Evufuation and Program Planning, Vol. 13, pp. 91-104. 1990 Printed in the USA. AII rights reserved. 0149-7189190 $3.00 + .oo Copyright ;cb 1990 Pergamon Press plc CONCEPTUAL AND STRATEGIC FOUNDATIONS FOR EFFECTIVE MEDIA CAMPAIGNS FOR PREVENTING THE SPREAD OF HIV INFECTION RICHARD A. WINETT Virginia Polytechnic Institute and State University DAVID G. ALTMAN AND ABBY C. KING Stanford University zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPON ABSTRACT To alter the course of the Acquired immune Deficiency Syndrome (AIDS) epidemic, public health campaigns are needed which directly and explicit/y focus on reducing risk behaviors that transmit HIV infection. Such campaigns will require the effective use of media, but there are practical and theoretical barriers that limit the impact of media-facilitated risk behavior change. This paper reviews some of the problems exhibited by the first part of the “America Responds to AIDS” campaign and describes an integrative framework that addresses the problems of that campaign and which can be used for mounting more effective media-based efforts. The frame- work is then used to formulate an exemplary AIDS prevention campaign for adolescents. The urgency of the AIDS epidemic presents an unusual opportunity for the behavioral sciences to demonsirate their ab2it.y and advance their disciplines through the design, implementation, and evaluation of prevention campaigns that have firm conceptuaf and strategic bases. By early 1989, about 85,000 cases of AIDS had been di- agnosed (Commonwealth of Virginia, 1989), and at least one important perspective was becoming prevalent in the professional (e.g., Kelly & St. L,awrence, 1988; Osborne, 1988) and responsible lay literature (e.g., Koop, 1988). HIV infection was no longer restricted to specific risk groups, living in certain locations, but was much better understood as a disease transmitted by par- ticular risk behaviors. Thus, potentially anyone engag- ing in HIV risk behaviors could contract the disease (e.g., see Flora & Thoresen, 1988). And, while the spread of HIV infection to the overall heterosexual population was apparently not as great as some alarmist reports suggested (e.g., Masters, Johnson, & Kolodny, 1988), nevertheless: . . . the increase in the number of heterosexual cases is proportional to increases in other risk groups. These in- creases are resulting in a doubling of heterosexual cases ev- ery 14 to 16 months (Haverkos & Edelman, 1988) Consistent with the focus on modifying risk behav- iors for HIV infection, major policy reports about the AIDS epidemic, such as those recently published by the National Academy of Sciences (Baltimore & Wolff, 1986; Cooper, 1988), have repeatedly made the same point. At present and in the near future the only likely means for altering the course of the AIDS epidemic re- sides in the effective use of public health strategies. These strategies, most often including media, must be properly targeted to particular population segments, with content that is explicit, graphic, and specific enough to promote behavior change. This perspective is reflected in the following two statements: The committee believes that government at all levels, as well as private sources, should continue to fund effective, factual educational programs designed to foster behavior change. This may mean supporting AIDS education efforts that contain explicit, practical, and perhaps graphic advice S~PPO~I for Preparation of this manuscript was provided by the NC1 & NiMH (Winett), the Kaiser Foundation (Altman), and NHLBi (King). Requests for reprints shdd be sent to Richard A. Winett, Department of Psychology, Virginia Polytechnic Institute, Blacksburg, VA 24061-0436. 91