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Keep Talking About It: HIV/AIDS-Related Communication and Prior HIV Testing in Tanzania, Zimbabwe, South Africa, and Thailand

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Abstract

Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members’ uptake of voluntary counseling and testing. Drawing from Noelle-Neumann’s spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication, prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.

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References

  1. Rogers EM, Kincaid DL. Communication networks: toward a new paradigm for research. New York: The Free Press; 1981.

    Google Scholar 

  2. Hutchinson PL, Mahlalela X, Yukich J. Mass media, stigma, and disclosure of HIV test results: multilevel analysis in the eastern cape, South Africa. AIDS Educ Prev. 2007;19(6):489–510.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  4. Voluntary HIV-1 Counseling, Testing Efficacy Study Group. Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: a randomised trial. Lancet. 2000;356(9224):103–12.

    Article  Google Scholar 

  5. Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health. 1999;89(9):1397–405.

    Article  CAS  PubMed  Google Scholar 

  6. Morin SF, Khumalo-Sakutukwa G, Charlebois ED, et al. Removing barriers to knowing HIV status, same-day mobile HIV testing in Zimbabwe. J Acquir Immune Defic Syndr. 2006;41(2):218–24.

    Article  PubMed  Google Scholar 

  7. Chesney MA, Smith AW. Critical delays in HIV testing and care: the potential role of stigma. Am Behav Sci. 1999;42(7):1162–74.

    Article  Google Scholar 

  8. Fortenberry JD, McFarlane M, Bleakley A, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health. 2002;92(3):378–81.

    Article  PubMed  Google Scholar 

  9. Ogden J, Nyblade L. Common at its core: HIV and AIDS-related stigma across contexts. Washington, DC: International Center for Research on Women; 2005.

    Google Scholar 

  10. Noelle-Neuman E. The spiral of silence: a theory of public opinion. J Commun. 1974;24(2):43–51.

    Article  Google Scholar 

  11. Noelle-Neuman E. Turbulences in the climate of opinion: methodological applications of the spiral of silence theory. Public Opin Q. 1977;41:143–58.

    Article  Google Scholar 

  12. Genberg BL, Kulich M, Kawichai S, et al. HIV risk behaviors in sub-Saharan Africa and Northern Thailand: baseline behavioral data from Project ACCEPT. J Acquir Immune Defic Syndr. 2008;49(3):309–19.

    Article  PubMed  Google Scholar 

  13. Genberg BL, Hlavka Z, Konda K, et al. A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS. Soc Sci Med. 2009;68(12):2279–87.

    Article  PubMed  Google Scholar 

  14. Bozette SA. Routine screening for HIV infection—timely and cost-effective. N Engl J Med. 2005;352(6):620–1.

    Article  Google Scholar 

  15. Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR-14):1–17.

    PubMed  Google Scholar 

  16. Kawichai S, Celentano DD, Chariyalertsak S, et al. Community-based voluntary counseling and testing services in rural communities of Chiang Mai province, Northern Thailand. AIDS Behav. 2007;11(5):770–7.

    Article  PubMed  Google Scholar 

  17. Matovu JK, Gray RH, Makumbi F, et al. Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda. AIDS. 2005;19(5):503–11.

    Article  PubMed  Google Scholar 

  18. UNAIDS. Zimbabwe. 2007. http://www.unaids.org/en/Country/Responses/Countries/zimbabwe.asp. Accessed 16 May 2007.

  19. Xu F, Kilmarx PH, Supawitkul S, et al. HIV-1 seroprevalence, risk factors, and preventive behaviors among women in northern Thailand. J Acquir Immune Defic Syndr. 2000;25(4):353–9.

    Article  CAS  PubMed  Google Scholar 

  20. Gage AJ, Ali D. Factors associated with self-reported HIV testing among men in Uganda. AIDS Care. 2005;17(2):153–65.

    Article  CAS  PubMed  Google Scholar 

  21. Manopaiboon C, Kilmarx PH, Supawitkul S, et al. HIV communication between husbands and wives: effects on husband HIV testing in northern Thailand. Southeast Asian J Trop Med Public Health. 2007;38(2):313–24.

