An assessment of global Internet-based HIV/AIDS media coverage: implications for United Nations Programme on HIV/AIDS' Global Media HIV/AIDS Initiative

INTRODUCTION

HIV/AIDS is projected to become the third leading cause of mortality worldwide by 2020. ¹ An estimated 33.2 million adults and children were living with HIV by the end of 2007. ² Media campaigns have been instrumental in increasing public knowledge and awareness about HIV/AIDS in resource-limited settings. ^3,4 They have contributed to increased uptake of HIV testing, ⁵ improved public and health-care provider knowledge about HIV transmission and enhanced self-efficacy of condom use. Moreover, mass media has influenced sexual behaviour, social norms and inter-personal communication regarding HIV/AIDS, and assisted in reducing stigma and discrimination. ^6–9

With the aim of increasing media leadership in the fight against HIV/AIDS, the United Nations Programme on HIV/AIDS (UNAIDS) established the Global Media AIDS Initiative in 2004. ¹⁰ Since the inception of this initiative, UNAIDS has collaborated with over 100 broadcasting companies from 62 countries. ¹⁰ As part of the initiative, UNAIDS has called upon participating media companies to increase local and global news coverage about the HIV/AIDS epidemic. ¹¹

Studies assessing the quality and quantity of global HIV-related news have generally focused on traditional sources, including print press, television and radio. ^3–6,12,13 None have examined HIV/AIDS reporting in Internet-based news sources. As global media companies increasingly make news available online, the Internet is having a significant displacement effect. ¹⁴ Although major television networks in the USA have 47 million viewers per month, Internet news sites receive in excess of 136 million monthly visitors. ¹⁵

In order to further establish priorities related to the Global Media HIV/AIDS Initiative, it may be useful for UNAIDS and participating media companies to assess the extent of HIV/AIDS-related news on the Internet, and whether it is appropriately focused on countries with elevated HIV/AIDS prevalence. We therefore sought to determine the proportion of language-specific Internet-based news articles focused on HIV/AIDS, and to determine whether any correlation exists between the amount of English, Spanish and French language HIV/AIDS news online and country-specific HIV/AIDS prevalence estimates.

METHODS

RESULTS

Table 1 shows media articles about HIV/AIDS, as a proportion of all articles, for the top nine languages most commonly spoken worldwide. English, French and Spanish language news sources had the highest proportion of articles about HIV/AIDS, compared with any other language, with 0.70%, 0.65% and 0.49% of all news articles about HIV/AIDS, respectively. Arabic language news sources also had a high proportion of HIV/AIDS news articles; 0.43% of all articles published in Arabic were about HIV/AIDS.

Figure 1 displays a scatter plot of the association between prevalence of HIV/AIDS media articles in English, French and Spanish and prevalence of HIV/AIDS disease, for 2007. The majority of HIV/AIDS English, French and Spanish language news reports were concentrated in sub-Saharan Africa, paralleling the epidemiological disease burden of HIV/AIDS in the region. We found a significant association between country-specific HIV/AIDS media coverage and HIV prevalence, with a Spearman's rank correlation of 0.6 (P < 0.001).

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Figure 1

Association between prevalence of HIV/AIDS English, French and Spanish media articles and prevalence of HIV/AIDS disease, by country, in 2007 ((a) media and epidemiological prevalence ≥5%, and (b) media and epidemiological prevalence ≤5%)

Among Anglophone countries with the most elevated HIV/AIDS prevalence (also the highest globally), the volume of HIV/AIDS-specific media coverage compared with all articles was highest in Swaziland (15.9%), Malawi (13.2%), Lesotho (12.6%), Zambia (10.8%) and Uganda (9.2%), and lowest in South Africa (4.8%), Namibia (4.9%) and Zimbabwe (6.1%). In Francophone countries with elevated HIV/AIDS prevalence, the volume of HIV/AIDS news was highest in Rwanda (6.9%), Burundi (4.5%) and the Central African Republic (4.1%), and lowest in and Côte d'Ivoire (1.1%) and Chad (0.8%). Among Spanish-speaking countries, the volume of HIV/AIDS news was highest in Equatorial Guinea (2.1%). Globally, coverage was lowest in South American countries, with Uruguay (0.24%) and El Salvador (0.18%) yielding the lowest proportion of HIV/AIDS-specific media coverage.

