Developing Media to Promote Community Awareness of Early Detection of Kaposi’s Sarcoma in Africa

Abstract

Abstract 44 Purpose Despite overt presentation on the skin, most Kaposi’s sarcoma (KS) in Africa is diagnosed too late for treatment to be effective. Training health care workers to recognize KS early can increase knowledge, but is only clinically impactful if providers actually encounter early KS—that is, if patients with early KS present to care. Indeed, recent work from Zimbabwe has shown that facility-based KS training failed to increase early diagnosis, which is unsurprising given the public’s lack of awareness of KS. We hypothesized that educating affected populations about KS is critical to making progress in early detection and that enhanced community awareness about KS can be achieved through exposure to common media. Methods Working in Uganda, we used community-engaged research to learn about health-related behaviors in the context of skin disease, craft a culturally appropriate educational theme regarding the detection of KS, and develop three forms of media. We interacted with survivors of KS, HIV-infected patients, facility-based and community health workers, traditional healers, and media professionals. We tested our media among adults at community-based venues in rural Uganda. Participants were randomly assigned to be exposed to one of the three media and were evaluated for changes in knowledge and attitudes concerning KS before and after exposure to media. Results In comics, 90-second radio plays, and a 10-minute film, we developed a three-part theme that was aimed at the public: “look,” meaning to regularly examine one’s skin and mouth; “show” to bring to the attention of a health care worker any skin changes; and “test” to remind providers about skin biopsy for diagnosis. Among the 240 participants who were exposed to media, median age was 30 years, 50% were women, 6% were HIV infected, and 60% were literate. Exposure to media resulted in increases in the ability to recognize and/or name KS (+47%), awareness that anyone is at risk for KS (+15%), and knowledge of how to prevent KS from becoming a substantial problem (+34%). Conclusion Featuring the theme, “Look, show, and test,” we developed media—comics, radio plays, and film—for the public in Africa about the early detection of KS. Exposure to these media resulted in increases in knowledge and changes in attitudes concerning KS. Although the increases in knowledge were not large, they may be as much as can be expected from a single exposure. Optimal outcomes will likely require multiple exposures and facilitated discussions. Media elements are freely available online. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.