摘要：Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide. We describe and report the results of a social marketing campaign that targeted an estimated 7000 heroin users in Sacramento, California. KEY FINDINGS ▪ A 21-month multicomponent HIV prevention social marketing campaign succeeded in reaching a majority of the estimated 7000 heroin users in Sacramento, California. ▪ Exposure to HIV prevention messages with small posters and a newsletter significantly reduced the community-wide prevalence of HIV-related injection risk behavior. ▪ Social marketing may be a cost-effective strategy for controlling the spread of HIV among injection drug users. The 4 components of the campaign included what has been variously called convenience advertising or “narrowcasting,” which involved the placement of small posters with HIV prevention messages in venues frequented by injection drug users (IDU). The San Francisco–based social marketing firm Better World Advertising designed and produced the posters. The venues included public restrooms, donut shops, cash-checking services, motels, and convenience stores. Outreach workers employed by Harm Reduction Services, a community-based organization, identified the venues in the course of ethnographic mapping of injection drug use in Sacramento. Seven different posters were placed at approximately 50 locations over a period of 21 months before the evaluation. The second component of the campaign involved distributing User News , a newsletter providing HIV prevention information and other news of interest to Sacramento's drug-injecting community. The quarterly newsletter was created by the Harm Reduction Services outreach team in collaboration with Better World Advertising. Outreach workers distributed an estimated 4000 copies of 6 issues of the newsletter in the same venues identified during ethnographic mapping. The third component involved the late night broadcast of User Friendly TV , a television program for IDUs shown on a public access channel. The 50-minute program, produced by Emmy award–winning producer Joyce Mitchell, reported on risk factors for HIV/AIDS, flesh-eating bacteria, vein care, and syringe exchange. Twenty-five episodes of the show were each shown twice during the campaign. The fourth and final component involved distributing giveaways, including an HIV prevention booklet in cartoon format and a “stress grip” emblazoned with 5 prioritized prevention messages that were also disseminated via the other components. Outreach workers distributed 4000 copies of the booklet and the stress grip as part of the campaign. Better World Advertising produced the giveaways. Figure 1 illustrates aspects of the campaign's 4 components. Open in a separate window Open in a separate window Open in a separate window Open in a separate window Open in a separate window FIGURE 1 The social marketing campaign featured (a) posters, (b) a newsletter, (c) a television show, (d) stress grips, and (e) a cartoon from a prevention booklet: Community Mobilization Project, Sacramento, California, 1999–2000.
