{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:59:37Z","timestamp":1791385177188,"version":"4.3.3"},"reference-count":37,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Unitaid","award":["Grant 1317919 (to MTV Staying Alive Foundation)"],"award-info":[{"award-number":["Grant 1317919 (to MTV Staying Alive Foundation)"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2022,3,2]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Innovative HIV technologies can help to reduce HIV incidence, yet uptake of such tools is relatively low among young people. To create awareness and demand among adolescents and young adults, a new campaign of the pan-African MTV Shuga series (\u2018Down South 2\u2019; DS2), featured storylines and messages about HIV self-testing (HIVST) and pre-exposure prophylaxis (PrEP) through television, radio and accompanying multimedia activities in 2019\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a mixed-methods evaluation of the new MTV Shuga series among 15\u201324 years old in Eastern Cape, South Africa, in 2020. Quantitative and qualitative methods were used to investigate complementary evaluations questions, namely, whether and how the DS2 campaign works. A web-based survey, promoted via social media platforms of schools, universities and communities, assessed exposure to MTV Shuga and knowledge of HIV status; secondary outcomes included awareness and uptake of HIVST and PrEP. We used multivariable logistic regression to estimate associations between exposure to DS2 and each outcome, adjusting for sociodemographic factors, media assets and exposure to other media campaigns. An embedded qualitative evaluation explored mechanisms of DS2\u2019s impact through deductive and inductive thematic analysis of in-depth individual and group interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3431 online survey participants, 43% had engaged with MTV Shuga and 24% with DS2 specifically. Knowledge of HIV status was higher among those exposed to DS2 (71%) vs those who were not (39%; adjusted OR=2.26 (95% CI 1.78 to 2.87)). Exposure was also associated with increased awareness of HIVST (60% vs 28%; aOR=1.99 (1.61 to 2.47)) and use of HIVST (29% vs 10%; aOR=2.49 (1.95 to 3.19)). One-third of respondents were aware of PrEP, with higher proportions among those exposed versus non-exposed to DS2 (52% vs 27%; aOR=1.90 (1.53 to 2.35)). Qualitative insights identified mechanisms by which DS2 increased awareness, confidence and motivation to use HIVST and PrEP, but had less influence on service access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found evidence consistent with a positive causal impact of the MTV Shuga DS2 campaign on HIV prevention outcomes among young people in a high-prevalence setting. As diverse testing and PrEP technologies become accessible, an immersive edutainment campaign can help to expand HIV prevention choices and close age and gender gaps in HIV testing and prevention goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2021-007641","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T11:44:21Z","timestamp":1648813461000},"page":"e007641","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Effects of a multimedia campaign on HIV self-testing and PrEP outcomes among young people in South Africa: a mixed-methods impact evaluation of \u2018MTV Shuga Down South\u2019"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-6588","authenticated-orcid":false,"given":"Isolde","family":"Birdthistle","sequence":"first","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mulwa","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Sarrassat","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venetia","family":"Baker","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Khanyile","sequence":"additional","affiliation":[{"name":"AIDS Risk Management, Epicentre Health Research, Hillcrest, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"AIDS Risk Management, Epicentre Health Research, Hillcrest, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherie","family":"Cawood","sequence":"additional","affiliation":[{"name":"AIDS Risk Management, Epicentre Health Research, Hillcrest, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Cousens","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"2025073014440821000_7.4.e007641.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004418"},{"key":"2025073014440821000_7.4.e007641.2","unstructured":"UNAIDS . Knowledge is power: know your status, know your viral load 2018."