Multiple Concurrent Partnerships Mass Media Campaign: Assessment of Reach, Recall and Effectiveness

This 52-page report, published by Population Services International (PSI) Botswana with funding from the President's Emergency Plan for AIDS Relief (PEPFAR), is an evaluation of a mass media campaign implemented by PSI in 2008. According to organisers, the campaign was integrated into community-based interpersonal communication projects in addition to mass media channels. The main messages focused on challenging norms about multiple concurrent partnerships (MCP) and HIV risk. The method was to cite common sayings and then point out the risks inherent in the behaviours the sayings help to normalise or legitimise. The evaluation found that the messages were well received by the target audience and appear to have succeeded in their key communications objectives of provoking personal reflection about patterns of sexual relationships and HIV risk and catalysing discussion between partners.

The evaluation involved selecting a random sample of sexually active adults stratified by geographic zone and urbanisation. From this sample, respondents were recruited to participate in focus group discussions that were used to assess the reach, recall, and effectiveness of the initiative. The findings will be used to inform planning of future mass media campaigns on MCP in Botswana.

According to the report, the reach of the campaign was moderately high, with 82% of respondents reporting having seen or heard the radio spots and billboards. 27% spontaneously mentioned it when asked whether they had seen or heard any HIV prevention campaigns over the past 3 or 4 months. The billboard component had the biggest average reach, with 51% of respondents reporting seeing them at least once a week. The report states that billboard messages that were placed more intensively had higher recall nationally. Recall of campaign messages in print spots ranged between 26% and 38%. The message flighted the longest had the highest overall recall. 49% of respondents reported hearing the radio spots at least weekly, and recall of some messages was higher than others. In general across the media, respondents remembered a message focusing on 'small houses' best (a 'small house' is a long-term sexual relationship between a married man and another, usually younger, woman).

Organisers say that, in general, feedback on the campaign was very positive. Most respondents found the language easy to understand, the visuals appealing, and the text easy to read. Additional information contained in the print and radio spots helped people understand the more limited information on the billboards. However, some groups noted that the visuals on the billboards were not as strong as the messages, and that the images did not work alone without the text.

The evaluation states that the reaction to the HIV risk messages contained in the campaign was unanimously positive, indicating that the campaign tapped into points of conflict in the minds of the audience. The report notes that the campaign succeeded in getting people to reflect on their own behaviour and HIV risk, as well as in sparking discussion around the issues, though most of the discussion occurred privately between friends and partners, as respondents generally felt uncomfortable discussing the issues in public. Although some men and women reported positive dialogue about the spots with their partners, some women reported being afraid to discuss the issues, and one woman reported having been beaten by her partner for questioning his comings and goings.

According to the report, rural women were particularly vocal about HIV risks and seem to have gained insight into how the inequalities in their relationships increase their chances of becoming infected. However, many people are pessimistic about the prospects for partner reduction and sceptical about whether the campaign can have real impact on behaviour. There is also some concern that people living with HIV did not identify with the messages.

The study concludes with several recommendations. These include expanding the campaign, using television, increasing coverage of billboards and radio airplay, and translating the messages into local languages. The evaluation notes that many respondents also spoke of the importance of combining media messages with facilitated discussions, and also suggested using roadshows and training unemployed youth as mobilisers.