HCT Concept Test and Logo Pre-test Report

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					HCT Concept Test and Logo Pre-test Report


                  HCP


               June 2008




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Table of Contents

Table of Contents ...................................................................................................................... 2
Background ............................................................................................................................... 3
Objectives for the Concept test ................................................................................................ 3
Methodology ............................................................................................................................. 3
  Focus Group Discussion Procedure ..................................................................................... 4
  Selection and screening of FGD respondents ...................................................................... 5
Findings ..................................................................................................................................... 6
  Respondents understanding of HIV Couple Counseling and Testing ............................... 6
  Logo 1 .................................................................................................................................. 10
  Logo 2 .................................................................................................................................. 12
  Logo 3 .................................................................................................................................. 14
  Selection of the best logo .................................................................................................... 15
  Concepts Testing ................................................................................................................. 18
  Concept 1............................................................................................................................. 18
  Concept 2............................................................................................................................. 20
  Concept 3............................................................................................................................. 22
  Concept 4............................................................................................................................. 23
  Selection of the best Concept ............................................................................................. 25
Appendix ................................................................................................................................. 27
  FGD Discussion Questions: ................................................................................................ 27
  Group Discussion Questions .............................................................................................. 27
  Questions about each of the logos...................................................................................... 27
  FGD Discussion Questions for each of the developed concepts: ..................................... 27




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Background


Health Communication Partnership is in the process of designing materials for its
upcoming couples HIV counseling and testing communication campaign. In order to
design the materials HCP had Lowe Scanad develop three concepts from which one was
expected to be chosen to guide the develpment of the campaign materials.


Lowe Scanda was also contracted to design a logo for the campaign; there logos were
designed and from these one was expected to be chosen by the campaign target audience.


HCP in the month of June conducted a logo pre-test and concept test exercise in the
districts of Kampala, Arua, Mbarara and Soroti among married couples.


Objectives for the Concept test

The objectives of the concept test exercise where:
   1. To establish the campaign logo
   2. To establish the overarching concept that is most convincing to the audiences
   3. Find out if the audience understand the developed campaign logo and concepts
   4. To establish whether the audience relate to the campaign concepts
   5. To establish whether there is anything that is offensive/ confusing in the concepts
       or the materials
   6. To establish if the materials is attractive to the audience




Methodology

Eight Focus Group Discussions (FGDs) where conducted in Kampala, Arua, Mbarara and
Soroti Districts with adults aged between 20 – 49 years. The FGD respondents were
mobilized by local mobilizers with the help of AIC staff in each of the districts.




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The respondents were divided into 2 FGDs as shown below;
     Group 1; Couples living HIV/ Discordant couples who have tested for the their
       HIV status
     Group 2; Couples who are unaware of their HIV status


Each FGD comprised of 10 – 12 respondents or 5 – 6 couples


The FGDs were conducted by the male and female Research; these were be recruited
from the pool normally used by HCP and were all graduates. The research assistants
under went a training where they were oriented to the campaign, the logos, concepts and
tools to be used in the concept test exercise. The research assistants were also trained on
how to write the concept test reports.




Focus Group Discussion Procedure

The FGDs were conducted as shown in the table below


Step    Activity                            Purpose and Description

1       Screening of respondents            Done to ensure that the right audiences
                                            participated in the discussion

2       Introductions and explanations This was done to ensure that the respondents
        to the respondents about the understood their roles and the purpose of the
        activity                            focus group discussions

3       Discussion about CHCT               Group discussion guided by the RA

4       Test Logos                          The RAs showed the respondents one logo at
                                            a time followed by questions about each.
                                            After having a discussion about each of the
                                            logos the respondents were asked to identify




                                                                                         4
                                              their best choice and also give reasons for
                                              their choice

5         Test Concept 1                      Group discussion about the concept guided by
                                              the RA

6         Test Concept 2                      Group discussion about the concept guided by
                                              the RA

10        Test Concept 3                      Group discussion about the concept guided by
                                              the RA

11        Selection of the best concept       After discussing each of the developed
                                              concepts the FGD respondents were then
                                              asked to choose the best concept among the 3.
                                              The respondents were also required to give
                                              reasons for their choices




Selection and screening of FGD respondents

The identified mobilizer for the FGD respodents invited participants of the following
characteristics.
        Living with HIV/AIDS and are aware of their status for the PLHA groups
        Unaware of their status for the non PLHA groups
        Literate in English
        Aged between 20 – 49 years
        Married
        Not a peer educator, health educator or local council official




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Findings

This section contains the findings of the HCT Logos’ pre-test and Concepts test conducted
in Arua, Soroti, Mbarara and Kampala Districts with HIV Positive and couples unaware of
their HIV status.



