Applying Social Marketing Principles to Understand the Effects of the Radio Diaries Program in Reducing HIV/AIDS Stigma in Malawi

ABSTRACT

Relatively little is known about the extent to which health campaigns can play a constructive role in reducing HIV/AIDS-related stigma. The Malawi Radio Diaries is a program in which HIV-positive men and women openly discuss day-to-day events in their lives with the goal of reducing stigma in the population. Adopting a social marketing perspective, we analyze the various components of the Radio Diaries program in terms of three of the “Four P's”: product (stigma reduction), place (radio), and promotion (the program itself). We first investigated the important dimensions of stigma and then developed a model to test the demographic and psychosocial correlates of these dimensions. A midterm household survey was then used to determine the relationship between exposure to the Radio Diaries program and stigma. In multivariate analyses, lower education and knowledge were associated with stronger beliefs that persons living with HIV should be isolated from others. Exposure to the Radio Diaries program did not have a main-effect on stigma, but there was a significant interaction between exposure and efficacy to reduce number of partners such that there was little difference in stigma by exposure level for those with low efficacy, but a significant difference by exposure level for those with high efficacy. Findings are discussed in terms of social marketing principles.

KEYWORDS:

• Condom use
• HIV/AIDS stigma
• knowledge
• social marketing
• self-efficacy

This project was funded by the United States Agency for International Development. Authors wish to acknowledge the assistance provided by Kirsten Böse, Glory Mkandawire, Jane Brown, and Lisa K. Folda from the Center for Communication Programs at Johns Hopkins University and Hestern Banda and Esnart Nawanga from Salephera Consulting in Lilongwe, Malawi.

Notes

Notes: RD = Radio Diaries

^a Cell entries are standardized factor loadings.

^b Pertains to the index comprizing items that load onto a given factor. Each index ranged from 1 to 3, higher values reflecting greater levels of stigma.

^a Zero-order correlation between dimension of stigma and predictor.

^b Standardized beta from regression equations with Step 1 variables in the model.

^c Standardized beta from regression equations with all (Step 1 and Step 2) variables in the model.

^∧ p < .1.

∗p < .05.

∗∗p < .01

∗∗∗p < .001.

^a Zero-order correlation between stigma and predictor.

^b Standardized beta from regression equations for Model 1, which includes all variables, except exposure to intervention channels, in the equation.

^c Standardized beta from regression equations for Model 2, which includes all variables.

∗p < .05,

∗∗p < .01,

∗∗∗p < .001.