COMMUNITY PERSPECTIVES AND RECOMMENDATIONS FOR

COMMUNICATION CAMPAIGNS ON CONCURRENT SEXUAL PARTNERSHIPS

AND SEXUAL NETWORKS IN TANZANIA

Haneefa Saleem1, Caitlin Kennedy1, Lusajo Kajula-Maonga2, Samuel Likindikoki2, Timothy Mah3, and

Jessie Mbwambo2 1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA, 2Muhimbili University of Health and Allied

Sciences, Dar es Salaam, Tanzania, 3United States Agency for International Development, Washington, DC USA

Recommendations (continued):

• Target HIV prevention campaigns to individuals

living in rural villages. Some participants felt that there

is a deficiency of HIV prevention messaging in rural

villages, despite high rates of risky sexual behaviors

such as lack of condom use during sexual intercourse.

I would like to advise the government or different

organizations to go into the villages because I know

what is happening in my village now. Now when you

look at the HIV infection rate; it’s high in villages

compared to cities. Focus group, Dar es Salaam

• Segment messages by economic status. Participants

felt that some of the current campaign messages might

not resonate with the poor due to the perceived higher

economic status of the characters portrayed.

That message is talking of high life… even that

house that the picture was taken is the house of

people with higher life. So the one with poor life when

they see it they will say that this message is directed

to certain people. Male, Focus group, Dar es Salaam

• Intervene in schools to reach young people. Young

people were perceived by some participants as being

particularly vulnerable to HIV acquisition due to

engagement in risky sexual behaviors, including multiple

sexual partnerships and sexual networks.

There should be seminars like in schools, starting

from primary schools, you see? As you can see that

now with globalization, the [sexual] network, you may

find that a primary school child has a lover, you see?

Focus group, Dar es Salaam

Haneefa Saleem, MPH. hsaleem@jhsph.edu. Johns Hopkins

Bloomberg School of Public Health, Baltimore, Maryland USA

Contact

• Twenty four in-depth interviews and 16 focus group

discussions were conducted with a total of 90 women and

68 men between the ages of 18 and 39 years in Dar es

Salaam and Iringa, Tanzania.

• Relevant communication campaign materials were

presented to participants to elicit their perceptions of

campaign messaging content, reach, and design, and to

allow participants to make recommendations for improving

HIV prevention campaigns presented to them.

• Interviews and focus group discussions were conducted

in Kiswahili by trained ethnographers, transcribed, and

translated to English.

• Thematic analysis was used to analyze transcripts.

Transcripts were read through by members of the

research team. A coding scheme was developed based

on a priori themes guided by research questions and

themes that emerged from a subset of transcripts.

Transcripts were coded using the coding scheme with

additional codes added as they emerged. All coding was

conducted using QSR Nvivo version 9.1.

Methods

Sophisticated health communication campaigns include a

variety of communication channels and segmented messages

by target audience. Findings from this qualitative study with

both urban and rural Tanzanians support using diverse

messaging channels to increase reach and segmentation of

messages by economic status to improve resonance of

messages. Results also suggest there may be benefits to

intervening in schools to better reach younger populations.

Conclusions

Introduction

• HIV prevalence in Tanzania is estimated at 5.7%.1 There

are over 1.3 million people living with HIV in Tanzania.1

• Concurrent sexual partnerships and sexual networks have

been speculated as being factors driving the HIV epidemic

in many sub-Saharan African countries, including

Tanzania.2,3 Multiple sexual partnerships have been found

to be associated with increased prevalence of HIV

infection in Tanzania.4

• To address the link between concurrent sexual

partnerships and HIV infection, several HIV prevention

communication campaigns in Tanzania have focused on

messages to reduce concurrent sexual partnerships and

explain the concept of sexual networks.

• The purpose of this study was to elicit community

perspectives and recommendations for HIV

communication campaigns on concurrent sexual

partnerships and sexual networks in Tanzania.

Key Findings

The study was implemented by USAID | Project SEARCH, Task Order No.2, which is funded by the U.S. Agency for

International Development under Contract No. GHH-I-00-07-00032-00, beginning September 30, 2008, and supported

by the President’s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project is led by the Johns

Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for

Communication Programs (CCP).

www.jhsph.edu/R2P

Presented at AIDS 2012 – Washington, D.C., USA

Community Perspectives:

• Few participants had been exposed to existing HIV

communication campaigns on concurrent

partnerships and sexual networks.

• When presented HIV campaign materials on sexual

networks and concurrent sexual partnerships,

participants generally liked the design and delivery.

They were also able to correctly describe the intended

message.

• Many participants suggested that campaigns have

difficulty reaching individuals who live in rural areas

in Tanzania. They highlighted how many rural residents

do not have regular access to television or radio.

Recommendations:

• Use a mix of media to reach a broader audience.

Participants recommended the use of a mix of media

channels to reach those who may not have access to a

television or radio, including billboards, flyers, and home

visits. Discussion groups were also recommended as a

method for spreading messages on the risk of concurrent

partnerships and sexual networks.

Key Findings (continued)

References

1 UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic,

2010. Joint United Nations Program on HIV/AIDS. 2 Morris, M. (2010). Barking up the wrong evidence tree. Comment on Lurie &

Rosenthal, "Concurrent partnerships as a driver of the HIV epidemic in sub-

Saharan Africa? The evidence is limited". AIDS Behav, 14(1), 31-3; discussion 34-7. 3 Mah, T., & Halperin, D. (2010). Concurrent sexual partnerships and the HIV

epidemics in Africa: Evidence to move forward. AIDS and Behavior, 14(1), 11-6;

discussion 34-7. 4 Landman, K. Z., Ostermann, J., Crump, J. A., Mgonja, A., Mayhood, M. K., Itemba,

D. K., Tribble, A. C., Ndosi, E. M., Chu, H. Y., Shao, J. F., Bartlett, J. A., & Thielman,

N. M. (2008). Gender differences in the risk of HIV infection among persons

reporting abstinence, monogamy, and multiple sexual partners in northern

Tanzania. PLoS One, 3(8), e3075.