Abstract
Background: ‘Condom’ is a stigmatized topic in India. Open discussion about its use and promotion are considered inappropriate. This study examines the association between exposure to public service announcements (PSA) around condoms and discussion, attitude and behavioral intentions about condom use among married men by their age and socio-economic status. Methods: A sub-sample of monogamous married men (N=2502) was obtained from 2009 BBC World Service Trust’s condom normalization survey among men in four high HIV prevalence states in India. The multiple logistic regression models were used to analyze the association of exposure to PSA around condoms with discussion, attitudes and behavioral intentions about condom and its usage. Result: More than half married men (55%) were younger (<=35 years), having better socio-economic status (educated above secondary levels and employed) (55%) and exposed to condom PSA (64%). Exposure to PSA was associated with greater likelihood to seek condom information (AOR: 1.33; p=0.010), positive attitude (AOR: 1.24; p=0.008), higher self-efficacy (AOR: 1.53; p=0.006) in using and, last time condom use (AOR: 2.15; p=0.023) among better SES group; with positive caring attitude (AOR: 1.27; p=0.010), ease in purchasing condom (AOR: 2.04, p=0.009) among older (35+ years) men, and with last time condom use among younger men (AOR: 1.85; p=0.037). Conclusion: The findings of the study highlight an important contention that linkage between mass-media campaigns and promotion of condom normalization through discussion, seeking information and intention to use and its usage goes beyond as a behavior change strategy to include dimensions of age, educational attainment and economic status. The effectiveness of mass media campaigns for normalizing condom discussion is largely mediated by demographic and socio-economic variables. Future campaigns need to address these variables to be more effective.
Highlights
The evidences from ethnographic and anthropological studies show that impact of men, as individuals, as social gatekeepers and as powerful family members who enforce cultural practices, often to the detriment of women’ reproductive health [1]
The findings of the study highlight an important contention that linkage between mass-media campaigns and promotion of condom normalization through discussion, seeking information and intention to use and its usage goes beyond as a behavior change strategy to include dimensions of age, educational attainment and economic status
The data used to assess the mass media, public communication campaign intervened by the British Broadcasting Corporation (BBC) World Service Trust (BBC WST) among married men were obtained from the end-line, behavioral and cross-sectional survey of ‘Condom Normalization Campaign’ (CNC) among men launched by the BBC WST in 2009 in four high HIV prevalence states (e.g. Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu) in India
Summary
The evidences from ethnographic and anthropological studies show that impact of men, as individuals, as social gatekeepers and as powerful family members who enforce cultural practices, often to the detriment of women’ reproductive health [1]. In this context, men’s participation is crucial for better outcomes in reproductive health such as contraceptive acceptance and continuation, safer sexual behaviors and women’s empowerment. Condom plays an effective and dual role (as a family planning method and prevention tool) in preventing unwanted pregnancy and STI infections [4] and its use acts as vital element and effective mechanism of any comprehensive HIV prevention efforts in the dynamics of the HIV epidemic among the general population [9]
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