Somos Diferentes, Somos Iguales (SDSI) 1 is a communication for social change strategy that aims to prevent future HIV infections in Nicaragua by means of mass communication actions, including entertainment-education (edutainment) programs; local capacity building; and the development of links, coordination, and alliances within communities. This report presents the results of the SDSI impact study, an inter-institutional evaluation that included collaboration from PATH, the Horizons Program/Population Council, the National Autonomous University of Nicaragua's (UNAN-León's) Center for Demographic and Health Research (CIDS), independent consultants, and Puntos de Encuentro, a Nicaraguan NGO. The purpose of the evaluation was to explore the intervention's impact on a representative group of young people, on collective processes, and on the local environment. In particular, it measured SDSI's impact on the following areas: gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and personal and collective efficacy for HIV prevention. In Nicaragua's national context of low HIV prevalence, the country's current challenge is prevention of future infections. SDSI was implemented from 2002-2005 and focused on addressing social and cultural issues that hinder HIV prevention. The project's intervention activities were designed to mutually reinforce each other and included: a national "social soap" TV series; a nightly youth talk call-in radio show; development and distribution of methodological materials for use by local groups; and various community-based activities such as training workshops for young people involved in communications work, youth leadership camp, and coordination with local non-profits and health and social service providers. The weekly TV drama Sexto Sentido was the strategy's largest component, broadcast not only in Nicaragua but also in Costa Rica, Guatemala, Honduras, Mexico, and the US. 2 The SDSI evaluation was conducted using both quantitative and qualitative survey instruments. Evaluation of SDSI included household surveys, as well as in-depth interviews and focus group discussions with participants, non-participants, and key stakeholders. A longitudinal panel study was used to quantitatively evaluate SDSI's impact in individuals. The study consisted of three surveys, administered in October 2003, 2004, and 2005 to the same group of young people, whose ages ranged from 13 to 24 years in 2003. The surveys were implemented in three Nicaraguan cities: Estelí, Juigalpa, and León. 3 The results of the evaluation reveal that exposure to the SDSI project was widespread. At the end of the intervention, nine out of every ten people interviewed were familiar with at least one of the mass communication components. Sexto Sentido TV was widely watched on a regular basis by a large part of the adolescent and youth population, with 59 percent of the sample corresponding to the category of "greater exposure" (peopl...

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The multifaceted intervention improved the targeted care practices during childbirth. However, a further decrease in the routine use of episiotomy would be desirable.