title: Keep talking about it: HIV/AIDS-related communication and prior HIV testing in Tanzania, Zimbabwe, South Africa, and Thailand.
abstract: Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members' uptake of voluntary counseling and testing. Drawing from Noelle-Neumann's spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication, prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA. ehendriksen@partners.org
authors.forename: Ellen Setsuko
authors.initials: ES
authors.lastname: Hendriksen
authors.forename: Daniel
authors.initials: D
authors.lastname: Hlubinka
authors.forename: Suwat
authors.initials: S
authors.lastname: Chariyalertsak
authors.forename: Alfred
authors.initials: A
authors.lastname: Chingono
authors.forename: Glenda
authors.initials: G
authors.lastname: Gray
authors.forename: Jessie
authors.initials: J
authors.lastname: Mbwambo
authors.forename: Linda
authors.initials: L
authors.lastname: Richter
authors.forename: Michal
authors.initials: M
authors.lastname: Kulich
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Coates
mesh_terms: D000293:Adolescent; D000328:Adult; D003142:Communication; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011287:Prejudice; D012307:Risk Factors; D012725:Sexual Behavior; D013019:South Africa; D013240:Stereotyping; D011795:Surveys and Questionnaires; D013636:Tanzania; D013785:Thailand; D055815:Young Adult; D015030:Zimbabwe