Cambodia Sentinel Survey 2007: Media and Discussion, Knowledge, Attitudes and Practice about Sexual Matters, HIV and AIDS, Risks, Condoms, HIV Testing and People Living with HIV

This document is a report on Cambodian research for the BBC World Service Trust that measured knowledge, attitudes, and practices (KAP) amongst young people (aged 15-29) related to the media and HIV and AIDS. According to the study, mass media is highly effective in providing information about HIV and AIDS to young Cambodians.

The Trust media projects include:

• a health campaign in collaboration with several Cambodian broadcasters featuring a 100-episode TV drama, ‘Taste of Life’, TV and radio public service advertising (PSAs), four weekly radio phone-in programmes, plus accompanying print materials
• niche media for at-risk populations such as men who have sex with men (MSM) and entertainment workers
• 21 TV PSAs
• 3 documentaries - each for a specific audiences such as People Living with HIV (PLHIV), MSM, and those seeking voluntary and confidential counselling and testing for HIV (VCCT)
• 3 drama features
• 18 radio PSAs
• Radio phone-in programmes: "Real Men" programme (rural men 20-29 years old), "Really" programme (urban, 15-24 years old), and "Hip Hop Girl" programme (young urban women 15-19 years old)

The 2007 survey had several objectives:

• "A 'baseline' measure of HIV and AIDS KAP indicators relevant to the mass media component on the Global Fund-supported work in Cambodia.
• A periodic assessment of the Cambodian media landscape and the performance of selected Trust outputs in reaching audiences.
• On-going trend measurement using indicators and data established since 2003 by the Trust's previous HIV and AIDS KAP studies.
• Development and use of more detailed measurements of discussion on key issues such as HIV and AIDS.

• Collecting new data that reflects and contributes to growing international knowledge about stigma and discrimination.

These last two objectives reflect the Trust's increasing attention to measuring its impact on social obstacles - stigma and discrimination, gender inequalities, weak or under-accessed health systems - that hinder responses to HIV and AIDS."

The research used cross-sectional household-based surveys with a total sample size of 1,368 young people aged 15-29 from six locations in Cambodia. It recorded current attitudes, practices and social norms around sexual matters, HIV and AIDS, condom use, PLHIV, and MSM. Data was collected using face-to-face interviews in the Khmer language.

The report found continued positive associations between mass media campaigns promoting condom use and positive condom behaviours that can prevent HIV transmission. Knowledge that condoms can prevent HIV was close to universal amongst survey respondents, and other findings indicated social support for discussing and using condoms.

Recommendations for media strategies based upon the research include the following:

• "Mass media is a strongly recommended method to communicate behaviour change and to address widespread social attitudes and norms that hinder access to HIV prevention, treatment, care and support: A large majority of respondents (89%) had access to media within the past month.
• A multi-format, multi-media (radio, TV, and interpersonal communications) approach is necessary [to reach young people]...
• On television, continue PSA format; consider use of longer formats such as drama and short film.

1. Incorporate elements of popular TV and radio programmes into longer format TV outputs.
2. For radio, continue PSA and phone-in formats; explore new formats.
3. Encourage interaction via radio, particularly increasing calling in to radio programmes.
4. Cross-promote long-format TV outputs with other media such as radio and mobile phones.
   
5. Use ‘niche media’ to promote relevant prevention responses and behaviours that specifically arise in certain social contexts and ‘risk environments’ and/or among specific social groups.

•  Developing outputs that incorporate or are distributed via mobile phone platforms should also be explored, given the high penetration of mobile phones.
• Internet is not yet widely used. Exploring internet outputs that will be a part of growing internet use as by young Cambodian people should be considered for HIV and AIDS communications, however.
• A key purpose of [interpersonal] communications should be to encourage and model for females and males how to discuss HIV and AIDS, sexual matters, condoms and HIV testing."

In addition, the study provides recommendations for differentiated messages for the following groups and topics: Sexual Matters and Practices - for men based on marital and/or partner status, single women, married women, at-risk sub-groups, and sex workers; HIV and AIDS Risks; Risk Perception; Condoms; Condom; VCCT; Anti-retroviral (ARV) Awareness; PLHIV: Stigma and Discrimination; MSM; and Stigma and Discrimination. The report concludes that "[t]he data confirms the important role of media and communications, and offers many new possibilities for responding to HIV and AIDS in Cambodia."