title: Effect of media use on HIV-related stigma in Sub-Saharan Africa: a cross-sectional study.
abstract: It is known that HIV-related stigma hinders prevention efforts. Previous studies have documented that HIV-related stigma may be associated with socioeconomic and socioecological factors. Mass media use may moderate this association, but there is limited research addressing that possibility. In this study, based on cross-sectional data pooled from the 2006-2011 Demographic and Health Surveys of 11 sub-Saharan African countries (N = 204,343), we investigated the moderating effects of exposure to mass media on HIV-related stigma. Hierarchical regression analysis indicated that HIV-related stigma tends to be higher among rural residents and individuals with low levels of education and HIV knowledge, as well as those who do not know people living with HIV. Media use was generally associated with low levels of HIV-related stigma, and attenuated the gap between individuals with high and low educational levels. However, the effect of mass media was found to be stronger among urbanites rather than among rural residents, which could lead to a widening gap between the two groups in endorsement of HIV-related stigma. The implication of this study regarding the effect of media use on HIV-related stigma in sub-Saharan Africa is twofold: 1) mass media may have the potential to minimize the gap in HIV-related stigma between individuals with high and low educational levels, and hence future efforts of reducing HIV-related stigma in the region may benefit from utilizing media; 2) due perhaps to low media penetration to rural sub-Saharan Africa, mass media could have the unintended effect of widening the urban-rural gap further unless other more customized and rural-focused communication interventions are put in place.
authors.affiliation: Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America; School for Mass Communication Research, University of Leuven, Leuven, Belgium; Department of Journalism and Communication, Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Mesfin Awoke
authors.initials: MA
authors.lastname: Bekalu
authors.affiliation: School for Mass Communication Research, University of Leuven, Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Eggermont
authors.affiliation: Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America.
authors.forename: Shoba
authors.initials: S
authors.lastname: Ramanadhan
authors.affiliation: Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Kasisomayajula
authors.initials: K
authors.lastname: Viswanath
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D008954:Models, Biological; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data; D057545:Social Stigma; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult