of family planning services and safer sex practices of HIV-infected mothers after participating in the prevention of mother-to-child transmission of HIV (PMTCT) process. A total of 146 HIV-positive women who participated in the PMTCT process at Kitale District Hospital in Western Kenya were administered a self-reported questionnaire. Analyses compared family planning usage between married and single women, women who want more children and those who do not, and the relationship between spousal awareness of HIV status and safer sex practices. The results revealed that 44% of women used family planning methods; temporary methods included injectable hormones (15%) and condoms (11%), and permanent methods included tubal ligation (13%). Only 38% of the women reported condom use with their partners for safer sex purposes. Women who were married and those who revealed their HIV status to their partners were most likely to use condoms. The study also found that the involvement of male partners was crucial in practicing family planning or safer sex.

To link to the abstract of this article, click here

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6. Can family planning outreach bridge the urban-rural divide in Zambia?

Authors: White, Justin; Speizer, Ilene
Source: BioMed Central Health Services Research, 2007, 7:143

This study explores differences in family planning methods of urban and rural areas of Zambia. Using data collected between 2001 and 2002 from the Zambia Demographic and Health Survey (DHS), the authors examined the effects of various factors (e.g., location of residence, access to family planning methods, and household visits by health care workers) on modern contraceptive use. The authors found that one third of the women surveyed used a contraceptive method, most commonly the oral contraceptive pill. Traditional methods were most commonly used in rural areas (47%). Household visits by a community health worker significantly increased the likelihood that rural women used modern contraceptives. The study concluded that increased access to contraceptive methods alone would not significantly improve family planning usage in rural areas, but that strategies that address both family planning demand creation and supply of services are needed.

To link to the abstract of this article, click here

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MALARIA

7. An exploratory study of community factors relevant for participatory malaria control on Rusinga Island, western Kenya

Authors: Opiyo, Pamela; Mukaban, W Richard; Kiche, Ibrahim; Mathenge Evan, Killeen Gerry; Fillinger, Ulrike
Source: Malaria Journal, 2007, 6:48

The knowledge and beliefs about malaria transmission, prevention, and treatment in a rural community of 1451 households in western Kenya were assessed by researchers through focus group discussions and semi-structured individual interviews. Results indicated that while community members realized that malaria was a major threat to life, their behaviors were based mostly on traditional beliefs. However, they did use modern bednets for prevention but also incorporated ineffective methods such as bush clearing and various hygienic actions. The study conclusions focus on the need to develop and integrate culturally sensitive and evidence-based participatory tools to help people understand the causal connection between the mosquito and malaria transmission, diagnosis, treatment and disease prevention.

To link to the abstract of this article, click here

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8. Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training

Authors: Harvey, Steven; Jennings, Larissa; Chinyama, Masela; Masaninga, Fred; Mulholland, Kurt; Bell, David
Source: Malaria Journa, 2008, 7:160

The introduction of artemisinin combination therapy (ACT) has increased the interest in, and use of, parasite-based malaria diagnosis and the use of rapid diagnostic tests (RDTs) in low resource settings. The lack of trained personnel in health facilities limits the use of RDTs in sub-Saharan Africa. Researchers in Zambia studied whether community health workers (CHWs) could safely and accurately carry out RDTs: 79 CHWs were divided into three groups; 32 used the manufacturer’s package instructions, 21 used job aid only, and 26 job aid and training. This study concluded that the most effective approach included a combination of jobs aid with clear instructions plus training to improve the ability of CHWs to prepare and interpret RDTs.

To link to the abstract of this article, click here

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COMMUNICATION FOR BEHAVIOR AND SOCIAL CHANGE

9. Radio role models for the prevention of mother-to-child transmission of HIV and HIV testing among pregnant women in Botswana

Authors: Kuhlmann, AK Sebert; Kraft, JM; Galavotti, C; Creek, TL; Mooki, M; Ntumy, R
Source: Health Promotion International, 2008 Apr 11. [Epub ahead of print]

The aim of this study was to asses how the exposure to a long-running radio serial drama in Botswana promoting the use of a prevention of mother-to-child transmission of HIV (PMTCT) program affects the HIV testing habits of pregnant women. Analyzing data from a 2003 survey of 504 pregnant or post-partum women, the study found several factors associated with an increased likelihood of women being tested for HIV. They include: having a partner who had been tested, knowing a pregnant woman who was taking AZT, higher level of education, and knowledge of PMTCT. Women who spontaneously named a PMTCT character in the serial drama as their favorite character were nearly twice as likely to test for HIV during pregnancy as those who did not.

To link to the abstract of this article, click here

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C-Change, managed by AED, is USAID's flagship program to improve the effectiveness and sustainability of communication programs for behavior and social change in low and middle income countries.
To contact us, please send an email to c-channel@healthnet.org
Additional information about the project is available at the website www.c-changeprogram.org/