Mass media interventions for promoting HIV testing: challenges of incorporating interrupted time series analysis

Article type
Authors
Vidanapathirana J, Abramson M, Fairley C
Abstract
Background: Use of the mass media is one of the important strategies in communicating behavioural change in relation to HIV/AIDS prevention. Mass media are used to promote voluntary HIV counselling and testing, and to sustain test seeking behaviour.

Objective: To assess the effect of mass media interventions at a general population level or in specific target populations, in relation to changes in HIV testing.

Method: Interrupted time series analyses were included to achieve the objective. The Cochrane Library, MEDLINE, NLM Gateway, EMBASE, CINAHL, AIDSearch, PsycINFO Sociological abstracts, and Communication studies were searched to identify the relevant studies.
Pooling Intervention impacts of all studies were measured in four ways. Change in trend over time was assessed by the difference between the pre- and post-intervention slopes. Initial impact of the intervention was assessed by the difference between the level predicted by the pre- phase, extrapolated to the first point in the post- phase, with that of the predicted level of the post-intervention regression at the first point in the post-phase. Long term impact of the intervention was assessed by the difference between the level predicted by the pre- phase, extrapolated to the last point in the post- phase, with that of the predicted level of the post-intervention regression at the last point in the post-phase. Overall impact of the intervention was assessed by the area under the curve, between the level predicted by the pre- phase, extrapolated to the entire post- phase, was compared with the predicted level of the post-intervention regression.

Results: Mass media interventions for promotion of HIV testing showed significant immediate (Random effect: Estimated mean = 5.487, 95%CI = 2.370 to 8.605) and overall (Random effect: Estimated mean = 6.095, 95%CI = 1.812 to 10.378) effect. No long-term effects were seen on mass media interventions for promotion of HIV testing (Random effect: Estimated mean = 4.447, 95%CI = -0.188 to 9.082).

Conclusions: Mass media interventions have immediate and overall effects in promotion of HIV testing. No long-term effects were seen.