The Impact of Television and Radio on Reproductive Behaviour and on HIV/AIDS Knowledge and Behaviour

This 55-page report shares findings of a study to examine the association of radio and television exposure with different aspects of reproductive behaviour and HIV/AIDS. Published as part of the MEASURE Demographic and Health Survey (DHS) project series, supported by the United States Agency for International Development (USAID), the first part of the report focuses on contraceptive behaviour and child spacing, while the second explores the implications of radio and television exposure for HIV/AIDS knowledge, attitudes, and risk behaviour. The study found that exposure to television and radio is an important factor in contraceptive use and HIV/AIDS knowledge, a programming consideration given dramatic increases in access to television in recent years.

Part 1: Mass Media and Reproduction

In terms of contraceptive use and family planning, the guiding rationale for the study's hypothesis was that media opens windows to the outside world, presenting aspects of modern life that can compete with traditional values about marriage and childbearing. The analysis is based on DHS data from 48 developing countries. According to the report, the frequency of watching television is clearly and fairly strongly associated with use of a modern method of contraception, as well as with the number of children desired and the percent with no births in the past five years. The association of television viewing with modern contraceptive use is greater in the least-developed regions and is least dramatic in the Asia/North Africa region, where television has been available for a longer period of time. However, there is a clear difference between sub-Saharan Africa and the other regions in the amount of television exposure, but not radio exposure. The influence of listening to the radio is generally weaker than that of watching television, except in sub-Saharan Africa.

For all countries combined, women who watch television sometimes are 1.6 times more likely to use modern contraception than are women who watch no television at all. For women who report daily exposure to television, this ratio increases to 2.4 times more. Overall, the odds of using modern contraception are roughly 2 to 1 for women who watch television. A similar picture appears with past use of modern contraception. Also relevant to the use of modern contraception is schooling in particular and wealth to a lesser extent, with odds ratios showing greater use by women with higher socioeconomic status. The difference between the unadjusted and the adjusted odds ratios is quite large, especially in sub-Saharan African countries, which means that the covariates (particularly schooling and wealth) play an important role in the connection between using contraception and watching television. An extreme example is Niger, where the odds of using modern contraception are 8.5 times greater if the women report television viewing compared with no such exposure. With all of the controls added, the odds ratio drops to 2.7, but this is still a considerable "effect". In Ethiopia, the unadjusted odds are 5.8 compared with the adjusted estimate of 1.4. Such large differences are not seen in the Asia/North Africa region.

Part 2: Mass Media and HIV/AIDS

According to the report, just as television and radio can communicate new ideas about later marriage, birth spacing, and having fewer children, and can expose audiences to modern values that often clash with traditional beliefs and behaviour about reproduction, in the context of the HIV/AIDS epidemic, they also can communicate awareness and concern about illness and the risks of promiscuity. The mass media can play an important role in disseminating information about the causes of the disease, how it spreads, how it can be avoided, including the importance of condom use, and where to go for HIV testing.

Each of the three beliefs surveyed (that a healthy person can have HIV, that HIV is not caused by a supernatural force, and that HIV is not caused by sharing food) shows a positive association with both television and radio exposure. The magnitude of this association, with simultaneous controls for schooling, wealth, urban-rural residence, geographic region, and age, is stronger with radio exposure than with television exposure. For women, daily radio exposure increases the odds of having accurate information by half. Television exposure shows statistically significant associations, but at much lower levels than radio exposure. Among the other covariates, schooling is especially significant, while wealth and urban residence also show important effects. The effects are greater in southern and eastern African countries than in the other sub-Saharan countries, presumably because of the much higher prevalence of the disease in southern and eastern Africa.

The range of preventative knowledge extends from about 60% with no media exposure to over 80% with daily exposure. This association persists in the presence of other and shows a somewhat stronger influence of radio compared with television. In general, there is a direct association between media exposure and positive attitudes toward people with HIV/AIDS. The two strongest associations are between media exposure and buying vegetables from a shopkeeper with HIV, and permitting an infected teacher to continue teaching. One important piece of survey information about risk behaviour with respect to HIV/AIDS is the association between media exposure and being tested for HIV; among those with no radio or television exposure (both women and men), between 8 and 16% have been tested, compared with 21 to 36% of those with daily exposure.

Conclusion

The general conclusion is that greater media exposure is associated with a desire for fewer children, higher rates of contraceptive use, and fewer births. Greater media exposure also is associated with more knowledge about causes and prevention of HIV/AIDS, as well as with supportive attitudes toward people who are HIV-positive. The strength of these associations with reproductive behaviour and HIV/AIDS is significant, even with adjustments for education, wealth, urban-rural residence, and age, particularly considering that media exposure is measured only by the frequency of watching television and of listening to the radio, without any information available about programme content.