Factoring Poverty and Culture into HIV/AIDS Campaigns: Empirical Support for Audience Segmentation

Published in Gazette in 2001, this study observes the communication patterns of poor black and Indian teenagers in Durban, South Africa, to investigate the extent to which ethnic and cultural factors may influence the effectiveness of communication campaigns on HIV/AIDS. The study is theoretically guided by the idea of audience segmentation, which posits that desired goals of communication (e.g., behaviour change) are easier to achieve when messages are tailored to economically and culturally distinct sub-groups in the audience. By using this model, the authors challenge the "one-shoe-fits-all" communication strategy in AIDS campaigns that have been utilised in the developing world for decades. The study specifically answers questions regarding two components of AIDS-related communications: (1) what to communicate about HIV/AIDS, and (2) how to communicate about HIV/AIDS. The authors provide empirical evidence in support of audience segmentation in HIV/AIDS communication campaigns.

Research Methodologies:

The authors conducted a survey in 1999 of black and Indian teenage boys and girls who attended schools in low-income neighbourhoods in Durban, which, according to the authors, is "capital of the providence that has the largest number of infected people, and is located in the country with the largest number of infected people, in the continent with the largest number of infected people." The section of these particular demographic groups for the study was based on several factors:

1. HIV prevalence is higher among the poor.
2. HIV prevalence is higher among non-white populations in African countries.
3. Teenagers are a high-risk HIV group in terms of HIV contacts and risk awareness.
4. Gender gaps in HIV infection risk.

Standard statistical techniques such as Chi-square and ANOVA were used to analyse variables, which were divided into two main categories:

1. What to communicate: Variables addressed teenagers' perception of HIV/AIDS risks, efficacy of HIV preventive practices, and knowledge on HIV transmission.
2. How to communicate: Variables dealt with their preferences on communication channels and venues to receive HIV/AIDS information, patterns of mass media and book use, interactions with peers, and role of parents.

Key Findings:


There were a number of differences in HIV/AIDS-related knowledge and behaviours between Indian and black South Africans, and between teenage boys and girls. Drawing on their findings, the authors argue for more efforts to design culturally nuanced media campaigns on HIV/AIDS. They assert that while poverty is a major contextual influence on health and health behaviour, other forces also influence HIV knowledge and the perceptions of subgroups who live in poverty. The key differences between sub-groups are summarised as follows:
What to communicate? between Indians and blacks:

• Perception of the worst thing that could happen to a school-aged teenager;
• Perceived severity of HIV/AIDS;
• Efficacy of condoms as a protective response against HIV;
• Threat of HIV (severity and personal susceptibility);
• Pregnant mothers with HIV may transmit the virus to their fetuses;
• Knowledge that persons with HIV may have many years of a symptom-free life ahead of them.

What to communicate? between boys and girls:

• Perception of the worst thing that could happen to a school-aged teenager;
• Perception of the efficacy of pre-marital abstinence as protection against HIV;
• Perception that it is women who carry and transmit the HIV virus to men;
• Perception that sex with one partner will save the person from HIV.

How to communicate? between Indians and blacks:

• Number of hours of television viewing;
• Favourite television programmes;
• Preferred source of accurate advice about HIV;
• Frequency of books read beyond school requirements;
• Number of friends;
• Frequency of advice-seeking from peers;
• Preference for school vs. medical center as location of HIV information/education;

How to communicate? between boys and girls:

• Favourite television programmes;
• Frequency of books read;
• Number of friends;
• Frequency of seeking advice from peers;
• Parental strictness.