15th International AIDS Conference Bangkok, Thailand — July 11-July 16, 2004

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrD31

M Fontes¹, P Roach², C Studart¹, G Barker^3
1JohnSnowBrasil, Brasilia, Brazil; ²SSL-International, London, United Kingdom; ³PROMUNDO Institute, Rio de Janeiro, Brazil

ISSUES: Studies carried out in Brazil demonstrated that the machismo (homophobia) culture is intrinsically linked with lack of condom use and spread of Sexually Transmitted Infections (STIs), including HIV/AIDS. A research conducted by PROMUNDO with more than 1,000 men in Brazil demonstrated that men who highly believe in homophobic values, such as homosexuality is a disease, are less likely to use condoms and indicate higher incidence of STI symptoms.

DESCRIPTION: JohnSnowBrasil, SSL-International and PROMUNDO developed a 12 month lifestyle social marketing project (Hora H) in selected Brazilian low-income communities (Bangú, Maré>, and Ceilândia) to reduce the impact of homophobic culture on the spread of HIV/AIDS among male populations in Brazil. The project includes several behavioral change dynamics and campaigns to engage men in questioning their beliefs on men to men relationships, different roles for women and men in society, and their own sexuality. A three phase impact evaluation (baseline, mid-post-1 and final-post-2) carried out by Project Horizons with more than 700 men in these communities demonstrated that the incidence of STIs was reduced from 23, to 14, and to 4.6%, respectively, and condom use with primary partner was increased from 58, to 79, to 84%, respectively. The evaluation was also applied to a control community which did not participate in the Hora H intervention (Morro dos Macacos) and the rates of condom use and incidence of STIs remained constant during the life of the project.

LESSONS LEARNED: Social marketing campaigns and projects that question homophobic cultural aspects of a local community, other than behaviors alone, have greater impact in reducing the spread of STIs and increasing condom use. The engagement of homophobic averse men is a key component for promoting resilience within these communities.

RECOMMENDATIONS: Public mass communication campaigns should not focus only on specific HIV/AIDS preventive behaviors and distribution of condoms. Homophobic cultural norms should be challenged by society at large.

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