'We are equal': increasing service uptake through strategic communications

BACKGROUND: Mozambique has approximately 2.1 million PLHIV; 710,000 are men, of which only 62% are on ART. With our partner, Ipsos, PSI conducted qualitative research to identify Mozambican men's barriers to treatment. A key finding was that both men and their influencers associate ART with HIV. Men fear that being on ART would limit acceptance by peers, creating a key barrier to treatment uptake.
METHODS: The "Somos Iguais" (We are equal) campaign was designed to reduce the negative associations with ART by normalizing PLHIV on treatment. From May-August 2021, 4,211 ads reached an estimated 30,496 people through TV and 16,131 through radio; over 20,000 were reached daily through social media. Key messages included 'We are all the Same, the virus doesn't define us' and depicted people taking ARVs in daily settings around friends and family.
After 6 months of the campaign, a cross-sectional study was conducted reaching 2,285 people dispersed across Mozambique (60% PLHIV, 45% of whom were female and 40% non-PLHIV, 39% of whom were female) with an additional analysis of social media performance to assess the impact of the campaign on attitudes and beliefs about HIV and ART.
RESULTS: 79% of respondents recalled messages from the campaign, with many respondents reporting preliminary steps towards behavior change as a result, including discussing HIV with someone else (54%) and seeking health services (21%). While three of the four most popular social media posts were unrelated to HIV, the fourth was a PLHIV testimonial video, illustrating similarities between the lives of PLHIV and non-PLHIV. Analysis of social media interactions showed 82% of private messages requested information or help related to HIV; this was unrelated to whether the post contained HIV or non-HIV content. The testimonial videos by PLHIV received positive feedback, showing the power of this form of content to connect with audiences.
CONCLUSIONS: Breaking the association between HIV and ART is key to increasing men's uptake of treatment. Mass, mid and social media campaigns normalizing HIV treatment behaviors can play an effective role in changing attitudes and increasing service uptake.

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