Communicating Health Messages: Leveraging Culture to Promote Safe Sexual Health Practices Among Thai Men

Purpose: HIV prevention in Thailand has focused on using mass media to promote condom usage. In the late 1990’s, the Government launched a mass media campaign (television and radio) to increase preventive sexual behaviors. The one-minute media spot ran every hour on all channels. Because of the cultural norm of men using commercial sex workers and the generally less conservative sexual attitudes, the messages focused on: (1) men having safe sex with sex workers, (2) conversations between spouses about safe sex with sex workers, and (3) incorporating Buddhist religious images and sounds to underscore the gravity of being infected with HIV. This study examined the association between the culturally relevant, HIV mass media messages and self-reported protective sexual behaviors among Thai men.

Methods: The study employed survey items from the 2003 National Behavioral Surveys. Logistic regression analyses were used to examine associations between exposure to the HIV/AIDS messages, wearing a condom during last visit and having visited a commercial sex worker in past 3 months.

Results: Eighty percent of the men reported that the messages “spoke to them” and 67% of the married respondents discussed safe sex behaviors with their spouses. Respondents who viewed the messages were three times more likely to use a condom during their last visit with a sex worker (p < .01) and were four times more likely not to have visited a sex worker in the past three months (p < .01). In contrast to unmarried men, married men were two times more likely to use condoms (p < 0.01) and were seven times less likely to visit a commercial sex worker (p = .05).

Conclusion: The study demonstrates that culturally relevant messages can be effective in changing behavior. Culture needs to be integral in designing appropriate public health messages aimed at preventive behaviors.