DISCUSSION

Our study assessed the quantity of global Internet-based HIV/AIDS news coverage, and determined the association between this coverage and country-specific HIV/AIDS prevalence. We found that English, French and Spanish news sources had the highest proportion of HIV/AIDS media coverage, compared with news sources in other languages. We found a statistically significant correlation between country-specific HIV/AIDS media coverage and HIV/AIDS prevalence, indicating that country-specific HIV/AIDS media coverage is generally proportionate to HIV/AIDS prevalence in 2007. However, some countries with elevated HIV/AIDS prevalence (≥10%) had extremely poor HIV/AIDS-specific media attention, including South Africa, Namibia and Zimbabwe. We also identified countries with elevated HIV/AIDS prevalence (≥10%) that had succeeded in gaining significant HIV/AIDS-specific media coverage, including Swaziland, Malawi and Zambia.

These findings are relevant in light of current international efforts aimed at increasing HIV/AIDS media reporting. Specifically, they are relevant to broadcasting companies seeking to support UNAIDS' efforts to increase HIV/AIDS reporting. ²⁰ UNAIDS' Global Media AIDS Initiative has made great strides in strengthening the volume and quality HIV/AIDS reporting, most notably by encouraging broadcasting companies to consider HIV/AIDS a corporate priority; committing media time and space to the topic; and promoting public service announcements on television and radio, via poster distribution, and through other common media forms. ¹² Comparatively little attention has been given to strengthening Internet-based HIV/AIDS news.

Internet access has increased substantially in sub-Saharan Africa over recent years, from an estimated 4.5 million users in year 2000 to 54.2 million in 2008. ²¹ Although Internet use in sub-Saharan Africa remains limited compared with the rest of the world, the rapid expansion of Internet access offers an important opportunity for HIV-related media campaigns to be proactive. Our findings highlight the need to increase global Internet-based HIV/AIDS news reporting about select countries with elevated rates of HIV/AIDS. Specific attention should be paid to countries such as South Africa, which has the highest number of people living with HIV/AIDS on the continent ² and has an estimated 4.6 million people (or 9.4% of the total population) accessing the Internet. ²¹

The Internet is playing a growing role in public health communication. ^15,16 With respect to HIV/AIDS, online information can supplement traditional public health media through promotion of global and national prevention, education and research. ^12,22 Studies in the United States have found that 34% of adults regularly consult the Internet for news, ²³ and 44% of young adults access the Internet to seek sexual health information, including about sexually transmitted infections and HIV/AIDS. ²⁴ In low-resource countries, high school students, physicians and research scientists are also increasingly using the Internet to seek HIVAIDS information. ^25,26 A survey in Uganda found that over a third of adolescent youth used the Internet to access health information, ²⁷ suggesting that the Internet may be a promising platform for delivering low-cost HIV/AIDS risk reduction interventions in resource-limited settings. ²⁵

An important limitation of our study is that we did not assess the quality of HIV/AIDS news content. Such an analysis was impossible with the search engine technique used. Future studies focusing on Internet-based HIV/AIDS media should seek to develop novel search engine querying methods to evaluate the quality of HIV/AIDS news sources. Assessing the quality of news reports would be valuable, especially given concerns about the accuracy of media reports of epidemiological data, ²⁸ the need for increased educational HIV/AIDS reportage and concerns about political interference with the media in some high prevalence countries. ²⁹

Our findings are also relevant for media companies seeking to support UNAIDS' Global Media AIDS Initiative. Our results indicate that several countries with elevated HIV/AIDS prevalence have received limited Internet-based media coverage about the HIV/AIDS epidemic. Focusing HIV/AIDS media efforts on these countries would support the Global Media AIDS Initiative overall goal to raise awareness about HIV/AIDS, change attitudes and fight HIV/AIDS-related stigma.