Respondents understanding of HIV Couple Counseling and Testing



Before pre-testing the logos and the concepts; the exercise also sought to establish the
respondents understanding of couple counseling and testing, it importance and the
reasons why couples avoid it.


According to the respondents in the 8 FGDs “HIV Couple counseling and Testing” means
couple going together as husband and wife to a health centre; gets counselled first and
then gets tested for HIV. In addition, they emphasized that CHCT is meant for people
who are in a meaningful relationship.



“I came with my husband and we tested after which we were counseled on how to avoid
re infecting each other” said a female HIV positive respondent




“... it is when two people who intend to be intimate or those who are already a couple
decide to go together to know their HIV status and they are usually taken through this
process by a counsellor who tells them mainly about the advantages of testing for HIV
and what to do in case the couple is found HIV positive and vice versa”, said a male
respondent from Mbarara.




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Why couples should test for HIV together

All the respondents said that couples should test for HIV together because it shows trust
for one another and helps avoid miss understandings especially if one of them is found
HIV positive.

They also said that it helps both of them to know their HIV status and be able to plan for
the family unlike when each of them goes alone.




“When each of you comes on their own, you may lie about your status e.g. When you are
found to be HIV positive and you tell your partner that you are negative”, said a male
PLHA from Kampala.




The respondents mentioned that testing for HIV together helps them get support from
their partners as well as counseling and treatment from health workers.




“It helps us especially when we are pregnant because it saves lives of our unborn children
and we are supported by our husbands “said a female PLHA from Kampala




“Planning for the future with your partner is very important more especially if you are

HIV positive. I do it with my wife daily unlike before”, said a male PLHA from Soroti.




“Its is important to test for HIV together because it removes anxiety and fear of telling

your partner alone that you are HIV positive since there is a counsellor to help you

through counselling” said a male respondent from Soroti.



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“... It is good for couples who want to have healthy kids in future”, said a female PLHA
from Mbarara.



Reasons which prevent couples from testing for HIV together

It was mentioned in all the FGDs couples don’t want to test for HIV together because one
of them might be having many partners and fear to found HIV positive.




“It’s very difficult to convince such a person to go for testing ” said a female respondent
from Kampala.




Respondents also said that some people get involved in relationships when they are
already infected and don’t want to go to test with their partners because they think
having HIV is a crime.




“For such men whenever you try to tell him to go and test, he tries to avoid the topic”
said a female PLHA from Kampala.




“Some men send their wives for testing as a way of finding out their status i.e. if she is
found negative then he also believes that he is negative.” , said a male PLHA from
Kampala.




The respondents in Arua and Mbarara mentioned that most people fear testing for HIV as
a couple for fear of being deserted and considered promiscuous when found positive. Such



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a case according to the respondents normally leads to domestic violence especially if it is
the woman who is found to be Positive.



“For us, we are ever in the garden or markets while our husbands are in the bars drinking
with other women. They only come home drunk and at times fight just can’t tell him that
I went for HIV testing more so when I am positive. He will just beat me and send me
back home”, said a female respondent from Soroti.


“I had gone to visit and when I came back, my wife told me she had tested positive. I
could not believe it and I even refused to go testing because I feared to be told that am
going to die. After counselling, I tested and know we are in TASO”, said a male PLHA
from Soroti.


“For me I don’t fear going fro HIV testing, but if I go and found to be positive, I will
know it is my husband who has infected me because he is ever in the bar”, said a female
respondent from Soroti.


“I would what to first test a lone and know my status alone before I disclose it to my
wife”, said a male respondent from Arua.