},{"key":"2025073014440821000_7.4.e007641.3","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1056\/NEJMp1801934","article-title":"HIV Population Surveys - Bringing Precision to the Global Response","volume":"378","author":"Justman","year":"2018","journal-title":"N Engl J Med"},{"key":"2025073014440821000_7.4.e007641.4","unstructured":"UNAIDS . Global AIDS strategy 2021-2026: end inequalities. End AIDS 2021."},{"key":"2025073014440821000_7.4.e007641.5","doi-asserted-by":"crossref","first-page":"e284","DOI":"10.1016\/S2352-3018(20)30315-5","article-title":"Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data","volume":"8","author":"Gigu\u00e8re","year":"2021","journal-title":"Lancet HIV"},{"key":"2025073014440821000_7.4.e007641.6","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6701a6"},{"key":"2025073014440821000_7.4.e007641.7","doi-asserted-by":"crossref","first-page":"S191","DOI":"10.1097\/QAD.0000000000001539","article-title":"Adolescents, young people, and the 90-90-90 goals: a call to improve HIV testing and linkage to treatment","volume":"31 Suppl 3","author":"Wong","year":"2017","journal-title":"AIDS"},{"key":"2025073014440821000_7.4.e007641.8","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25256","article-title":"To thine own test be true: HIV self-testing and the global reach for the undiagnosed","volume":"22 Suppl 1","author":"Wong","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2025073014440821000_7.4.e007641.9","doi-asserted-by":"crossref","first-page":"S203","DOI":"10.1097\/QAD.0000000000001516","article-title":"'I will choose when to test, where I want to test': investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe","volume":"31 Suppl 3","author":"Indravudh","year":"2017","journal-title":"AIDS"},{"key":"2025073014440821000_7.4.e007641.10","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1111\/tmi.13456","article-title":"Willingness to use HIV Self-Test kits and willingness to pay among urban antenatal clients in Cote d'Ivoire and Tanzania: a cross-sectional study","volume":"25","author":"Ashburn","year":"2020","journal-title":"Trop Med Int Health"},{"key":"2025073014440821000_7.4.e007641.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-10072-1","article-title":"Young people's preferences for HIV self-testing services in Nigeria: a qualitative analysis","volume":"21","author":"Obiezu-Umeh","year":"2021","journal-title":"BMC Public Health"},{"key":"2025073014440821000_7.4.e007641.12","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.medmal.2020.07.007","article-title":"Hiv self-testing in adolescents living in sub-Saharan Africa","volume":"50","author":"Tonen-Wolyec","year":"2020","journal-title":"Med Mal Infect"},{"key":"2025073014440821000_7.4.e007641.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003670","article-title":"Prep uptake, persistence, adherence, and effect of retrospective drug level feedback on PreP adherence among young women in southern Africa: results from HPTN 082, a randomized controlled trial","volume":"18","author":"Celum","year":"2021","journal-title":"PLoS Med"},{"key":"2025073014440821000_7.4.e007641.14","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2989\/16085906.2020.1743726","article-title":"\"I'm doing this test so I can benefit from PrEP\": exploring HIV testing barriers\/facilitators and implementation of pre-exposure prophylaxis among South African adolescents","volume":"19","author":"Yoshioka","year":"2020","journal-title":"Afr J AIDS Res"},{"key":"2025073014440821000_7.4.e007641.15","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s10508-020-01880-y","article-title":"Exploring perceived barriers and facilitators of PreP uptake among young people in Uganda, Zimbabwe, and South Africa","volume":"50","author":"Muhumuza","year":"2021","journal-title":"Arch Sex Behav"},{"key":"2025073014440821000_7.4.e007641.16","unstructured":"Segal KF , Riaz L; , Rodrigues F; . The evolution of oral PreP access: tracking trends in global oral PreP use over time. HIV research for prevention 2021. Virtual: International AIDS Society, 2021."},{"key":"2025073014440821000_7.4.e007641.17","unstructured":"MTV staying alive Foundation, 2021. Available: https:\/\/www.mtvstayingalive.org\/campaign\/shuga\/"},{"key":"2025073014440821000_7.4.e007641.18","unstructured":"Banerjee A LFE , Orozco V . The Entertaining way to behavioral change. 1st TCD\/LSE\/ CEPR workshop in development economics. Dublin, 2017."},{"key":"2025073014440821000_7.4.e007641.