The threat that HIV/AIDS poses to sub-Saharan Africa is staggering. The region accounts for ∼73% of the world’s 40 million HIV cases (UNAIDS, 2002), with <30 000 of its 28.5 million infected having access to antiretroviral drugs. The disease is the leading cause of death in the region, projected to claim 68 million lives between 2000 and 2020.
With no vaccine or cure for HIV/AIDS, there have been calls for improvements in health communication, education and prevention (Livingston, 1993; Ratzan, 2000; World Bank, 2000; United Nations, 2001). Over the past two decades, HIV/AIDS public health campaigns have become common around the world, with research focusing primarily on the content and effects of public service announcements (Freimuth et al., 1990; DeJong and Winsten, 1992; Johnson et al., 1997; DeJong et al., 2001). In the developed world, the television medium has been found to be a much more effective means for HIV prevention than ‘small media’ such as posters (Ross and Scott, 1993).
Research in this area, however, leaves two important questions unanswered. First, what message frames are used in small media such as posters, pamphlets and flyers? Second, what are the social determinants of message frames in such small media?
Answering the first question is critical in Africa, where small-media campaigns are incredibly important (Okigbo et al., 2002; Peltzer and Cherian, 2002; Tomaselli et al., 2002). Because of low literacy rates and low levels of infrastructure and technological development in African countries (Ibelema et al., 2004), small media such as posters, pamphlets and flyers are widely used. The benefits that such small media have over large media include their being more strongly rooted in African cultures, having longer periods of effectiveness (i.e. longer ‘shelf life’), and having effects that are more independent of literacy and education levels (Tomaselli et al., 2002). Research supports the effectiveness of small-media campaigns in different developing countries. For example, instructional flyers were the most effective media input when it came to influencing understanding and use of oral re-hydration therapy in Gambia (Rice and Foote, 2001), and posters were the most effective media input in a rat control promotional project in Bangladesh (Adhikarya, 2001). Despite the grave consequences of AIDS in Africa and the great potential that posters have for influencing public health change, the emphasis of related HIV/AIDS research has been on large media, not small media. In fact, no previous studies could be located that examine message frames in HIV/AIDS posters.