Mass media and communication interventions to increase HIV testing among gay and other men who have sex with men: Social marketing and visual design component analysis

Abstract

Mass media and communication interventions can play a role in increasing HIV testing among gay, bisexual and other men who have sex with men (GBMSM). Despite the key role of social marketing principles and visual design within intervention development of this type, evidence is limited regarding interventions’ social marketing mix or visual design. As part of a systematic review, intervention content was assessed using social marketing theory and social semiotics. Data were extracted on the nature of the intervention, mode of delivery, use of imagery, content and tone and the eight key characteristics of social marketing. Data were synthesised narratively. Across the 19 included studies, reference to social marketing principles was often superficial. Common design features were identified across the interventions, regardless of effectiveness, including: the use of actors inferred to be GBMSM; use of ‘naked’ and sexually explicit imagery; and the use of text framed as statements or instructions. Our results suggest that effective interventions tended to use multiple modes of delivery, indicating high social marketing complexity. However, this is only part of intervention development, and social marketing principles are key to driving the development process. We identified consistent aspects of intervention design, but were unable to determine whether this is based on evidence of effectiveness or a lack of originality in intervention design. An openness to novel ideas in design and delivery is key to ensuring that evidence-informed interventions are effective for target populations.

Media Exposure, Behavioural Risk Factors and HIV Testing among Women of Reproductive Age in Papua New Guinea: A Cross-Sectional Study

“…We show that exposure to any form of media such as TV, radio and print increases the likelihood of HIV testing. This positive correlation is congruous with other findings in different countries [23,24]. Similarly, studies in Bangladesh and North India also showed a significant association between media exposure and HIV awareness [25,26] With regard to behavioural risk factors among women in PNG, several studies support the involvement of behavioural risks factor in HIV testing among women of reproductive age [9] and previous knowledge of their HIV status [27].…”

“…A total of 15,198 women of reproductive age were included in this study. The median (IQR) age at the time of the study was 28 (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) years, that at first sex 18 (16)(17)(18)(19)(20)(21) years and that at first cohabitation 19 (17)(18)(19)(20)(21)(22) years. The majority of the women were Christian (99.0%), and 95.3% had never used condoms.…”

A qualitative examination of affect and ideology within mass media interventions to increase HIV testing with gay men garnered from a systematic review

“…By contrast, the non-Western interventions we identified through our search strategy are striking for how they move beyond the highly individualized nature of the sexual subject that forms the basis of most other interventions whilst at the same time eschewing a porn aesthetic. Whilst the cultural context may be a factor in the success (or not) of different (individualistic vs. collectivist) strategies, it may also be the case that these decisions are being based on the ideologies of the researchers and/or those commissioning the work, alongside key contextual factors such as where such images are being deployed (see Riddell et al, under review , for more on this), rather than empirical evidence concerning the effectiveness of particular affects within particular cultural contexts.…”

“…The study is also limited through an analysis that is distanced from the original intended context of the intervention, with images subject to critical analysis outside of their original viewing context (see Riddell et al, under review , for more on this). Also, ideally, it would be possible to map this analysis of affect and ideology to effectiveness but that was not possible in this study.…”

“…The broader systematic review from which the data for this study have been garnered has sought to utilize a pluralistic approach to better understand intervention content and its relationship to effectiveness. To date, we have examined effectiveness per se (McDaid et al , 2019), behaviour change techniques and theoretical domains (Flowers et al , 2016), and the social marketing, mode of delivery, and use of imagery focusing upon the social position of the viewer and context of viewing (Riddell et al , under review). In contrast to these analyses, the focus in the present study is on an analysis of the cultural determinants of visual materials, as visual materials provide one of the primary means for the encoding of affect within mass media oriented health communications (Langdridge, Davis, et al , 2019; Noar, Francis, et al ., 2016).…”