Can Fear Arousal in Public Health Campaigns Contribute to the Decline of HIV Prevalence?

Abstract

Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in AIDS preventive education, believing it to be counterproductive. Meanwhile, many Africans, whether laypersons, health professionals, or politicians, seem to believe there is a legitimate role for fear arousal in changing sexual behavior. This African view is the one more supported by the empirical evidence, which suggests that the use of fear arousal in public health campaigns often works in promoting behavior change, when combined with self-efficacy. The authors provide overviews of the prevailing American expert view, African national views, and the most recent findings on the use of fear arousal in behavior change campaigns. Their analysis suggests that American, post-sexual-revolution values and beliefs may underlie rejection of fear arousal strategies, whereas a pragmatic realism based on personal experience underlies Africans' acceptance of and use of the same strategies in AIDS prevention campaigns.

Acknowledgments

Most of the original research in this article was supported by various grants and contracts from the U.S. Agency for International Development.

Notes

¹Coincidence or not, there was a roughly 50% decline in the proportion reporting 2+ partners in the past year, among men and women, according to Kenya Demographic and Health Surveys in 1998 and 2003. See http://www.measuredhs.com/statcompiler/start.cfm?action=new_table&userid=149920&usertabid=164740&CFID=209082&CFTOKEN=13002560

²Composed of two distinct dimensions—perceived susceptibility (likelihood of personally experiencing the threat) and perceived severity (magnitude of harm from the threat).

³Composed of two distinct dimensions—perceived self-efficacy (perceived ability to achieve a recommended response) and perceived response efficacy (beliefs about whether the recommended response works in averting the threat).