Abstract
Although stigma is considered a major barrier to effective response to the HIV/AIDS epidemic, there is a lack of evidence on effective interventions. This media intervention took place among key HIV-vulnerable communities in Southern India. Two HIV stigma videos were created using techniques from traditional film production and new media digital storytelling. A series of 16 focus group discussions were held in 4 rural and 4 urban sites in South India, with specific groups for sex workers, men who have sex with men, young married women, and others. Focus groups with viewers of the traditional film (8 focus groups, 80 participants) and viewers of the new media production (8 focus groups, 69 participants) revealed the mechanisms through which storyline, characters, and esthetics influence viewers’ attitudes and beliefs about stigma. A comparative pre-/post-survey showed that audiences of both videos significantly improved their stigma scores. We found that a simple illustrated video, produced on a limited budget by amateurs, and a feature film, produced with an ample budget by professionals, elicited similar responses from audiences and similar positive short-term outcomes on stigma.
Highlights
Since the beginning of the HIV epidemic, stigma has been identified as a major barrier to HIV prevention [1,2,3,4]
Discussion topics focused on media characteristics that have been shown by others to influence viewers’ attitudes and beliefs [13,14,15], including: [1] Cultural relevance and believability of storyline, [2] clarity, comprehension, and knowledge of key stigma educational messages, [3] perceived susceptibility, relevance, and attitudes related to stigma, [4] identification and empathy with main characters, and [5] video esthetics
QUALITATIVE THEMES The primary issues discussed by participants included: [1] Cultural relevance & believability of storyline, [2] perceived susceptibility, relevance, and attitudes related to stigma, [3] identification and empathy with main characters, and [4] video esthetics
Summary
Since the beginning of the HIV epidemic, stigma has been identified as a major barrier to HIV prevention [1,2,3,4]. Among the many challenges posed by stigma, it has been directly attributed to lower uptake of HIV prevention services, testing, and counseling [1, 5,6,7]. There is little strong evidence on interventions that address stigma [8]. Most efforts have focused primarily on information dissemination, empathy induction, counseling, and cognitive behavioral therapy. These interventions have been evaluated with little attention to rigor if evaluated at all [1]. The stigma intervention literature offers a limited practical understanding of how programmatic leaders might work to change stigma beliefs as a part of increasing demand for prevention services within key communities [9]
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