The effectiveness of social marketing campaigns in changing HIV/STI-related behaviour among MSM in Australia
A. Pedrana1,2, M. Hellard1, C. El-Hayek1, M. Stoové1
1Burnet Institute, Centre for Population Health, Melbourne, Australia, 2Monash University, Department of Epidemiology & Preventive Medicine, Melbourne, Australia
Background: Evidence for the effectiveness of social marketing for HIV/STI prevention is mixed. There is debate about the most appropriate outcomes to assess interventions and the time needed to measure changes in outcomes such as health seeking and risk behaviours, community awareness, and ultimately transmission rates. Program planners should ensure they establish appropriate aims and consider appropriate outcomes to assess campaign effectiveness.
Methods: To evaluate HIV prevention social marketing campaigns in the Australian state of Victoria we assessed knowledge, health seeking and risk behaviours, campaign recognition, and community dialogue by surveying an online cohort of MSM three times over 12 months (2008-2009); and HIV testing rates in four high MSM caseload clinics. We assessed trends in HIV/STI testing in clinic attendees using time-series regression and changes in online survey responses using matched proportions tests.
Results: 245 MSM completed the final survey (197 HIV-negative, 22 HIV-positive); 91% recalled at least one HIV prevention campaign. Among those recalling campaigns, there were significant changes in reported frequency of health seeking behaviours, requesting HIV tests from doctors (14% v 23%, p=.04) and searching for sexual health information (16% v 23%, p=.04). There were also significant increases in knowledge (p< .01) and community dialogue around sexual health (p< .01). No significant changes were detected in the reported frequency of risk behaviours.
Clinic data showed a steady increase across 2007-2008 in the average number of monthly HIV tests among MSM (average 3 additional tests/month; p < .01); similar trends were observed for syphilis and chlamydia.
Conclusions: Short-medium term aims for HIV prevention campaigns need to be realistic and carefully considered. We found changes in campaign recall, awareness, community dialogue and health seeking behaviour over the life of the social marketing campaigns. Although no changes in risk behaviours were found, observed outcomes should be considered necessary pre-cursors to such changes.