Attitudes toward abortion in Zambia.

Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes - support for legalization, immorality, rights, and access to services - were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes.

Personal involvement of young people in HIV prevention campaign messages: the role of message format, culture, and gender.

To examine young people's reactions to and understanding of HIV prevention messages developed for MTV's global HIV prevention campaign Staying Alive, videotaped campaign materials were shown to focus group discussion (FGD) participants living in urban areas of Brazil, Kenya, Nepal, and Senegal. Responses related to "personal involvement" with the message were identified in the data from these FGDs and were examined in relationship to the emerging message themes, the message format (public service announcements [PSAs] vs. documentary), cultural context (site), and participant gender. Across groups, greater personal involvement (measured by personal connections, emotional reactions, and lessons learned) was found in responses about the documentary format compared to the PSA format. Exceptions were found for specific PSAs that were considered more relevant within specific gender or cultural contexts. Implications of findings for global campaigns were considered.

Exposure to MTV's global HIV prevention campaign in Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal.

In 2002 MTV aired a global media campaign, "Staying Alive," to promote HIV prevention among 16- to 25-year-olds. Skeptics believed that a global MTV campaign would reach only a small group of elite young people. MTV increased access to its campaign, however, by making all materials "rights free" to third-party (non-MTV) broadcasters. Over 789 million households in over 166 countries had access to some or all of the campaign. To understand the level of actual exposure and the types of young people exposed, data were analyzed from population-based household surveys in three diverse urban areas where a campaign evaluation was conducted: Kathmandu, Nepal; São Paulo, Brazil and Dakar, Senegal. Exposure rates ranged from 12% in Kathmandu, 23% in São Paulo, and 82% in Dakar, reaching an estimated 32,000, 400,000, 220,000 16- to 25-year-olds in each city, respectively. A number of personal, social and economic characteristics found to predict campaign exposure were identified in each site; in general, these were related to economic status and use of "new" media technologies. Though this skew toward more exposure by those with greater resources existed, we found that the campaign audience was in no way composed only of "elite" young people. (For example, although more of those exposed to the campaign had used the Internet compared with those not exposed, this was not the majority of those exposed in most countries.) The possibility of reaching millions of young people through global networks with minimal marginal costs after production, creates a new paradigm for reaching an important segment of young people.

MTV's "Staying Alive" global campaign promoted interpersonal communication about HIV and positive beliefs about HIV prevention.

In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household surveys. Using linear regression techniques, our evaluation examined the effects of campaign exposure on interpersonal communication about HIV and the effects of campaign exposure and interpersonal communication on beliefs about HIV prevention. We found a consistent positive effect of exposure on interpersonal communication across all sites, though there were differences among sites with regard to whom the respondent talked about HIV. We also found a consistent positive effect of exposure on HIV prevention beliefs across sites when interpersonal communication was simultaneously entered into the model. Finally, in two sites we found a relationship between interpersonal communication and HIV prevention beliefs, controlling for exposure, though again, the effects differed by the type of person the communication was with. These similar findings in three diverse sites provide ecological validity of the findings that "Staying Alive" promoted interpersonal communication and influenced young people's beliefs about HIV prevention in a positive way, evidence for the potential of a global media campaign to have an impact on social norms.

Does MTV reach an appropriate audience for HIV prevention messages? Evidence from MTV viewership data in Nepal and Brazil.

In response to the growing numbers of young people affected by HIV around the world, MTV (Music TV), the world's largest television network, has aired a global HIV prevention campaign since 1999, expanding it into a multicomponent campaign in 2002. Questions have been raised, however, about whether MTV is an appropriate channel for these messages, given its provocative content and its reach to those at the upper end of the socioeconomic scale. To address questions about who MTV reaches, viewership data were analyzed from baseline surveys conducted as part of an evaluation of the 2002 HIV prevention campaign. The two sites included in this analysis were Kathmandu, Nepal, and São Paulo, Brazil-each with very different cultures and media environments. We found that, in general, heavier viewers of MTV are younger, better educated, and more dependent on their parents, and they have more access to satellite television and the Internet. MTV viewing was associated with positive attitudes toward HIV prevention behaviors (except for abstinence until marriage) but not with premarital sexual activity.

Respondent perspectives on self-report measures of condom use.

There is much concern about the validity of self-reported condom use. In an effort to improve self-report measures, a study using semistructured interviews was conducted to elicit the perspectives of women who had participated in a microbicide clinical trial in which self-reports of condom use were included. Women were asked about their comprehension of the questions, how they remembered their condom use and their sensitivity to the expectations of the interviewer, and how this affected their answers. Although most women believed they were accurate in their answers about condom use, a number of women admitted to exaggerating their condom use or believed other women did, citing concerns related to interviewers' expectations of them as the primary reason. Most women did not believe that comprehension or memory was a problem and a number were able to articulate strategies for remembering their condom use.