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Project 2: Persuading people to voluntarily report for HIV/AIDS Counselling, Testing and Referral

Who & When
General Background
Research Questions
Theoretical Embedding
Research Methodology
Work Plan
Expected Outcomes


Who & When

Project co-ordinator Prof. Dr. P.H. Swanepoel (University of South Afrika)
Researchers: Prof P H Swanepoel (Unisa, Pretoria)
Dr. H. Boer
MA students from participating universities
Advisors: Prof. C. Jansen
Dr. H. den Besten
Prof. F. Maes
Prof. A. Carstens
Starting date: August 2002
Date of completion: December 2006


up General background

Voluntary HIV/AIDS counseling, testing and referral (HIV/AIDS CTR) is a corner-stone in HIV/AIDS prevention and care programmes. The potential benefits of voluntary HIV/AIDS CTR are well documented (cf. Unaids 1997), also in African countries. The potential benefits of HIV/AIDS CTR as part of a comprehensive set of measures to address the pandemic is also recognized by the South African government: expanding accessibility to HIV/AIDS CTR services is one of the major components of governments HIV/AIDS strategic plan until 2005 (Department of Health SA 2000).

To stop the spread of HIV, it is important that people who are infected with HIV inform their sex partners and to perform safer sex. As a prerequisite, they have to know their sero-status.

A major aim of this project is to identify rhetorical strategies to persuade various target groups at high risk for HIV/AIDS to voluntarily report for HIV/AIDS CTR. Given that there is no universal and free access to antiretroviral therapy in South Africa, persuading high-risk target groups are difficult because knowing that one is infected with HIV for most people equates to knowing that one will die. There are very little personal benefits to gain from HIV/AIDS CTR when one is tested positive.

As very few people in South Africa have access to antiretroviral therapies and medications, appealing to social or moral values might be more appropriate for certain target groups than appealing to personal values (cf. Van Dyk 2001; Murray-Johnson, Witte, Liu & Hubbel 2001). As in other subprojects, this project will take into account possible cultural differences between different target groups.

The major objective of this project is therefore (i) to determine and analyse the complex set of variables that determine high-risk individuals' decisions to report for HIV/AIDS CTR (or not) and (ii) to determine how these variables should be used in the design of effective messages to persuade these individuals to voluntarily report for HIV/AIDS CTR. For example, appealing to cultural, social or moral values might be more appropriate for certain target groups than appealing to concerns of personal health (cf. Van Dyk 2001; Murray-Johnson, Witte, Liu & Hubbel 2001). As in other subprojects, this project will take into account possible cultural differences between different target groups with regard to both the determinants of uptake behaviour and the kind of persuasive messages required for these different groups.



up Research questions

  • What are the cognitive and ecological barriers that prevent diverse target groups in South Africa from reporting voluntary for HIV/AIDS CTR?

  • Which kind of arguments are used to persuade people to go for HIV/AIDS CTR?

  • Do different target groups respond differently to different arguments?

  • How should culturally sensitive health messages be designed to persuade individuals at high risk for HIV/AIDS to voluntarily report for HIV/AIDS CTR?


up Theoretical embedding

Psychosocial theories of health behaviour (cf. Bowes 1997; DiClemente & Peterson 1994; Kelly, Parker & Lewis 2001; Hullit & Witte 2001) will be used to develop instruments to analyse the problematic behavioural variables and a set of design heuristics will be developed in accordance with theories and guidelines for effective health communication (cf, .e.g. Perloff 2001; Kreuter et al 2000; Bartholomew et al 2000, Brug et al 2001, Unaids 2000).



up Research methodology

  • Review of literature on relevant audience and text variables for HIV/AIDS CTR messages and relevant design and evaluation heuristics

  • Participatory methodologies to determine and analyse the variety of variables which determine target-groupsí decisions to report for HIV/AIDS CTR

  • Functional analyses of existing HIV/AIDS CTR messages

  • Quantitative and qualitative evaluation of the effects of text design features on specified target groups


up Work plan

Phase 1
July 2003 - December 2003: Literature review

Phase 2
January 2004 - December 2004: Qualitative and quantitative research on the determinants of uptake behaviour for HIV/AIDS CTR; corpus analysis of existing text-mediated communication for voluntarily HIV/AIDS CTR

Phase 3
January 2005- December 2006: Developing heuristics for the design of effective text-mediated communication for HIV/AIDS CTR; qualitative and quantitative assessment of text design heuristics



up Expected outcomes

Expected main findings:
  • Insight into the cognitive and ecological determinants of the target group's decisions on whether or not to report for voluntary HIV/AIDS CTR

  • Empirical findings on text and reader variables that optimize the persuasive character of HIV/AIDS CTR messages (which would motivate specific design and evaluation heuristics for these messages)

  • Heuristics for the design and evaluation of theory-based, culturally sensitive health messages to persuade high-risk South Africans to report for voluntary HIV/AIDS CTR services
Expected packaged results

  • Research articles on each of the main findings

  • Workshop contributions

  • Conference papers