Effect of media use on HIV/AIDS-related knowledge and condom use in sub-Saharan Africa: a cross-sectional study

Abstract

It is known that the level of HIV/AIDS-related knowledge and the degree of condom use varies by socioeconomic status (SES). However, there is limited research on the effect of mass media use on HIV/AIDS-related cognitive and behavioral outcomes in low-income countries and how it might influence the association between SES and HIV-related outcomes. We investigated the moderating effect of media use on the relationship between SES and HIV/AIDS-related knowledge and condom use in sub-Saharan Africa in terms of communication inequalities. Cross-sectional data from the Demographic Health Surveys from 13 sub-Saharan countries (2004-10) were pooled. Gender-stratified multivariable poisson regression of 151,209 women and 68,890 men were used to calculate adjusted relative ratios and 95% confidence intervals for the associations between SES, media use, HIV-related outcomes, and condom use. We found significant disparities in mass media use among people from different SES groups as well as among countries. Education and wealth are strongly and positively associated with awareness of HIV/AIDS and knowledge about transmission and prevention of HIV/AIDS and are significantly associated with condom use. These associations are attenuated when the use of various types of mass media is added to the models, with newspapers showing the strongest effect. The findings of this study suggest that media use has the potential to blunt the impact of socioeconomic status though not completely eliminate it. Thus, we need to pay attention to reducing communication inequalities among social groups and countries to moderate the effect of wealth and SES on HIV/AIDS.

Figure 1. The conceptual frame of this study.

Figure 2. Relative risk and its 95% confidence interval for communication inequalities in media use for the relationships between socioeconomic inequalities and HIV/AIDS-related knowledge and condom use among thirteen sub-Saharan Africa countries and their regions.

Note 1: A (HIV/AIDS awareness (A); T-K (HIV/AIDS transmission knowledge (T-K); P-K (HIV/AIDS prevention knowledge (P-K); CU (Last intercourse used condom (CU). Note 2: Each bar indicates relative risk and its 95% confidence interval for communication inequalities in media use for the relationships between socioeconomic inequalities and HIV/AIDS-related knowledge and condom use among thirteen sub-Saharan Africa countries and their regions. All figures are adjusted for potential confounders of this study and standardized by the average characteristics of the pooled population of all countries (Ref. = 1.00).