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Impact of an AIDS prevention video on AIDS-related perceptions.

Key words: AIDS prevention AIDS risk reduction Video People Like Us University students

ACKNOWLEDGEMENTS: Parts of this research were presented at the Annual Convention of the Canadian Psychological Association in Toronto, Ontario (June, 1997) and at the Canadian Sex Research Forum in Toronto, Ontario, (September, 1997). This research was supported in part by the National Health Research and Development Program through a National Health Fellowship to B.J. Rye. Many thanks to William Fisher for helpful comments on this manuscript.

The prevention of the spread of human immunodeficiency virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS), is a major focus of public health promotion campaigns. Mass dissemination of information in an attempt to encourage the practice of AIDS preventive behaviours may be achieved through video media. Video media are an effective means of reaching a large audience and have been used effectively in public health promotion in the past (e.g., Crawford & Jason, 1990; Jason, Crawford & Gruder, 1989; Lau, Kane, Berry, Ware & Roy, 1980). Indeed, television programs have been listed as the most popular source from which young adults learn the most about AIDS (Abraham, Sheeran, Abrams, Spears & Marks, 1991). This learning may be the first step on the road to behaviour change that reduces the risk of HIV infection.

The 40 minute AIDS prevention video, People Like Us(1), is the focus of the current study. The design of this video was based upon the Information-Motivation-Behavioral Skills model (IMB; J. Fisher & W. Fisher, 1992; W. Fisher & J. Fisher, 1992a; W. Fisher & J. Fisher, 1992b). In short, this model suggests that there are three determinants of successful AIDS risk reduction behaviours: (1) information about AIDS transmission and prevention; (2) motivation to change one's behaviour in an AIDS preventive direction and motivation to continue engaging in AIDS preventive behaviour; and (3) behavioural skills required for the performance of AIDS preventive behaviours. The information and motivation components are thought to influence the behavioural skills component; that is, one must have information and motivation in order to enact existing skills. If one does not have the requisite behavioural skills, the information and motivation components may prompt one to develop or learn such skills. All three components may have a direct effect on AIDS preventive behaviour as well.

People Like Us was designed primarily to address the motivational component of the IMB model. The video was created in the northeastern United States as part of a joint American-Canadian AIDS risk reduction program. It focuses on young adults' sexual behaviour as an HIV risk activity. The video contains testimonies of six young HIV+ men and women with whom a target audience can easily identify. The people in the video tell the audience about their lives -- their likes and their dislikes, their goals and aspirations -- and then tell about how they contracted HIV. They describe the effect that having HIV has had on their lives. This presentation style allows the audience to develop a fondness for the people in the video and identify similarities between the HIV+ individuals and themselves. The presentation of similar others with HIV in People Like Us is thought to motivate viewers to take precautions against contracting HIV because of social comparison processes. That is, comparison of similar others with HIV to oneself should increase perceptions of vulnerability, increase the personal relevance of the topic, and increase awareness of the riskiness of unprotected sexual behaviour (Festinger, 1954). People Like Us was thought to provide a source of information about AIDS risk and AIDS preventive behaviours, as people are more likely to attend to similar others compared to other sources of information (see J. Fisher & Misovich, 1990). As well, the persons with HIV in the video discuss various strategies for AIDS preventive behaviours, such as how to introduce safer sex to a partner and how to discuss condom use. In this manner, People Like Us addresses the behavioural skills needed to enact AIDS preventive behaviours (W. Fisher & J. Fisher, 1992b).

The current study investigates the effects of People Like Us on a sample of university student viewers. Students viewed the video and, immediately afterward, indicated the impact the film had on them in a free response format. Then, the viewers completed a checklist of safer sexual behaviours in which they intended to engage as a result of watching People Like Us. Finally, the students completed an AIDS Opinion Survey, responding to several 7-point items concerning their vulnerability to AIDS, fear of AIDS, and attitudes toward persons with AIDS. Students who were participating in a homophobia and heterosexism awareness workshop and who did not view the video also completed the AIDS Opinion Survey. This allowed those who viewed the video to be compared to those who did not view the video on the AIDS attitudinal items. Because of the use of a non-equivalent control group, the design of the first portion of the study must be considered as quasi-experimental. In the second portion of the study, students in another human sexuality class completed the AIDS Opinion Survey before and after having viewed the video.

