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Table 2 Study characteristics

From: An exploratory review of HIV prevention mass media campaigns targeting men who have sex with men

Study

Aims

Design

Sample

Study process and outcome measures

Results

Hecht et al. [14]

To compare certainty of HIV negative status before and after the campaign

Repeat pre-test/post-test cross-sectional study (campaign May - July 2008, post-test July - Oct 2008). Part of National HIV Behavioral Surveillance

Recruitment: MSM venue-based, time-space sampling

Campaign awareness

45% reported they had seen the campaign. Of these:

Response rate: Not reported

64% correctly identified the subject of the campaign

Sample size: 316 men

Analysis confined to 255 men who reported being HIV negative

Hilliam et al. [21]*

To measure campaign awareness; HIV awareness; attitudes toward testing, prevention and safe sex; and behaviour change

Repeat pre-test/post-test cross-sectional study - post-test 4-5 months after launch

Recruitment: Via LGBT and HIV organisation websites, and Gaydar (post-test only). Men recruited via Gaydar (G) were analysed separately from those recruited via other non-Gaydar (nG) websites due to differences observed between samples

Campaign awareness

3-13% reported non-prompted awareness of campaign

Response rate: Not reported

 

69%nG and 82%G reported prompted awareness of campaign (men most commonly reported seeing the web adverts 50%nG and 77%G, followed by the web site 17%G and 29%nG, and finally by the posters 27%G and 32%nG)

Sample size: Pre-test sample = 88, Post-test sample = 775

Campaign attributes

Campaign attributes most commonly reported by men: clear message (62%nG and 63%G) and relevance (51% G and 61%nG). Campaign attributes least commonly reported by men: motivating (11%nG and 20%G) and trustworthy (23%nG and 25%G)

 

HIV test

Men who had seen the campaign were more likely to report having had an HIV test in the last 6 months than those who had not seen the campaign, 33%G and 38nG% versus 9%nG and 16%G, respectively

Sigma Research [2326]*

 

Repeat cross-sectional surveys – Gay Men’s Sex Survey (GMSS) questionnaire

Recruitment: Via Pride-type events across UK and the Internet

Campaign Awareness

2005

Focus groups and interviews

A variety of recruitment methods described for nested qualitative component, including established agency networks, e-newsletters, fliers and use of snowballing techniques. Purposive sampling, UK cities

Be confident, be covered: 32% recognised, and of those 52.4% had read

Response rate: Not reported

PEP: 16.1% recognised, and of those 56.6% had read

Sample size:

2004

Surveys

Infection situations: 18.6% recognised, and of those 51.6% had read

Between 1997-2000 data gathered via face data collection at Pride events, then from 2001 via booklets and online

Think again: 29.1% recognised, and of those 54.0% had read

2005: N = 12,322

2003

2004: N = 11,909

Biology of transmission: 26.1% recognised, and of those 50.3% had read

2003: N = 9,482

2002

2002 N = 11,046 (booklet = 3515, online = 7531)

Just as unbelievable: 30.7% recognised (40.4% of booklet users and 26.5% online users), and of those that recognised 64.6% (booklet) and 58.2% (online) had read

2001 N = 9226 (Pride attendees = 2401, booklet = 2384, web = 4441)

Clever dick: 31.9% recognised (43.9% of booklet users and 26.7% online users), and of those that recognised 72.2% (booklet) and 64.8% (online) had read

2000 N = 312

2001

1999 N = 313

Facts for life: Recognised by 42.1% of Pride attendees, 43.0% of those using the booklet and 24.8% of those online, and of those that recognised 54.5% (booklet) and 41.4% (online) had read

1998 N = 294

In two minds? Recognised by 62.9% of Pride attendees, 59.6% of those using the booklet and 39.3% of those online, and of those that recognised 71.5% (booklet) and 63.1% (online) had read

Focus groups

2000

2009: 6 groups, 49 men

Better off knowing: 48.1% recognised

2004: 7 groups, 33 men

What’s on Your Mind: 31.7% recognised

2003: 5 groups, 46 men

What am I?.. See to it: 47.1% recognised

2001: 5 groups, 37 men

1999

Interviews

Homophobia: 34.1% recognised image in gay press, 36.5% recognised images in general media

