A Nationally Representative Analysis of HIV Communication Norms, Self-Efficacy, and Practices Among Hispanics/Latinos

Theoretical Background and research questions/hypothesis: Hispanics/Latinos in the United States are disproportionately affected by HIV/AIDS. Poor HIV communication can negatively affect HIV prevention and treatment efforts, including HIV testing, status disclosure, and medication adherence, whereas positive perceived norms and self-efficacy enhance outcomes. The objective of this study was to identify factors influencing HIV-related communication among a nationally representative sample of Hispanics/Latinos. This purpose was to inform strategic development of CDC’s We Can Stop HIV One Conversation at a Time (OCAT) campaign, part of the Act Against AIDS initiative. A primary goal of the campaign, which launched in August 2014, is to encourage communication about HIV among Hispanics/Latinos.

Methods: Data from the Porter Novelli Estilos survey were collected from a web-based panel of Hispanics/Latinos aged 18-64 years in 2013 and 2014 (N=2,006). Data were weighted to represent the Hispanic/Latino population in the United States. Variables included demographics, sociocultural variables, perceived norms and self-efficacy about HIV communication, and self-reported HIV communication practices. Descriptive statistics were calculated, and bivariate analyses were conducted using SPSS.

Results: Nearly three-fourths (72.8%) of respondents reported talking about HIV over the past 12 months.  There were significant differences between those who reported communication in the last 12 months and those who did not, specifically in educational level, household income, preferred language, and cultural identity as Hispanics/Latinos.  A higher proportion of those who reported talking about HIV reported feeling comfortable discussing HIV with family or friends, believing that their community thinks it is important to talk about HIV, and feeling confident that they could talk about HIV with others in their community.

Conclusions: HIV communication is a key strategy to increase the uptake of HIV-related services and enhance HIV prevention.  Study results indicate that education and income, as well as sociocultural factors, may impact HIV communication among Hispanics/Latinos.  Increasing self-efficacy and perceived social norms may also foster increased HIV communication among Hispanics/Latinos.

Implications for research and/or practice: OCAT and other structural interventions addressing HIV prevention and communication among Hispanics/Latinos need to incorporate targeted strategies that address sociodemographic and sociocultural factors. Additionally, inclusion of culturally appropriate strategies that increase self-efficacy and social norms regarding HIV prevention should be considered. This may be achieved in communication efforts and social marketing campaigns through audience segmentation and tailoring of messages and approaches. The application of these findings are reflected in CDC’s multi-faceted OCAT campaign, which was strategically designed to reach and influence Hispanics/Latinos in communities across the country—particularly in those most affected by HIV. A suite of bilingual campaign advertising and collateral materials, featuring men and women from culturally diverse backgrounds and a range of culturally appropriate messages are disseminated to the target audience via traditional and non-traditional media channels, unique partnerships, and grassroots community engagement activities. Campaign resources, including a dedicated campaign website, provide facts and practical tools and resources that address the needs, concerns, and perspectives of the Hispanic/Latino community.