Effect of fear appeals in HIV/AIDS messages on the intention to use condom among college students in Bungoma County

Abstract

BACKGROUND: HIV is mostly sexually transmitted with this mode accounting for 94 % of the incidence in Kenya. With no cure, the most efficient strategy is prevention mainly encompassing behavior change in our case the intention to use condoms. To enhance behavior change, the message can either focus on hope or fear with different efficacies. The more effective approach among these in sexual behavior change is however not known. OBJECTIVE: To determine the effectiveness of fear in HIV messages on the intention to use condom among college students in Bungoma County. METHODS: The study was an experimental design. College students from Kibabii Diploma Teachers College were enrolled into the experiment after meeting inclusion criteria. A sample size of 96 participants were picked using a statistical formula by R-core computer software and randomly divided into four equal groups. Each group was shown a different set of AIDS prevention messages. Threat and coping efficacy in these messages were manipulated in a two (high and low threat message) by two (high and low efficacy message) factorial design. RESULTS: The median age was 21 with an approximately equal number of males and females. Eighty percent reported having sexual intercourse in the preceding one-year period. Before the experiment, the levels of fear and efficacy were similar among all groups. The two groups with high threat level messages had higher fear induction scores than those groups with low threat messages at (44.0, 41.5) and (25.8, 24.8) respectively with a p-value 0.001. The participants in the two high efficacy message groups also recorded significantly higher levels of efficacy scores than those in the low efficacy groups at (61.3, 67.5) and (37, 39.8) respectively p-value 0. 001.Intention to use condom was higher in the high efficacy and high threat group than all other 3 groups(32.9 vs 19.5, 22.3, 23.5). The high-level efficacy messages were associated with higher scores than low efficacy messages after adjusting for fear induction post treatment. CONCLUSION: Our study demonstrated that high threat worked better than low threat appeal messages in increasing the intention to use condom for our study population. RECOMMENDATION: We recommend a study with a longer duration of follow up and more diverse study subjects to assess the conversion of intention to use condom to actual condom use.