The role of communication inequality in mediating the impacts of socioecological and socioeconomic disparities on HIV/AIDS knowledge and risk perception

Steven Eggermont,Mesfin Bekalu

doi:10.1186/1475-9276-13-16

Steven Eggermont, Mesfin Bekalu

Open Access

https://doi.org/10.1186/1475-9276-13-16

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Abstract

IntroductionAlthough the link between social factors and health-related outcomes has long been widely acknowledged, the mechanisms characterizing this link are relatively less known and remain a subject of continued investigation across disciplines. In this study, drawing on the structural influence model of health communication, the hypothesis that differences in concern about and information needs on HIV/AIDS, HIV/AIDS-related media use, and perceived salience of HIV/AIDS-related information, characterized as communication inequality, can at least partially mediate the impacts of socioecological (urban vs. rural) and socioeconomic (education) disparities on inequalities in HIV/AIDS knowledge and risk perception was tested.MethodsData were collected from a random sample of 986 urban and rural respondents in northwest Ethiopia. Structural equation modeling, using the maximum likelihood method, was used to test the mediation models.ResultsThe models showed an adequate fit of the data and hence supported the hypothesis that communication inequality can at least partially explain the causal mechanism linking socioeconomic and socioecological factors with HIV/AIDS knowledge and risk perception. Both urbanity versus rurality and education were found to have significant mediated effects on HIV/AIDS knowledge (urbanity vs. rurality: β = 0.28, p = .001; education: β = 0.08, p = .001) and HIV/AIDS risk perception (urbanity vs. rurality: β = 0.30, p = .001; education: β = 0.09, p = .001).ConclusionsIt was concluded that communication inequality might form part of the socioecologically and socioeconomically embedded processes that affect HIV/AIDS-related outcomes. The findings suggest that the media and message effects that are related to HIV/AIDS behavior change communication can be viewed from a structural perspective that moves beyond the more reductionist behavioral approaches upon which most present-day HIV/AIDS communication campaigns seem to be based.

Highlights

The link between social factors and health-related outcomes has long been widely acknowledged, the mechanisms characterizing this link are relatively less known and remain a subject of continued investigation across disciplines
Testing the hypothesized Model1 The model shown in Figure 3 estimates the hypothesized relationships between urbanity versus rurality, education, HIV/AIDS communication inequality (HIV/AIDS concern and information needs, HIV/AIDS-related media use, and the perceived salience of HIV/AIDS-related information), and HIV/AIDS knowledge
The model showed an adequate fit of the data, χ2(3) = 12.06, p = .007, CMIN/ DF = 4.02, comparative fit indices (CFI) = .99, root mean square error of approximation (RMSEA) = .05, goodness-of-fit statistic (GFI) = .99, adjusted goodness-of-fit statistic (AGFI) =

Summary

Introduction

The link between social factors and health-related outcomes has long been widely acknowledged, the mechanisms characterizing this link are relatively less known and remain a subject of continued investigation across disciplines. In a review synthesizing knowledge about SES and health, Adler and Ostrove [4] observed an increase in the number of studies purporting to address the mechanisms by which SES affects health. This increasing body of research has identified several mediating factors, such as behavior, lifestyle, environmental exposure, health care, biological determinants, and chronic stress [6,7]. The present study seeks to extend and/or add to this body of research by assessing the role of HIV/ AIDS communication inequality in mediating the impact of social factors on HIV/AIDS-related outcomes among people who are highly affected by the epidemic

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