2000: 68

What’s on Your Mind: 54.3% recognised

1998: 71

What am I?.. See to it: 47.9% recognised

1997: 62

Think, Talk, Time to Test: 35.1% recognised

1998

Think, Talk, Time to Test: 40.5% recognised, and of those 62.5% had read

Assume nothing: 44.6% recognised, and of those 56.1% had read

Roedling et al. [29]

To compare clinical data, exposure characteristics, follow-up and awareness of post-exposure prophylaxis following sexual exposure to HIV pre and post campaign

Retrospective case note review from 2004 pre and post campaign

Recruitment: Not applicable. Case notes for all those attending for PEP in 2004 included

Sexual behaviour

Condom use

Campaign launched in July 2008

Response rate: not applicable

Pre-campaign 20/33 (61%)

Sample size: 216 attendees requested PEP, data available on 197 (91%)

Post-campaign 39/66 (59%), p = 1.00

Analysis: Confined to 112 MSM commencing PEPSE, pre-campaign n = 36 and post-campaign n = 76

Median number of sexual partners in the previous 3 months

Pre-campaign 3 (range 1-50)

Post-campaign 4 (1-100), p = 0.51

Hartfield et al. [22]*

To evaluate campaign coverage and impact

Repeat pre-test/post-test cross-sectional study. Campaign launched June-Aug 2008. Pre (March – May 2008) and post campaign (June-Dec. 2008) survey

Recruitment: Via MSM venues

Campaign awareness

75% reported exposure (24% unaided and a further 50% prompted)

Response rate: Not reported

Campaign acceptability

80% of those who saw campaign very positive/positive. Only 3% negative

Sample size: Baseline survey n = 197

Intention to have HIV test

38% of those who had seen the campaign and were HIV negative (n = 279) said they would test more frequently due to the campaign

Post-campaign survey n = 464

Katzman et al. [16]

To examine the potential impact of the manifesto

Cross-sectional survey and focus groups (in English and Spanish)

Recruitment: Survey posted on web, left in 38 gay venues for mail-in and distributed by street intercepts. Method of focus group recruitment not stated

Campaign awareness

84% seen or heard manifesto

Response rate: 2506 surveys distributed in gay venues and 137 surveys returned (5.5%). 69 surveys from women and men without a partner excluded

Campaign acceptability

Of those who had seen it:

61% strongly agreed/agreed with the manifesto, 19% disagreed/strongly disagreed

Sample size: Survey n = 103

HIV testing

13% had HIV test

9 Focus groups (139 participants) with representation of gay men both HIV positive and negative

HIV status disclosure

12% disclosed HIV status

10% asked partner to disclose status

Sexual behaviour

16% increased condom use

Lombardo & Léger [15, 28]*

To assess impact

Cross-sectional survey

Recruitment: Via “gay spaces” across Canada

Campaign awareness

79% average national exposure

Top messages received “rethinks risks” 47%, “protect self and partner” 37% and “use condoms”35%

Response rate: Not reported

Campaign acceptability

73% found messages appealing

Sample size: N = 417

Sexual behaviour

48% report message prompted them to change “something” about sexual practices, but men were not asked about the direction of change

The TASC Agency [27]*

Not stated

Cross sectional surveys (2006) and online survey (2007), focus groups and in-depth interviews

Recruitment: For surveys via Internet and a Pride event in Glasgow. Not stated for focus groups and interviews

Campaign awareness

Survey 2006: 82% had seen phase 1 and 2 poster images. 5.3% had visited the Equal website

Response rate: Not reported

Online survey: 8/26 had previously seen the Phase 1 posters; 9/24 the Phase 2 posters and 15/25 the Phase 3 ones

Sample size: Survey 2006: 222 men responded. Analysis confined to men aged 25-40 years, N = 116

Campaign acceptability

Survey 2006: Phase 1 posters 57% reported that they “Love’em” or “They’re good”; Phase 2 posters 53%

Online survey: N = 27

6 focus groups with 28 participants

10 interviews

McOwan et al. [9]