It was expected that common themes about the impact of the video would arise in the free response section of the questionnaire. As well, it was expected that students would have a heightened intension to engage in safer sex behaviours as a result of having viewed the film. It was also expected that those who viewed the film would have greater perceived vulnerability and greater AIDS fear than those who did not view the film.


PARTICIPANTS Participants included three samples of Canadian university students: 31 students who were enrolled in a human sexuality course at a small affiliated college of the main university campus; 79 students who were enrolled in a different section of the same human sexuality course at the main campus of a large Canadian university; and 121 students who were participating in a homophobia and heterosexism awareness workshop. The human sexuality course draws students from a variety of course majors because of the interdisciplinary nature of the course. The homophobia and heterosexism awareness workshop participants were also comprised of students from a variety of academic disciplines. These participants were used in the between-subjects analyses, and hence are referred to as sample 1.

Another sample of 105 university students who were enrolled in a different section of the human sexuality course were included in the study. These participants were used in the within-subjects analyses, and are therefore referred to as sample 2.

INSTRUMENT: THE AIDS OPINION SURVEY Three subscales were identified on the 20-item AIDS Opinion Survey using factor analytic techniques. The three factors were: (1) an affective or fear reaction to AIDS scale; (2) a personal risk assessment regarding AIDS score; and (3) an irrational fear of contagion scale. The factor structure of the three subscales of the AIDS Opinion Survey are replicated from the first sample to the second sample through confirmatory factor analysis (see Figures 1 and 2).


Affect/Fear The affect or fear factor was calculated by averaging eight 7-point Likert-style items on the AIDS Opinion Survey. These items were: (1) I am afraid that I will get AIDS; (2) I am extremely worried about getting AIDS; (3) Fear of AIDS is interfering with my sex life; (4) I feel very anxious about AIDS; (5) How frequently are you disturbed by thoughts about AIDS?; (6) Fear of AIDS has made me cut down on my number of sexual partners; (7) Whenever I get sick these days, I am afraid it might be AIDS; and (8) Worrying about AIDS keeps me awake at night. Participants indicated their opinions on these items on a 7-point agree-to-disagree scale with the exception of (5) above where participants responded to a 7-point scale ranging from constantly-to-never. This factor accounted for 30% of the variance in the AIDS Opinion Survey. Items were coded such that higher scores indicated agreement with the item (meaning greater affect/fear). Scores of those in the first sample ranged from a low of 1 to a high of 6.75, and had a mean and standard deviation of 3.14 and 1.22, respectively. Scores from the second sample ranged from 1 to 6.06 with a mean and standard deviation of 3.11 and 1.22, respectively. The affect score had good reliability (e.g., [[Alpha].sub.sample 1] = .85 and [[Alpha].sub.sample 1] = .83 [pre-film] and .89 [post-film]).

Personal Risk Personal risk was calculated using the average of 6 AIDS Opinion Survey items. These items included: (1) I am personally vulnerable to contracting AIDS; (2) It is likely that I will get AIDS someday; (3) It is likely that I will be exposed to the AIDS virus in my lifetime; (4) Compared to other people I know, my chance of being exposed to the AIDS virus is [higher-to-lower]; (5) It is likely that I may have been exposed to the AIDS virus; and (6) As a result of your sexual activity, how much do you think you, personally, are at risk for being exposed to the AIDS virus [no risk-to-in between-to-great risk]? Participants responded to these items on 7-point agree-to-disagree scales (exceptions were items 4 and 6 as noted above). This factor accounted for 13% of the variance in the overall scale. Items were coded such that higher scores indicated greater agreement with the item (i.e., greater personal risk assessment). Scores from sample 1 ranged from 1 to 5.83, with a mean of 3.00 and a standard deviation of 1.20. Scores from sample 2 ranged from 1 to 5.67, with a mean of 3.07 and a standard deviation of 1.36. This scale also had good reliability ([[Alpha].sub.sample 1] = .79 and [[Alpha].sub.sample 2] = .87 [pre-film] and .91 [post-film]).

