Reducing the Negative Effects of Cultivation: Evaluation of a Digital Media Intervention for HIV/AIDS Stigma

• In Event: Media and Message Effects: High Density Panel in Health Communication

Abstract

Background: While hysteria-fueled media coverage of Ebola increasingly dominates the airwaves, a more common infectious disease continues to pose a severe threat to public health. Around the globe, approximately 35 million people are currently living with HIV, the virus that causes AIDS (WHO, 2014). Whether informational or entertainment-oriented, television content related to HIV has the potential to negatively impact the health of infected individuals by cultivating myths that lead to fear, stigma, and discrimination (Bryant & Oliver, 2008; Gerbner & Gross, 1976). The first aim of this study is to examine cultivation effects on HIV prevalence estimates, transmission risk estimates, and interpersonal comfort with HIV-infected individuals. We hypothesize that medical-oriented TV viewing (i.e., genre-specific cultivation) will be a better predictor than overall TV viewing (i.e., traditional cultivation). We then turn to an evaluation of a digital media intervention designed to reduce HIV stigma and discrimination among the general population. We predict that reductions in transmission risk estimates will mediate the intervention’s positive effect on interpersonal comfort. Method: Participants (N = 1306) were recruited in October 2014 from Amazon’s Mechanical Turk online participant pool. All were United States residents at least 18 years of age (M = 36, SD = 12; range = 18 to 75). The majority were Caucasian (77%), female (54%), unmarried (59%), and identified as hetereosexual (87%). Approximately 34% reported knowing someone with HIV. Participants reported overall television viewing in addition to genre-specific viewing of medical dramas, talk shows, reality shows, and comedies (adapted from Shrum, 2001). They were then randomly assigned to a control condition or to a treatment condition in which they viewed an anti-stigma digital media intervention. In this one-minute PSA-style YouTube campaign, an animated physician attempted to increase interpersonal comfort by debunking transmission myths commonly perpetuated by popular media (www.youtube.com/watch?v=jA4fkO6Vz98). Participants in both groups then estimated HIV prevalence in the United States. This was followed by a 6-item measure of transmission risk estimates (e.g., using public toilets; sharing eating utensils; alpha = .89) and a measure of interpersonal comfort across eight situations (e.g., taking care of someone who is infected; working with someone who is infected; alpha = .93). Results: Age, education, sex, social conservatism, and knowing someone with HIV/AIDS were included as covariates in each analysis. All hypotheses were supported. Multiple regression analyses confirmed that medical-oriented (but not overall) TV viewing was associated with increased prevalence estimates (b = .10, p < .05), heightened transmission risk estimates (b = .09, p < .05), and decreased interpersonal comfort (b = -.08, p < .05). Intervention effectiveness was examined with Hayes’ (2013) PROCESS macro for SPSS. Controlling for demographics and medical-oriented TV viewing, a total of 5000 bootstrap samples were generated, producing bias-corrected and accelerated 95% confidence intervals for assessing the significance of the indirect effect. The total effect of intervention exposure on interpersonal comfort was positive and significant (B = .21, p < .001). The hypothesised indirect effect was also positive and significant (B = .24; 95% BCa CI = .18 to .30). Intervention exposure led to decreased transmission risk estimates (B = -.55, p < .001). This in turn led to increased interpersonal comfort (B = -.43, p < .001). Controlling for all other variables, the direct effect was non-significant (B = -.03, p > .50). Discussion: Findings support the genre-specific cultivation perspective. Variance accounted for was small, but in line with similar effect sizes reported in the cultivation literature. Although our digital media intervention successfully corrected misconceptions and increased interpersonal comfort, it remains unclear how persuasiveness might be moderated by relevant health and media constructs. Future work should extend these findings to other stigmatized health conditions such as obesity and mental illness.

Authors

• Amanda M. White, U of Connecticut

• John L. Christensen, U of Connecticut

• Bryan M. Vanco, U of Connecticut