To evaluate effect of an HIV testing campaign

Retrospective case note review of GUM attendees – comparing the same time points across two years and comparing campaign clinic with two other sexual health clinics

Recruitment: Not applicable. Those testing in the three clinics were retrospectively identified through a central laboratory

HIV testing

In the campaign clinic 4.5 fold increase in numbers of men testing in 2000, n = 292, compared to 1999, n = 65, (p < 0.001), 14.0 fold increase in men of Southern European origin (n = 42 in 2000 vs. n = 3 in 1999, p < 0.001), 6.5 increase in Black men (n = 13 in 2000 vs. n = 2 in 1999, p = 0.003) and 9.5 increase in men under 25 (n = 57 in 2000 vs. n = 6 in 1999, p < 0.001)

Response rate: Not applicable

No significant differences for these outcomes observed in two control clinics. Total number of men testing in 2000 = 236 and in 1999 = 239 (p = 0.982), Southern European men testing n = 37 and 25, respectively (p = 0.341), Black men testing n = 3 and 5, respectively (p = 0.864) and men aged less than 25 years n = 32 and 36, respectively (p = 0.807)

Sample size: See Results

Sexual behaviour

Unprotected anal intercourse (campaign clinic only)

Pre campaign 35/65 (53.8%, 95% CI 41.0 - 66.3%)

Post campaign 156/292 (53.4%, 95% CI 47.5-59.1%)

Sherr et al. [17]

To evaluate permeation (picture recognition), recall of message, endorsement, and decision to have a test

Cross sectional survey

Recruitment: Two sexual health clinics

Campaign awareness

80.1% reported seeing the campaign pictures

Clinics attendees having an HIV test. In one clinic this included heterosexual men and women, and homosexual men requesting an HIV test and in the other all homosexual men

Decision to have HIV test

25.5% recalled the message (half of this group had correct recall)

Response rate: Not reported

 

9.3% reported campaign played important part in decision to have a test

Sample size:

  

667 individuals completed questionnaire, of these 339 reported they were homosexual or bisexual

  

Dawson & Hartfield [18]

To look at exposure to and satisfaction with campaign

Repeat cross sectional surveys

Recruitment: Gay bars and a Pride event at different points in time

Campaign awareness

1993 interviews – 73% familiar with comic

Structured-interviews

Response rate: Not reported

1993 clinic forms - 32% gay and bisexual clients who tested reported seeing the campaign

Review of clinic HIV testing and voice mail calls

Sample size:

1994 bar survey – 47% had seen comic strip

Oct 1993 gay bar structured interviews - number unknown

1994 rally survey – 44% had seen comic strip

July-Nov 1993 clinic review – number of case notes reviewed not reported

Campaign acceptability

1993 interviews - Of those familiar, 89% positive. Negative comments mainly around format, such as confusing and hard to read

May 1994 gay bar survey, n = 662

1994 rally survey – Of those who had seen it, 57% liked a lot and 41% thought OK

June 1994 Gay Pride Rally survey, n = 198

Voice mail – weekly average of 200-400 calls. Report that most were positive

Griffith et al. [19]

To describe association between HIV educational campaigns and long-term testing trends between Sept 1985 – Sept. 1993. Of the 38 media interventions, 6 aimed at gay men and 2 at bisexual men

Continuous – prospective collection of demographic and behavioural data from all GUM attendees having an HIV test

Recruitment: Not applicable

HIV testing

Unable to extract data - trends in testing amongst homosexual and bisexual men annotated with media campaigns shown graphically. Authors report periods of peak testing generally corresponded temporally with increased media coverage

Response rate: Not applicable

Sample size:

19 242 tested in three London sexual health clinics, UK

12 183 men (37.6% homosexual and 7.9% bisexual)

  1. LGBT Lesbian, Gay, Bisexual and Transgender.
  2. nG = Non-Gaydar and G = Gaydar. A variety of MSM-related websites were used to recruit men for the survey. However in the post-test Gaydar added. Noted there were differences in reported partnership status and number of partners between Gaydar and non-Gaydar recruited participants, so results presented separately.
  3. *‘Grey’ literature.