    PubMed  Google Scholar 

  22. Sivaram S, Johnson S, Bentley ME, et al. Sexual health promotion in Chennai, India: key role of communication among social networks. Health Promot Int. 2005;20(4):327–33.

    Article  PubMed  Google Scholar 

  23. Chaterjee N. AIDS-related information exposure in the mass media and discussion within social networks among married women in Bombay, India. AIDS Care. 1999;11(4):443–6.

    Article  Google Scholar 

  24. Smith LS, Lucas KJ, Latkin C. Rumor and gossip: social discourse on HIV and AIDS. Anthropol Med. 1999;6:121–31.

    Article  Google Scholar 

  25. Apinundecha C, Laohasiriwong W, Cameron MP, Lim S. A community participation intervention to reduce HIV/AIDS stigma, Nakhon Ratchasima province, northeast Thailand. AIDS Care. 2007;19(9):1157–65.

    Article  CAS  PubMed  Google Scholar 

  26. Lin W, Pfau M. Can inoculation work against the spiral of silence? A study of public opinion on the future of Taiwan. Int J Public Opin Res. 2007;19:155–72.

    Article  Google Scholar 

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Acknowledgments

NIMH Project Accept is funded as a National Institute of Mental Health (NIMH) Cooperative Agreement (grants 5U01MH066687, 5U01MH066688, 5U01MH066701, and 5U01MH066702) involving the NIMH and several US and international institutions. The HIV Prevention Trials Network (HPTN) is also providing support to the project (HPTN 043)); support has also been provided by the Office of AIDS Research of the National Institutes of Health. E.S.H. conceptualized the paper, contributed to the analysis, and drafted the paper. D.H. performed the statistical analysis. S.C. was principal site investigator in Chiang Mai, Thailand and oversaw the data collection at that site. A.C. was principal site investigator in Harare, Zimbabwe, and oversaw the data collection at that site. G.G. was principal site investigator in Soweto, South Africa, and oversaw the data collection at that site. J.M. was the principal site investigator in Dar Es Salaam, Tanzania, and oversaw the data collection at that site. L.R. was the principal site investigator in Vulindlela, South Africa, and oversaw the data collection at that site. M.K. provided major support for the statistical analysis T.J.C. was the principal investigator of the overall project and oversaw the study team. All authors reviewed the manuscript. We would like to thank the many Project ACCEPT staff, both in-country and in the US, who have made this work possible.

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Authors and Affiliations

  1. Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, One Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Ellen Setsuko Hendriksen

  2. Department of Probability and Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic

    Daniel Hlubinka & Michal Kulich

  3. Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand

    Suwat Chariyalertsak

  4. Department of Psychiatry, School of Medicine, University of Zimbabwe, Harare, Zimbabwe

    Alfred Chingono

  5. Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital/University of the Witswatersrand, Johannesburg, South Africa

    Glenda Gray

  6. Department of Psychiatry, College of Health Sciences, Muhimbili University, Dar Es Salaam, Tanzania

    Jessie Mbwambo

  7. Human Sciences Research Council, Durban, South Africa

    Linda Richter

  8. Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Thomas J. Coates

Authors
  1. Ellen Setsuko Hendriksen
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  2. Daniel Hlubinka
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  3. Suwat Chariyalertsak
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  4. Alfred Chingono
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  5. Glenda Gray
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  6. Jessie Mbwambo
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  7. Linda Richter
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  8. Michal Kulich
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  9. Thomas J. Coates
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Correspondence to Ellen Setsuko Hendriksen.

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Hendriksen, E.S., Hlubinka, D., Chariyalertsak, S. et al. Keep Talking About It: HIV/AIDS-Related Communication and Prior HIV Testing in Tanzania, Zimbabwe, South Africa, and Thailand. AIDS Behav 13, 1213–1221 (2009). https://doi.org/10.1007/s10461-009-9608-0

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  • DOI: https://doi.org/10.1007/s10461-009-9608-0

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