Contagion Participants indicated their irrational fear of contagion on 6 items which were: (1) I would object to sending my non-infected child to a school which had a child who has the AIDS virus; (2) I am worried about catching AIDS in a public restroom; (3) I would not mind being in the same room with a friend who had AIDS; (4) Children with AIDS should be allowed to attend public school; (5) Even if a friend had AIDS, I would not mind touching him/her; and (6) If I found out a friend had AIDS, I would be afraid to hug him/her. Participants responded to these items on 7-point agree-to-disagree scales with lower scores indicating less fear of contagion. This factor accounted for 8% of the variance in the AIDS Opinion Survey. The contagion score was an average of these 6 items; scores of the first sample participants ranged from 1 to 4.67, with a mean of 2.02 and a standard deviation of 1.01. Scores of the second sample participants ranged from 1 to 6.25, with a mean of 1.98 and a standard deviation of 1.08. Thus, the absolute level of irrational fear of contagion was quite low. This scale had slightly lower reliability compared to the other scales ([[Alpha].sub.sample 1] = .73 and [[Alpha].sub.sample 2] = .81 [pre-test], and .81 [post-test]).

PROCEDURE Students who were enrolled in the human sexuality courses completed a Student Feedback sheet after having viewed People Like Us as part of their human sexuality course. First, they indicated the personal effect that the film had on them in a free response format. That is, they were asked to indicate what effect the film had on them (neutral, positive, and/or negative) and elaborate in a few sentences. Then, they indicated on a brief checklist the safer sexual behaviours in which they intended to engage as a result of having viewed the film. The intention checklist included: buying condoms, using condoms, talking to a sex partner or a potential sex partner about safer sex, getting an AIDS blood test, asking a sex partner or a potential sex partner to get an AIDS blood test, and an "other: please specify" intention. Students in the homophobia and heterosexism awareness workshop did not complete these measures as they had not viewed the film, Participants indicated all relevant intentions. Finally, students enrolled in the human sexuality course completed the AIDS Opinion Survey. After completing the questionnaire, students were debriefed in the form of a discussion with an AIDS educator about HIV/AIDS and safer sex. The workshop participants completed the AIDS Opinion Survey, embedded within a longer questionnaire, during the workshop. These participants discussed their feelings about HIV/AIDS within the context of the workshop, and they were able to ask questions about any aspect of the research.

With the second sample, participants completed the AIDS Opinion Survey before viewing the film, and then immediately afterward. Because some arrived late, a few students completed the AIDS Opinion Survey after having viewed the film only. In total, 94 students completed both the pre-test and post-test version of the questionnaire.


SAMPLE 1 Scores on the affect/fear, perceived vulnerability/risk and irrational contagion scales were compared for the two sub-samples of human sexuality class students (i.e., the 31 students from the affiliated college and the 79 from the main university campus). The multivariate analysis of variance indicated that the two groups did not differ from each other on these scales, and thus, the two groups were combined and considered as the treatment (i.e., viewers) group (Wilks' Lambda statistic, F(3,106) = 1.41, ns).

The participants who viewed the video differed significantly from those who did not view the video (Wilks' Lambda statistic, F(3,215) = 6.31, p [is less than] .0001). At the univariate level, viewers had significantly greater affect/fear scores (mean = 3.46) than nonviewers (mean = 2.80; F(1,217) = 17.05, p [is less than] .0001). On an absolute level, this fear rating is relatively low (with the lowest score 1 and the highest score 7). As well, viewers were more likely to rate their risk of contracting AIDS as greater (mean = 3.27) than those who did not view the video (mean = 2.72; F(1,217) = 12.06, Viewers' irrational contagion (mean = 2.11) did not differ from that of non-viewers (mean = 1.92; F(1,217) = 1.86; ns).

SAMPLE 2 With regard to the second sample, scores on the AIDS Opinion Survey differed from the pre-test to the post-test at the multivariate level (Wilks' Lambda statistic, F(3,91) = 10.37, p [is less than] .0001). At the univariate level, participants had significantly greater affect/fear scores (mean = 3.14) after having viewed the film than before (mean = 2.89; t(93) = 3.49, p = .001). Similarly, risk scores were elevated (mean = 3.21) at post-test compared to pre-test scores (mean = 2.79; t(93) = 5.05, p [is less than] .0001). There was no difference between pre-test (mean = 2.00) and post-test (mean = 1.92) regarding the irrational fear of contagion scores (t[93] = -1.28, ns).

