When the media encourage HIV testing, more people get tested

When the media encourage HIV testing, more people get tested, according to a new systematic review of studies.

“Changing behavior is a complex process that involves several factors. Mass media can be used to educate and raise awareness about a topic and can enhance appropriate utilization of health care services,” according to lead review author Dr. Janaki Vidanapathirana, of Monash University in Melbourne, Australia.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Fourteen studies from the United States, Canada, the United Kingdom, Australia and Israel looked at HIV-testing promotions through radio, television, print films, documentaries, billboards and skits.

Studies analyzed effects of promotions on both the general public and high-risk groups, such as men who have sex with men, bisexuals, pregnant women, people who have received blood transfusions and sex workers.

Two of the studies were randomized controlled trials, three were nonrandomized controlled studies, and nine were interrupted time series, which, although not controlled trials, “may be useful in evaluating large trials at the community level,” according to the authors.

One U.S. intervention compared two sets of videos — one with a positive spin on the benefits of HIV testing, the other emphasizing bad consequences of not being tested — to low-income ethnic minority women. Thirty-eight percent of the women viewing a “gain” video went for HIV testing, compared with only 26 percent of those who saw a “loss” video.

“Some of the findings from studies on the mass media’s impact on rates of HIV testing suggest a non-specific impact of the message conveyed by the campaigns, resulting in an increase in the overall volume of tests performed across all risk groups. Overall one would expect a positive impact of communicating behavior change on the prevention of HIV/AIDS,” Vidanapathirana says.

Researchers note that the findings were limited by the short duration of the studies and insufficient data for making comparisons between different types of mass media. In addition, none of the studies reported cost-effectiveness. And since all studies were “limited to developed country settings,” Vidanapathirana says, there is no evidence that media interventions work in the same way among high-risk groups in epidemic countries.

Testing is considered one of the key tools in HIV/AIDS prevention. According to the review authors, HIV testing, which must be both voluntary and confidential, includes counseling to explain the test process, debunk myths, and provide prevention and coping strategies. HIV testing prompts changes in behavior, such as having safer sex and taking steps to prevent mother-child transmission.

AIDS claimed more than three million lives across the globe in 2003, with an estimated five million people testing positive for HIV that same year. As the epidemic goes into its third decade, 42 million people worldwide are living with the virus. In the U.S., more than 1 million people are living with HIV, and more than 500,000 have died from the disease, according to the Centers for Disease Control and Prevention.