Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social norms—especially injunctive norms around gender and relationship dynamics—significantly influence attitudes and behaviors related to gender equity and HIV prevention. The study finds that exposure to a dialogue-based communication intervention can shift these norms by increasing interpersonal communication and changing what participants perceive others approve or expect. The results highlight the importance of addressing both individual attitudes and collective normative expectations when designing social and behavior change programs.
Objectives To assess the effects of the Tchova Tchova communication intervention in Mozambique on attitudes and perceived norms regarding gender roles, HIV prevention behaviors, and relationship dynamics.
Methods The study used a quasi-experimental design with two cross-sectional household surveys conducted in 2009 and 2010 across six urban locations in Mozambique. Participants included men and women aged 18–49. Exposure to the intervention was self-reported. Social norms and individual attitudes were measured through structured questionnaires. Statistical analyses included bivariate comparisons and multivariate logistic regression models controlling for demographic variables and exposure to other HIV-related media.
Social Norms Measures Perceived injunctive norms were measured by asking respondents whether they believed people in their community or reference group approved or disapproved of specific gendered behaviors, such as men helping with domestic work or women negotiating condom use. These were distinguished from personal attitudes, allowing separate assessment of normative influence.
Intervention Details The Tchova Tchova program was a small-group, community dialogue intervention focused on promoting gender-equitable norms and behaviors to reduce HIV risk. It consisted of six weekly sessions featuring video stories, guided discussions, and action planning. Topics included couple communication, shared decision-making, sexual health, and power dynamics in relationships.
Results Exposure to the intervention was significantly associated with more gender-equitable attitudes and perceived injunctive norms. For example, those exposed were more likely to believe that community members support women initiating condom use and that couples should make joint decisions. Changes in perceived norms were often stronger than changes in individual attitudes. Interpersonal communication served as a pathway for normative influence, reinforcing the program’s content and reach.
Conclusions The study demonstrates that participatory communication interventions can effectively shift social norms around gender and HIV-related behaviors. Addressing injunctive norms and facilitating interpersonal dialogue are critical components in fostering sustainable change in communities, making them essential elements in the design of gender and health programming.
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