Scores on the AIDS Opinion Survey of the second sample prior to viewing the film did not differ significantly from the control group of the first sample's AIDS Opinion Survey scores ([t.sub.affect] = 0.57, ns; [t.sub.risk] = 0.44, ns; and [t.sub.contagion] = 0.56, ns). Similarly, the second sample's post-test scores did not differ from the viewers in the first sample ([t.sub.affect] = 1.20, ns; [t.sub.risk] = 0.12, ns; and [t.sub.contagion] = 1.07, ns). These findings suggest that the homophobia-heterosexism awareness workshop participants were an appropriate comparison group. As well, the findings that the first sample viewers did not differ from the second sample post-test in terms of their AIDS Opinion Survey scores suggests that a priori knowledge of the items on the survey did not affect responding in the second sample.



Fear-Arousal The results indicate that viewers of the video had a significantly greater affective reaction to AIDS than did those who did not view the video. Viewers of the video were more likely to feel anxious and worried about AIDS than were nonviewers. It is noteworthy that, on an absolute level, the average amount of "fear" was below the midpoint, meaning that while viewers felt anxiety, they were not overly concerned about HIV/AIDS (i.e., they tended to disagree with the majority of statements, but they disagreed less than did nonviewers). Similarly, after having viewed the video, participants' level of fear regarding AIDS was high relative to the level of fear prior to their viewing the film. Again, the post-viewing fear score was below the midpoint.

The video was effective at increasing anxiety and concern regarding AIDS to a higher level. This might serve to increase the motivation of the viewers to take preventive action (i.e., their reported fear and anxiety level was not high enough for the viewers to be paralysed by their fear). Classic research suggests that elevating fear using a high-fear message can result in defensive avoidance, that is, the audience will fall to contemplate the message because they are so frightened by it (Petty & Cacioppo, 1981). A fear appeal can be effective when the actions that are recommended to avoid the negative consequences are communicated in a convincing, reassuring manner. That is, the recommended preventative actions need to be presented as effective and easily enacted (Rogers, 1983; Zimbardo, Ebbesen, & Maslach, 1977), an outcome achieved by People Like Us. The current video attempts to raise awareness of personal vulnerability to the negative consequences of unprotected sex by using credible sources with whom the viewers can easily identify. The personal testimonies about HIV/AIDS are likely to be more effective than statistical, scientific presentations because of their vividness (O'Keeffe, Nesselhof-Kendal, & Baum, 1990), and because of the ease of social comparison with the people in the video (hence the title, People Like Us; see Festinger, 1954).

As well, viewers rated their perceptions of personal risk of contracting HIV/AIDS as greater than did the non-viewers. On an absolute level, viewers tended to disagree that they were likely to contract HIV, but they disagreed less strongly than did the nonviewers. Similarly, viewing the film elevated perceptions of risk relative to perceived risk prior to viewing. Thus, the film was effective at raising perceptions of personal vulnerability to HIV/AIDS. Gerrard, Gibbons, and Bushman (1996) have concluded that there is no evidence that perceived vulnerability to HIV motivates AIDS preventive behaviour. Rather, they argue that perceived vulnerability to HIV is influenced by risk and precautionary behaviour. Thus, the film may be making the viewer's past risk behaviour more salient, and this is reflected in the change in perceived risk scores. This may or may not be motivational in terms of AIDS preventive behaviour change.

However, a person must perceive that there is a risk that the health threat could happen to him/her in order to take the recommended actions to prevent the negative consequences from occurring. Various theorists suggest that perceived susceptibility is a necessary, but not sufficient, condition for preventive action to occur (O'Keeffe et al., 1990; Rogers, 1983; Rosenstock, 1974). According to Rogers' (1983) protection motivation theory, for example, fear-arousal is evoked by perceptions of vulnerability to the health threat and severity of the health threat. These perceptions are integral parts of a threat appraisal process. In order for protection motivation to be elicited, however, a second process, termed coping appraisal, must be enacted. Coping appraisal entails perceiving response efficacy (e.g., the recommended actions will be effective at preventing the health threat), self-efficacy (e.g., one has the skills necessary to engage in the preventative behaviour), and low response costs (e.g., engaging in the recommended behaviour will not be costly for the actor). Threat appraisal and coping appraisal processes are both necessary for protection motivation to be generated. Eliciting protection motivation is key, in that protection motivation is thought to be the psychological underpinning of adopting effective coping techniques for dealing with the health threat.

