Engaging Families in the Choice of Social Marketing Strategies for Male Circumcision Services in Johannesburg, South Africa

In: Social marketing quarterly: SMQ ; journal of the AED, Volume 16, Issue 3, p. 60-76

Abstract

Male circumcision (MC) prevents HIV acquisition in males, leading to calls for extensive implementation in sub-Saharan Africa. The widespread adoption of male circumcision will require social marketing targeted at various families and family members. The objective of this article is to demonstrate the utility of conjoint analysis in the choice of social marketing strategies tailored to different populations to promote male circumcision in Johannesburg, South Africa. Seven social marketing strategies for MC were identified through open-ended interviews ( n = 25). Preferences were assessed using conjoint analysis, implemented in a cross-sectional survey of randomly selected households. An oversampling strategy ensured balance between Blacks (34%), Coloreds (mixed-race; 32%), and Whites (34%). Respondents randomly received a block of 4 conjoint analysis tasks comparing 2 mutually exclusive and exhaustive subsets of the 7 strategies. Preferences were then evaluated using logistic regression stratified by ethnicity and family member. Whereas all strategies were attractive, television marketing, endorsement by church/school leaders, and a countrywide program were most preferred ( p < .0001). Stratified analyses identified heterogeneity, e.g., only Coloreds valued radio ( p < .0001) and a lasting presence in the community ( p < .0001). Within families, mothers and sons were most concordant for Blacks ( p < .05) and Coloreds ( p < .01), but fathers were most concordant with sons among Whites ( p <.05). Conjoint analysis provides valuable insight into preferences and can be used in the development of social marketing, especially when aimed at promoting behavioral change.