Study: Unrealistic HIV/AIDS prevention campaigns largely ineffective
GAINESVILLE, Fla. — Fear of HIV infection is not enough to get everyone to practice safe sex, according to a University of Florida research team’s comprehensive study of AIDS prevention strategies.
Successful campaigns must be geared to individual groups such as gay men and include techniques of condom use under specific conditions, the study found.
Results showed that the most familiar form of safe-sex campaign — one consisting of radio and television ads reminding people of the dangers of AIDS — has no effect on condom use. The ads focus on making people aware of their risk, increasing their fear or providing general information, but none of those strategies is effective, said UF associate professor Dolores Albarracin.
“Campaigns that do not get people to clearly imagine the situations in which they will be having sex do not increase condom use,” Albarrracin said. “The approach has to be realistic; it has to anticipate the real problems of the individuals in that situation such as being drunk or high.”
Albarracín’s research team reviewed the results of 354 HIV-prevention programs conducted between 1985 and 2003.The result was the largest analysis of AIDS-prevention studies ever conducted. The team included Jeffrey Gillette, Allison Earl, Laura Glasman and Marta Durantini, all at the University of Florida, and Moon-Ho Ho of McGill University.
“The reason that people don’t use condoms is not that they don’t know they should, everybody has heard that by now,” Albarracín said. “They don’t use them because it’s not always easy. You have to help them attain new behavioral skills that allow them to overcome the obstacles impeding condom use. Many researchers have known this for quite some time, but now we have data pooling all available programs with research on them.”
In a project financed by the National Institute of Mental Health and appearing in this month’s issue of the American Psychological Association’s Psychological Bulletin, the researchers created a clear-cut chart for how to design interventions based on gender, age, ethnicity, sexual preference and high-risk groups such as intravenous drug users.
That kind of how-to instruction seems to increase condom use in every demographic group. While women can benefit from participating in discussions on the merits of condom use and learning the facts on HIV/AIDS, men need hands-on training and access to condoms before they will practice safe sex. “Still, there are many pressures to not implement these programs, particularly in schools, because policy makers are concerned that such an approach may have negative moral consequences,” Albarracín said.
Gay men, intravenous drug users and their partners, and people with multiple sex partners all seem to benefit most from receiving information, being supplied with condoms, and training in how to succeed at condom use given the multiple obstacles. Teenagers and the more disenfranchised populations — women and ethnic minorities — also need behavioral-skills training and actual access to condoms.
“In general, the big message is you need to go with active and very realistic strategies,” Albarracín said. “Use role-playing games to get participants highly involved in the process. Teach them to anticipate the difficulties they are likely to experience. Show them how to apply condoms or practice how to bring it up in conversation. Any intervention in which the audience gets to participate seems to work better. Until we find a cure for HIV/AIDS, this is the best vaccine we have.”