title: Regarding realities: Using photo-based projective techniques to elicit normative and alternative discourses on gender, relationships, and sexuality in Mozambique.
abstract: This paper argues for the methodological merit of photo-based projective techniques (PT) in formative HIV communication research. We used this technique in Mozambique to study multiple sexual partnerships (MSPs) and the roles of social and gender norms in promoting or discouraging these behaviours. Facilitators used ambiguous photographs and vignettes to ease adult men and women into discussions of sexual risk behaviour and HIV transmission. Visuals upheld a third-person perspective in discussions, enabling participants to safely project their worldviews onto the photographed characters, and indirectly share their attitudes, normative environments, personal and peer experiences, perceived risks and benefits, and theories about motivations for extramarital sex. Visually grounded storylines contained rich detail about the circumstances and interpersonal conversations that contextualise MSP behaviour and norms. The research yielded findings about conflicting social practices of public encouragement and private disapproval. Despite concerns around the verifiability of PTs, the repetition and convergence in the elicited conversations - and confirmation through subsequent campaign design and evaluation - suggest these techniques can reliably elicit information for formative public health and communication research on psychosocial and normative factors.
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Holman
authors.affiliation: b Children's Investment Fund Foundation , London , UK.|c Johns Hopkins Center for Communication Programs, Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Catherine K
authors.initials: CK
authors.lastname: Harbour
authors.affiliation: c Johns Hopkins Center for Communication Programs, Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Rosa Valéria
authors.initials: RV
authors.lastname: Azevedo Said
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore , MD , USA.|c Johns Hopkins Center for Communication Programs, Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Figueroa
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D010781:Photography; D011386:Projective Techniques; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D066262:Social Norms
keywords: HIV prevention behaviour; Mozambique; Projective techniques; formative research; multiple concurrent partners; photo-elicitation