Using social and behavior change communication to increase HIV testing and condom use: The Malawi BRIDGE Project
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways
The BRIDGE II program addressed harmful norms related to gender, sexual behavior, and HIV stigma through mass media and community engagement. By challenging prevailing beliefs and encouraging community discussion, the intervention helped shift social expectations around HIV testing and condom use. These shifts supported individuals in adopting healthier behaviors within a more accepting social environment.
Objectives
To assess the impact of BRIDGE II on psychosocial factors (knowledge, self-efficacy, and risk perception) and behaviors (HIV testing and condom use) among adults in southern Malawi.
Methods
The study used a cohort design with baseline and midterm data collected from 594 participants across 11 districts. Researchers measured program exposure, HIV knowledge, self-efficacy, and risk perception, along with HIV testing and condom use behaviors. Regression analysis examined the relationships between program exposure, intermediate factors, and behavior change.
Intervention Details
Led by the Johns Hopkins Center for Communication Programs, BRIDGE II used a multilevel approach combining mass media (e.g., radio) with community activities like small group discussions, drama performances, and couples’ counseling. The program aimed to reduce stigma, improve HIV knowledge, and encourage safer sexual behaviors. Although it didn’t provide direct testing, it offered referrals and distributed condoms.
Results
Program exposure was significantly linked to higher HIV knowledge and self-efficacy. While these psychosocial changes did not directly predict behavior outcomes, exposure itself was strongly associated with recent HIV testing and condom use. This suggests that beyond individual knowledge, the program may have shifted broader community norms supporting these behaviors.
Conclusions
BRIDGE II effectively influenced HIV-related behaviors and attitudes by combining media campaigns with local engagement strategies. While individual-level factors alone didn’t fully explain behavior change, the program’s ability to shift social norms around HIV testing and condom use was likely key. Multilevel communication strategies like BRIDGE II can play an important role in reducing HIV risk and promoting public health.
Norms Addressed
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