Applying Persuasion Strategies to Alter HIV-Relevant Thoughts and Behavior:

Health communication strategies are at the core of both mass media campaigns and public health interventions conducted at the community level concerning the prevention of HIV/AIDS. They are often nested in complex contexts that prevent us from being able to identify the persuasive impact of a specific message. The authors attempt to account for an array of factors contributing to the persuasiveness of messages about HIV. The aim is to synthesize the psychological literature on persuasion and thus provide a conceptual framework for understanding message effects in HIV communications. This discussion concerns fear appeals, message framing, tailoring, cultural targeting, and additional factors pertaining to the message, source, and channel of the communication. Whenever possible, recommendations for further research are formulated. In view of the public health threat posed by the HIV epidemic, government agencies have invested considerable resources in mass media campaigns aimed at informing the public about this disease and its prevention. Numerous behavioral interventions have been implemented as well among vulnerable subgroups of the population with the purpose of shaping health behaviors relevant to HIV prevention. Both mass media and behavioral intervention strategies entail a communication component: Information is disclosed and transmitted by a source to potential receivers with the purpose of persuading and inducing behavior change. In this article, we attempt to account for an array of factors contributing to this communication goal. Our aim is not to provide an evaluation of media campaigns devoted to HIV/ AIDS; neither is it to conduct an exhaustive review of complete intervention programs. Rather, our approach consists of synthesizing the psychological literature on persuasion to provide a conceptual framework for understanding the particular effectiveness of certain kinds of messages in HIV communications. We also review evidence from the literature on health promotion—and, when available, HIV prevention—that supports these principles. We first consider the use of threat appeals to motivate HIV-preventive behaviors. We provide an overview of theoretical considerations regarding the effectiveness of such appeals and then discuss studies investigating the impact of HIV communications based on threat. The second section addresses the role of message framing in the promotion of various health behaviors. Few investigators have studied systematically the impact of gain and loss frames on the persuasiveness of HIV-related messages. The findings obtained in this area reveal the complexity of HIV-relevant behaviors, notably with respect to the perceived risk or uncertainty associated with them. They also underscore the importance of matching the type of frame used to individuals’ risk appraisals. In the third section, we report research designed to match messages to characteristics of the population or individuals targeted. The tailoring of information about cancer prevention offers a good ilEditor’s Note. Geoffrey Cohen served as the action editor for this article.—PS