Social science & medicine (1982) · 2026
The long-term and spillover effects of a radio drama on HIV knowledge, expressed stigma, willingness to disclose, and political priorities: Evidence from a cluster-randomized trial in Tanzania.
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Groves Dylan W, Kagaigai Alphoncina, Manda Constantine, Montano Beatrice, Nivin Savannah, Rahmani Bardia, Green Donald P
Аннотация
BACKGROUND: Entertainment-education can influence public health knowledge and attitudes, but evidence on persistence and spillovers is limited.
METHODS: We conducted a placebo-controlled, cluster-randomized trial in 30 villages in rural Tanzania. Within 15 matched ward pairs, we randomly assigned villages to a community screening of a radio drama modeling HIV disclosure and obtaining treatment or to a screening of an unrelated drama. Of 1205 respondents enrolled at baseline, 87% attended the screening and 97% completed the endline survey. Participants and enumerators were blinded to assignment. The primary outcomes at 18 months were preregistered indices of HIV knowledge, expressed stigma, willingness to disclose, and HIV policy prioritization. We also surveyed participants' partners, close friends, and teenage children to assess spillovers (secondary outcomes). The study was preregistered on the Open Science Framework.
RESULTS: At 18 months, the HIV drama increased participants' knowledge (d = 0.14), willingness to disclose (d = 0.17), and prioritization of HIV policy (d = 0.17), but not expressed stigma (d = 0.07). These effects were about half as large as those measured two weeks after exposure. Willingness to disclose also increased among the partners (d = 0.16) and teenage children (d = 0.23) of screening attendees. The estimated effect on partners' policy prioritization was similar (d = 0.16) but less precisely estimated. We found no spillover in knowledge or stigma and no effects among friends.
CONCLUSION: A single group screening produced changes in HIV-related knowledge and attitudes that remained evident 18 months later. Spillover effects were evident but limited to household relationships.
METHODS: We conducted a placebo-controlled, cluster-randomized trial in 30 villages in rural Tanzania. Within 15 matched ward pairs, we randomly assigned villages to a community screening of a radio drama modeling HIV disclosure and obtaining treatment or to a screening of an unrelated drama. Of 1205 respondents enrolled at baseline, 87% attended the screening and 97% completed the endline survey. Participants and enumerators were blinded to assignment. The primary outcomes at 18 months were preregistered indices of HIV knowledge, expressed stigma, willingness to disclose, and HIV policy prioritization. We also surveyed participants' partners, close friends, and teenage children to assess spillovers (secondary outcomes). The study was preregistered on the Open Science Framework.
RESULTS: At 18 months, the HIV drama increased participants' knowledge (d = 0.14), willingness to disclose (d = 0.17), and prioritization of HIV policy (d = 0.17), but not expressed stigma (d = 0.07). These effects were about half as large as those measured two weeks after exposure. Willingness to disclose also increased among the partners (d = 0.16) and teenage children (d = 0.23) of screening attendees. The estimated effect on partners' policy prioritization was similar (d = 0.16) but less precisely estimated. We found no spillover in knowledge or stigma and no effects among friends.
CONCLUSION: A single group screening produced changes in HIV-related knowledge and attitudes that remained evident 18 months later. Spillover effects were evident but limited to household relationships.