Experimental research on the influence of message framing to reduce the intentions of sexual risk behavior in adolescents in the Limpopo province, South Africa

Abstract

Context: HIV is still a major problem in South Africa, 17.9% of the adults aged 15 to 49 is estimated to be HIV positive. Young people are a major risk group when new HIV infections are concerned, because adolescents are likely to engage in sexual risk behavior. To reduce new HIV-infections, HIV evidence-based prevention programs should be implemented such as CHAMP in which information provision combined with gender and sexual and reproductive health training is very important. Knowledge training seems insufficient to attain safer sexual behaviour, if offered in isolation. Message framing could play an important role in the effectiveness of knowledge provision. Rothman and Salovey (1997) developed a theory regarding shaping perceptions to motivate healthy behavior considering the role of message framing. Framing should match individuals’ beliefs about a behavior and should make a distinction in how health-relevant communications is framed; namely in terms of the benefits (gains) or costs (losses) associated with a particular behavior. The current study is based on their theory. The research question is: Is there a difference in sexual risk behavior intentions in rural South African adolescents when providing either gain- or loss-framed messages, considering prevention and detection behavior? Method: This experimental study used a one factor between-subject design. An experiment was conducted where information framing was manipulated (gain-framed, loss-framed, and control condition). The main analysis consisted of comparing the means on sexual health behavior intentions (condom use and HIV-testing) across the different conditions. Results: No significant differences were found between the three different message frame conditions. Logistic regression analysis was conducted as exploratory means and indicated a unique statistically significant contribution to the model by grade (on both condom use intentions and HIV-testing intentions) and by sexual history (on HIV-testing intentions). Conclusion: The absence of a main effect of condition in the current study might be due to several limitations, language barrier to name one of them. Further research is needed to enhance the effects of message framing since message framing has been found effective in changing health behavior in previous research, which could be applied to change sexual risk behavior of South African adolescents living in a rural area.