Viewing People Like Us resulted in fear-arousal, as measured both by the affective and risk assessment scales of AIDS Opinion Survey. Severity of the condition and vulnerability to HIV/AIDS were addressed in the film, and an effective preventive response (i.e., condom use) was discussed. As well, skills that would be useful in engaging in condom use were described (e.g., what to say to a partner who does not want to use condoms). Based on the theory of protection motivation and its predecessor, the health belief model, People Like Us has the essential components necessary in order to be effective as an AIDS intervention strategy.

Beliefs about the Contagiousness of HIV/AIDS Viewers and non-viewers did not differ in their reported contagion beliefs. As well, participants did not differ in their irrational fear of contagiousness of AIDS after having viewed the film relative to their perceptions prior to viewing. This is positive, in that the video influenced both fear of HIV/AIDS and perceptions of vulnerability to HIV/AIDS, but did not foster irrational beliefs about the contagiousness of HIV/AIDS. Thus, the video was effective at elevating the fear of AIDS and perceptions of personal vulnerability to a level where they are likely to motivate enactment of AIDS preventive behaviour without encouraging irrational concern about contagion. It is thus likely that the film did not encourage prejudice toward persons with AIDS.

LIMITATIONS OF THE CURRENT STUDY The findings of the between-subject portion of the study must be considered with caution because of the quasiexperimental nature of the design. That is, the results could be attributed to pre-existing differences between the two groups (human sexuality students versus homophobia and heterosexism awareness workshop students), as opposed to having viewed or not having viewed the video. Because random assignment to viewing or non-viewing conditions did not occur, we cannot be sure that the results are due solely to having viewed the video. However, the equivalency of the scores on the subscales of the AIDS Opinion Survey of the between-subject participants and the within-subject participants lends credence to the between-group comparison.

Because they were both participating in sexually sensitive endeavours, the two groups may have been comparable. That is, the viewers were students enrolled in a human sexuality class, while the nonviewers were participants in a homophobia and heterosexism awareness workshop. Thus, it is likely that both of these groups were somewhat liberal in their sexual attitudes, probably the most critical dimension on which differences might exist (see Kaats & Davis, 1971, for a discussion of volunteer bias in sex research). As well, if the findings were attributable to group differences, then we would expect the two groups to differ on all of the scales of the AIDS Opinion Survey. However, this was not the case; participants in both groups were equivalent on their endorsement of irrational contagion beliefs.

Social desirability may have been a confounding factor in true anxiety levels, risk perceptions, and contagion beliefs. However, there is no reason to expect that one group was more influenced by social desirability than the other. Future research could address the issue of social desirability.

DIRECTIONS FOR FUTURE RESEARCH The current preliminary investigation into the impact of an AIDS awareness video on AIDS-related attitudes was promising. Future research needs to evaluate the impact of other types of AIDS-awareness films in order to determine if the films are successful in conveying their message and imparting positive AIDS preventive attitudes. In addition, research needs to be conducted with samples from a variety of populations outside of the university setting. Use of the video with samples who are more and less similar to the HIV+ people in the film would also aid in testing the social comparison hypothesis. That is, if social comparison processes are occurring, then the film should have a more beneficial impact on those who are more similar to the HIV+ speakers.

The effect of the film on AIDS-related behaviours needs to be investigated. While Gerrard et al. (1996) conclude that there is no evidence for the supposition that vulnerability determines HIV-risk related behaviour, this hypothesis has not been tested experimentally (studies reviewed were prospective, not intervention-based). People Like Us may afford the opportunity to test experimentally the motivational hypothesis that changes in risk perceptions lead to changes in preventive and risk behaviour. That is, we know that the film has an immediate impact on HIV risk perceptions. How this intervention affects behaviour is yet to be determined (see W. Fisher & J. Fisher, 1992b). As well, the longer term impact of viewing the film needs to be addressed in a longitudinal study (e.g., are these perception changes maintained).


