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Straight talk increases knowledge, improves behavior.

The Straight Talk mass media program has been bringing information about HIV and reproductive health to young people in Uganda since 1993. The program is considered one of the most successful ongoing media efforts of its kind. But are its messages reaching young people and having a positive impact on their attitudes and behaviors? In 2005-2006, the Population Council's USAID-funded Horizons Program conducted the first evaluation of Straight Talk to document its effects on young people, with partners PATH, the International Center for Research on Women, and Makerere University. The assessment focused particularly on the relationships between exposure to Straight Talk media and healthy behaviors.

The main part of the evaluation involved a survey of 1,019 girls and 1,021 boys between the ages of 10 and 19 years. Data were collected between 29 August and 7 September 2005 in six districts in Uganda.

Straight Talk produces various media products, primarily multilingual Straight Talk radio shows, multilingual Straight Talk newspapers, and an English-language Young Talk newspaper. Straight Talk also conducts school-based activities to engender a youth-friendly school environment.

Straight Talk materials used widely

The survey shows that Straight Talk materials have reached virtually all secondary and two-thirds of primary school students, as well as 56 percent of out-of-school young people. Adding local-language Straight Talk products doubles exposure, showing the value of these products in a multilingual country such as Uganda, Nearly 60 percent of adolescents who were familiar with Straight Talk reported that the main message they had gotten was about the importance of abstinence. The Straight Talk materials and programs advocate a variety of HIV risk-reduction strategies including abstinence, monogamy, condom use, and knowledge of one's HIV status through voluntary testing for and counseling about HIV.

"The results suggest that greater exposure to Straight Talk products is significantly associated with higher reproductive health knowledge," said Karusa Kiragu of Horizons/ PATH (now of UNAIDS). Kiragu was one of the principal investigators on the study. "Each incremental exposure to Straight Talk is associated with increased knowledge. This relationship holds for both boys and girls."

Sexual activity and condom use

About one-fourth of the respondents said that they had a boyfriend or girlfriend, and 12 percent of the study sample had ever had sex (15 percent of boys and 9 percent of girls). Among boys, those exposed to all three Straight Talk media products were 61 percent less likely to be sexually active than boys unexposed to Straight Talk. Among girls, the pattern was not clear or statistically significant, in part because so few girls were sexually active. Among adolescents who had ever had sex, about 38 percent of boys and 41 percent of girls had not had sex in the 12 months before the survey. They were thus practicing "secondary abstinence." The boys who had the highest level of exposure to Straight Talk were three times more likely to report practicing secondary abstinence than were boys unexposed to Straight Talk.

Two keys to HIV prevention are condom use and knowledge about one's HIV status. Half of the sexually experienced girls and 41 percent of such boys reported having used condoms at their last intercourse. While two-thirds of the boys reported being responsible for using condoms, more than half the girls reported taking the initiative to use them. Exposure to Straight Talk was clearly associated with having been tested for HIV and with knowing whether a partner had been tested. Among respondents who had been exposed to all three Straight Talk products, boys were 4 times as likely and girls were 3.5 times as likely as unexposed adolescents to have been tested for HIV.

For girls, exposure to Straight Talk materials is associated with greater self-assuredness, greater sense of gender equity, and the likelihood of having a boyfriend but not having a sexual relationship. Among boys, Straight Talk exposure is associated with lower likelihood of sexual activity, greater likelihood of resuming abstinence, and a greater likelihood of taking relationships with girls seriously.

Among both boys and girls, exposure to Straight Talk activities is associated with greater sexual and reproductive health knowledge and more communication with parents about sexual and reproductive health issues. Both girls and boys exposed to all three Straight Talk products were about four times as likely as unexposed adolescents to have talked with parents about reproductive health matters. The research suggests, however, that many parents need help to feel comfortable engaging in such conversations. Parents were asked about talking with their children about "sexuality, growing up, relationships." Although 45 percent said they preferred that their child speak to a parent, 55 percent said they preferred that their child go elsewhere for such information.

"Straight Talk may have protected many boys and girls from HIV by helping them to stop sexual activity or to delay starting it all together," concluded Tobey Nelson Sapiano, of Horizons/ICRW, another principal investigator on the study.


Adamchak, Susan E., Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey Nelson Sapiano, Ann Akia-Fiedler, Richard Kibombo, and Milka Juma. 2008. "Helping youth prevent HIV: An evaluation of the Straight Talk program in Uganda," Horizons Research Summary. Washington, DC: Population Council.

Adamchak, Susan E., Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey Nelson Sapiano, Ann Akia-Fiedler, Richard Kibombo, and Milka Juma. 2007. "The Straight Talk campaign in Uganda: The impact of mass media initiatives." Horizons Final Report. Washington, DC: Population Council.


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Title Annotation:HIV AND AIDS
Publication:Population Briefs
Date:Aug 1, 2008
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