Impact of mass media campaigns on intentions to use the female condom in Tanzania

Context: Mass media campaigns have been used in social marketing programs designed to prevent HIV infection by changing sexual behavior. More information is needed about the effectiveness of these campaigns and the mechanisms through which they influence behavior. Methodology: Data on 2,712 sexually experienced men and women in Tanzania, collected in an exit survey at outlets that sell the female condom, were used to determine if a mass media campaign promoting the female condom had an impact on women's and men's intentions to use this method. Respondents were asked about their exposure to the mass media campaign, to peer education and to explanation of the female condom by a medical provider. They were also asked about their intention to use the female condom in the future. Path analysis was used to determine the impact of the three exposure factors on respondents' intentions to use the female condom. Results: About 6% of respondents had been exposed to peer education and 6% had been given an explanation by a provider on the use of the female condom. In contrast, about 38% of respondents had been exposed to the mass media campaign promoting the female condom. Mass media exposure significantly increased the likelihood that a man or a woman would discuss use of the female condom with a partner. In turn, discussion of the female condom with a partner strongly influenced the intention to use the female condom in the future. Peer educators and providers had limited coverage, but they had a stronger impact than the mass media on an individual's intention to use the female condom. Conclusions: Although mass media campaigns do not have as strong an impact on a particular individual's motivation to use the female condom as do peer educators or providers, such campaigns have a substantial impact at the population level because of their considerably greater reach.