INTENDED SAFER SEX BEHAVIOURS Using the free response checklist questionnaire, participants who viewed the film (N= 110) indicated their future intentions to engage in a variety of safer sexual behaviours. Fifty-nine percent reported that they would practice safer sex as a result of having viewed the film; 56% reported that they intend to use condoms in the future; and 55% reported that they intend to talk with their partner about safer sex. Only 33% reported that they intended to buy condoms as a result of having seen the film, and 33% reported that they would ask a partner to get an HIV test. Twenty-eight percent reported that, as a result of having seen the film, they would get an HIV test themselves. Fifteen percent of the respondents generated their own intended behavioural responses to the film which could broadly be classified into one of three areas: 1) intention to discuss safer sex with children or other family members; 2) intention to abstain from intercourse; or 3) intention to remain in a relationship or engage in monogamy. The intention rankings correspond to W. Fisher and J. Fisher's (1992b) findings regarding self-reported behavioural change by students after their having viewed People Like Us (Spearman's rank correlation coefficient: [r.sub.s]=.90). That is, the intentions that were endorsed highly (i.e., ranked number one, two, three, etc.) by the participants in the current study tended to correspond to those ranked highly by the participants in W. Fisher and J. Fisher's (1992b) study where human sexuality students who viewed People Like Us early on in the course rated their actual behaviour change as a result of having watched the video.

QUALITATIVE RESULTS: FREE RESPONSE COMMENTS Six categories have been identified by the researcher as representing the comments made by the first sample of viewers of People Like Us. These six categories are:

(1) Concern about one's own sexual behaviour, awareness of one's own sexual behaviour (either past, present, or future behaviour) or safer sex behaviour-related questions. For example, one viewer stated, "(I will) ensure that I practice safe sex [...] In a way it scares me because I have been foolish in the past.";

(2) Calls for education or praise for the film as educational or informative. For example, "Being educated about AIDS is useful and seeing the reality of it is needed because many of us have not encountered people with AIDS and we need to know their feelings and what they go through mentally and physically.";

(3) Compassion for people with AIDS or appreciation of the portrayal of persons with AIDS. For example, "In using young people to talk about how HIV has changed their lives, it really made me think that anyone who has sexual intercourse can contract the disease. I already knew that but the film shows you people with HIV and AIDS. It makes the disease more real.";

(4) Plan to talk about safer sex more. For example, "You cannot be embarrassed because talking about it (safer sex, contraception) may one day save your life.";

(5) AIDS fear. The video appeared to instill some level of fear. For instance, "AIDS is a very scary disease. When you hear about someone's personal experience, it makes it more real to you. You see that they are no different from us and it is frightening."

(6) Calls for celibacy or abstinence. For example, "[...] the fact alone that there are [...] diseases out there has presently caused me to abstain from sex until I feel that I want to take a chance with someone. I say chance because even with a condom you can never be guaranteed safety."

The free responses elicited by the film were classified into these categories by four raters. A participant's comment was classified as belonging in a particular category if at least three of the four raters agreed that a particular comment belonged in that category. The responses could be represented in more than one category (i.e., the comments and categories were not mutually exclusive). Participants often made more than one comment. Each comment was treated as a piece of data. Thus, verbose participants tend to be represented more than reticent participants (hence an N=227 comments). Of the responses elicited and classified, 35% fell into the "concern about sexual behaviour" category; 20% of classifications were "calls for education"; 16% of the classifications related to "compassion for persons with AIDS"; 14% belonged in the "talking more about safer sex." category; 11% were classified as being about "AIDS fear"; and 4% of classifications advocated for celibacy or abstinence.

The agreement rate for the four raters was moderate, with an overall agreement rate of 51% That is, 227 classifications were made by the raters and, of these, at least 3 raters agreed upon 116 of these classifications. This agreement rate would be higher if the raters were required to assign each participant's response into only one category.


SUMMARY OF FINDINGS It is clear that People Like Us motivated some viewers to intend to engage in safer sex. When given a checklist of behaviours in which they intended to engage as a result of having seen the film, many people stated that they intended to practice safer sexual behaviours, including talk about safer sex, use condoms and, to a lesser extent, buy condoms, ask a partner to have an HIV test, and have an HIV test themselves. Some respondents reported that the video made them intend to discuss safer sex with their children, abstain from intercourse and/or maintain a monogamous relationship.

The movie elicited a variety of responses from those who viewed the film. These free responses could generally be classified by raters into one of six categories. If the mandate of a researcher or educator were to elicit concern about one's own sexual behaviour in young adults or teenagers, use of the film would be advised. Concerns about sexual behaviour were the primary comments cited by the respondents. As well, many of the viewers commended the film as informative and called for further education about AIDS. To a lesser extent, plans to talk about safer sex with significant others were expressed by the audience. Also, the movie seemed to arouse some compassion for people with AIDS, as well as some fear of contracting AIDS.