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0209969","article-title":"The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: a meta-analysis, 1985-2017","volume":"14","author":"Orozco-Olvera","year":"2019","journal-title":"PLoS One"},{"key":"2025073014440821000_7.4.e007641.20","doi-asserted-by":"crossref","unstructured":"Shahmanesh MM , Chimbindi N; , Zuma N; . \u2018MTV Shuga\u2019: Mass Media Communication, HSV2 and sexual health in adolescent girls and young women in rural South Africa STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI). Vancouver: Sexually Transmitted Infections, 2019.","DOI":"10.1136\/sextrans-2019-sti.496"},{"key":"2025073014440821000_7.4.e007641.21","unstructured":"Creswell JW PCV , Gutmann M . Hanson W Advanced mixed methods research designs. In: Teddlie ATC , ed. Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage, 2003: 209\u201340."},{"key":"2025073014440821000_7.4.e007641.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005019"},{"key":"2025073014440821000_7.4.e007641.23","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25249","article-title":"The Self-Testing Africa (StAR) initiative: accelerating global access and scale-up of HIV self-testing","volume":"22 Suppl 1","author":"Ingold","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2025073014440821000_7.4.e007641.24","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199901000-00005"},{"key":"2025073014440821000_7.4.e007641.25","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"2025073014440821000_7.4.e007641.26","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025073014440821000_7.4.e007641.27","doi-asserted-by":"crossref","unstructured":"Pawson R . The science of evaluation: a realist manifesto. London: SAGE, 2013.","DOI":"10.4135\/9781473913820"},{"key":"2025073014440821000_7.4.e007641.28","doi-asserted-by":"crossref","unstructured":"Pawson R , Tilley N . An introduction to scientific realist evaluation. Shadish ECWR. Sage Publications, Inc, 1997.","DOI":"10.4135\/9781483348896.n29"},{"key":"2025073014440821000_7.4.e007641.29","unstructured":"B A . Social learning theory. Englewood Cliffs, NJ: Prentice-Hall, 1977."},{"key":"2025073014440821000_7.4.e007641.30","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25167","article-title":"Power to participants: a call for person-centred HIV prevention services and research","volume":"21 Suppl 7","author":"Pantelic","year":"2018","journal-title":"J Int AIDS Soc"},{"key":"2025073014440821000_7.4.e007641.31","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-20-00229"},{"key":"2025073014440821000_7.4.e007641.32","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-3960-1"},{"key":"2025073014440821000_7.4.e007641.33","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1038\/pr.2016.28","article-title":"Seeking wider access to HIV testing for adolescents in sub-Saharan Africa","volume":"79","author":"Sam-Agudu","year":"2016","journal-title":"Pediatr Res"},{"key":"2025073014440821000_7.4.e007641.34","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-2620-6","article-title":"What are the characteristics of 'sexually ready' adolescents? Exploring the sexual readiness of youth in urban poor Accra","volume":"16","author":"Biney","year":"2016","journal-title":"BMC Public Health"},{"key":"2025073014440821000_7.4.e007641.35","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/10810730490271575","article-title":"Diffusion of innovations and HIV\/AIDS","volume":"9 Suppl 1","author":"Bertrand","year":"2004","journal-title":"J Health Commun"},{"key":"2025073014440821000_7.4.e007641.36","unstructured":"National Department of Health - NDoH SSA-SS, South African Medical Research Council - SAMRC, ICF . South Africa demographic and health survey 2016. Pretoria, South Africa, and Rockville, Maryland, USA, 2019."},{"key":"2025073014440821000_7.4.e007641.37","doi-asserted-by":"crossref","unstructured":"Matenda SNG , Rugbeer H . A study of young people\u2019s use of social media for social capital in Mthatha, Eastern Cape. Communitas 2020;25.","DOI":"10.18820\/24150525\/Comm.v25.10"}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2021-007641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T21:44:18Z","timestamp":1753911858000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2021-007641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,1]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjgh-2021-007641"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2021-007641","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.10.16.21264987","asserted-by":"object"}]},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}