Can Fear Arousal in Public Health Campaigns Contribute to the Decline of HIV Prevalence?

Abstract

Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in AIDS preventive education, believing it to be counterproductive. Meanwhile, many Africans, whether laypersons, health professionals, or politicians, seem to believe there is a legitimate role for fear arousal in changing sexual behavior. This African view is the one more supported by the empirical evidence, which suggests that the use of fear arousal in public health campaigns often works in promoting behavior change, when combined with self-efficacy. The authors provide overviews of the prevailing American expert view, African national views, and the most recent findings on the use of fear arousal in behavior change campaigns. Their analysis suggests that American, post-sexual-revolution values and beliefs may underlie rejection of fear arousal strategies, whereas a pragmatic realism based on personal experience underlies Africans' acceptance of and use of the same strategies in AIDS prevention campaigns.

Condom use among low-literate, rural females in Ethiopia: the role of vulnerability to HIV infection, condom attitude, and self-efficacy

“…In view of the recent discussion on the use of fear appeals in AIDS prevention education in Africa (Green & Witte, 2006;Kirby, 2006), the results indicate that programs that shape accurate perceptions of vulnerability to HIV may be effective to promote condom use. Especially among these low-literate females, a lack of awareness of the risks of unprotected sex may contribute to HIV risk behaviors.…”

“…To date, some controversy exists on the usefulness of fear-based (or riskperception-arousing) approaches in promoting condom use in Africa (Green & Witte, 2006;Kirby, 2006;Halparin, 2006). The controversy seems to focus on the role of perceived vulnerability as a main determinant of HIV preventive behaviour among young people in Africa.…”

Effects of a Theory-Based Audio HIV/AIDS Intervention for Illiterate Rural Females in Amhara, Ethiopia

“…This means that perceptions of vulnerability are directly related to condom use intention. This finding is important, given the current controversy on the role of perceived vulnerability as a determinant of condom use behavior in Africa (Bogale et al, 2010a;Green & Witte, 2006;Halparin, 2006). The results of this study show that programs that shape accurate perceptions of vulnerability may be effective to promote condom use, although the risk should not be exaggerated (Bogale et al, 2010a).…”

HIV/AIDS messaging in Germany and Nigeria: A corpus linguistics study

“…In reference to Uganda, which at a time had a high HIV-prevalence, several analysts have pointed to the role that threat played in communications which, alongside other factors like state commitment, led to a decline in new infection rates (Green & Witte 2006, Stoneburner & Low-Beer 2004). On this reading, then, the high threat volume in Nigerian messaging is quite consistent with what would be expected in a resource-poor environment that also has a high prevalence of HIV.…”

“…Witte's Extended Parallel Process Model (EPPM) has been used extensively in persuasive health communication research (Witte 1992, Murray-Johnson & Witte 2003, Green & Witte 2006. The claim made within this model is that there are four variables which determine whether a health message is accepted: perceived severity ("effects or dangers of X on me"), perceived susceptibility ("the likelihood of me contracting X"), perceived response efficacy of recommendation ("recommendation Y actually does avert or mitigate the effects of X"), and perceived self-efficacy ("I am able to do recommendation Y").…”