Multi-media campaign exposure effects on knowledge and use of condoms for STI and HIV/AIDS prevention in Uganda

This study examined the influences of behavior change communication (BCC) campaigns on knowledge and use of condoms for prevention of HIV/AIDS and other sexually transmitted infections in target areas of Uganda. Data were drawn from the 1997 and 1999 Delivery of Improved Services for Health (DISH) evaluation surveys, which collected information from representative samples of women and men of reproductive age in the districts served by the DISH project. Logistic regressions were used to assess the associations between BCC exposure and condom knowledge and use, controlling for individuals' background characteristics. Results indicated that BCC exposure was strongly associated with higher condom knowledge: women and men who reported being exposed to messages in the mass media were at least twice as likely as those with no exposure to know of condoms as a mean to avoid HIV/AIDS. A dose–response effect was observed, suggesting that campaigns using multiple media channels may be most effective in improving sexual health knowledge. At the same time, certain gender differences of the influences on condom use were found, with the channel and content of messages seemingly more important in terms of instilling safer sex practices. While there was some evidence of bias of self-report, exploratory analysis of the indirect effects of communications campaigns suggested that impacts may be compounded as overall awareness is increased at the community level eventually leading to behavior change among individuals.