INTERPRETATION OF THE FINDINGS Because viewers were asked to describe their reactions to the film, they likely had to process the content of the film in a thoughtful manner. That is, by writing about the anticipated effect that the film would have on their subsequent behaviour, the respondents likely had to review and generate conclusions about the content of the video, analyze and synthesize this information, and then apply this analysis and synthesis to their lives in order to forecast the impact that the video would have on their personal lives. Thus, the respondents had to engage in considerable self-generated thought, a process that can have a significant persuasive effect on attitudes (Petty & Cacioppo, 1981), and perhaps subsequently, through intentions, on behaviour (Ajzen & Fishbein, 1980).

Within the Elaboration Likelihood framework (Petty & Cacioppo, 1981; 1986), People Like Us would be interpreted as an effective safer sex persuasive tool. The video presented credible sources (i.e., members of the viewers' peer group with whom they could easily identify) who introduced strong arguments for engaging in safer sexual behaviour (i.e., the sources discussed the catastrophic effects of not engaging in safer sexual behaviour). Ng and Lindsay (1992) have found that same-gender speakers with AIDS in public service announcements were effective at increasing general risk perceptions of female viewers, in particular. By having peer sources discuss the negative effects of HIV and AIDS on their lives, the film was likely promoting the high personal involvement of the viewers. That is, the viewers of the film were able to identify with the people with AIDS and were easily able to take the perspective of the person with AIDS. Flora and Maibach (1990) found that participants who viewed AIDS public service announcements and were highly involved in the issue tended to exhibit superior message recall. Those who were low in AIDS issue involvement tended to have poorer message recall, especially when the message was presented rationally, in contrast to emotional message appeals which tend to be recalled better (Flora & Maibach, 1990). As well, important messages such as "you cannot tell by looking at someone if they have HIV" were repeated by different sources in the video. This repetition would be expected to encourage favourable thoughts about the arguments. Having viewers process the information in People Like Us from a thoughtful perspective (i.e., Petty & Cacioppo's central route) is expected to have long-term attitudinal and behavioural implications (Petty & Cacioppo, 1986).

DIRECTIONS FOR FUTURE RESEARCH Base rates of intended safer sexual behaviours are unknown; it would be valuable to compare rates of intended safer sexual behaviours of viewers to those of non-viewers in order to determine how much behaviour change is attributable to the viewing of the film. The role that social desirability plays in reported intended safer sexual behaviour needs to be investigated as well. Follow-up research needs to assess whether effects that were cited during the free responding procedure translate into some form of preventive behaviour (i.e., actual practice of safer sex or attempts to acquire behavioural skills required for the practice of safer sex). Viewers who engage in the free responding procedure could be compared to those who view the film but do not engage in the free responding procedure on reported safer sex intentions, as well as on issue involvement.


The results of the current study suggest that People Like Us elicits thoughts of concern about the viewer's past sexual behaviour; proclamations of the importance of AIDS education; compassion toward persons with AIDS; and plans to engage in safer sexual activities, such as talking more about safer sex. As well, those who view the film report that they intend to engage in a variety of safer sexual behaviours. Other research suggests that viewers of People Like Us are likely to act on these safer sex intentions (W. Fisher & J. Fisher, 1992b). Viewers are likely to perceive themselves at greater risk for HIV and have greater fear of HIV. These perceptions are thought to be motivators of safer sexual behaviours (see Gerrard et al., 1996). The film does not appear to foster prejudice towards persons with AIDS. The film may be used to address some theoretical issues that exist in the HIV literature surrounding the motivational effect of perceived vulnerability. From a practical perspective, People Like Us may be an effective safer sex promotional too] and it can be used in conjunction with other safer sex promotion materials as part of a comprehensive AIDS preventive behaviour campaign.

(1.) People Like Us is available from the AIDS Risk Reduction Project, Department of Psychology, University of Connecticut, 406 Babbidge Road, Box U-20, Storrs, Connecticut, USA, 06269-1020.


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Correspondence concerning this paper should be addressed to B.J. Rye, The Addiction Research Foundation, Gordon J. Mogenson Building, Suite 200, 100 Collip Circle, University of Western Ontario Research Park, London, Ontario, N6G 4X8. email:
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Author:Rye, B.J.
Publication:The Canadian Journal of Human Sexuality
Date:Mar 22, 1998
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