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Logo 1




Description


According to majority of participants in the eight FGDs, got an impression of two people
pulling each other in letter O and the respondents also mentioned that the two people
appear in form of the heart which means love. Others however mentioned that they saw
two heads on top of one heart which to them means one couple.


According to the respondents in Arua and Soroti the bigger head belongs to the man
while the smaller one belongs to the woman.


The respondents from Kampala mentioned that by the two people holding their hands
together meant that their relationship is strong and that one of them seems to be HIV
positive and the other HIV negative.


” If those two go together for testing I don’t think they can quarrel if the results are not
good.” said a female respondent from the HIV positives group.

Some respondents in Arua mentioned that they saw a face with two eyes, one bigger than
the other, a nose attached to the mouth while some in the group of respondents unaware
of their HIV status mentioned that they saw two people who were protesting about
something, one is thin and the other is fatter.




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Call to Action


When the participants were asked about what the action the logo is calling for, majority
said that it is telling them to go for HIV testing together as a couple.
However some respondents in Kampala wondered what logo was asking them to know
together.


” But what they should get to know is not clear” said a male respondent from Kampala.


Suggestions for improvement


Respondents from Mbarara and Soroti pointed out that it is not clear whether the two
people in letter O are of different sex and therefore they suggested that the logo should be
improved upon to show the man and woman clearly.


Ever seen the Logo


Ten respondents from Mbarara mentioned that they had seen a similar logo at local NGO
called ICOBI (Integrated Community Based Initiative)


Two respondents from Kampala mentioned that they had ever seen the logo on a
magazine published by AFFORD with messages about HIV opportunistic infections.




                                                                                         11
Logo 2




Description
Majority of the respondents in the 8 FGDs mentioned that they saw two people holding
their hands together which shows that one is telling the other that they should go and
test for HIV together according to the words besides the hands.

Two respondents from Kampala also mentioned that they saw two hands stuck on one
thing.

Some respondents in Arua and Kampala mentioned that they saw as if the arms were
wrestling since they looked to be tightly held together.


“It looks like they are arm wrestling” said a female respondent from Kampala.

Respondents in Arua also mentioned that they saw two hands being shaken may be after
testing which shows the level of strength and reliance because one hand is leaning on
each other


Call to Action


According to the majority, the logo is asking them to join hands as couples and go for HIV
testing and counselling together.


“...It is also asking all of us to raise hands and fight against HIV infection and I think this
can be done by using protective measures like condoms and abstaining especially for
young couples who have not yet married” said a male participant from Mbarara.




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The respondents in Arua also mentioned that the logo was encouraging them to test in
order to know their status and build confidence between each other. In addition to that
they said that the logo was asking them to be strong irrespective of how the results will
be after testing as a couple.


“It is just like the saying together we stand” said a male HIV positive respondent from
Kampala


“I can’t tell which hand belongs to a female or male but at least I can tell that they are
calling upon others to go and test according to the words” said a respondent from Soroti.


Ever seen the Logo


Two respondents from Mbarara said that they had ever seen the logo on cooking oil
Jericans from Mukwano industries while one female participant said she had seen it at
organisations that implement palliative care activities.


Three respondents in Kampala said that they had ever seen the logo on ACTION AID
posters while 6 had ever seen it on USAID cars, 4 said that PSI gives out posters with the
logo with messages asking people to go for HIV testing and counselling




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Logo 3




Description
The respondent mentioned that they saw a woman and a man who have shown interest
and love in knowing their status holding hands together. In addition to that, they
mentioned that they saw a man and a woman in love supporting and advising each other
to go for HIV testing in order to build a strong love.


Call to Action


The FGDs’ respondents interpreted the logo to be asking them to encourage each other to
go for HIV testing together in order to know their status together so that they can grow
to love and trust each other.


Some respondents in the Kampala FGD for those unaware of their HIV status mentioned
that the logo shows two people at a Zebra Crossing.


The HIV positive respondents in Arua and Soroti mentioned that the logo was
encouraging them to love trust and support each in case one partner is HIV negative and
the other is not.




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  “When I was pregnant, I came with my husband, we tested for HIV together, now we
  know our status and we are happy.” said a female HIV positive respondent from Kampala.




  “A couple that loves one another should agree and go together for HIV counseling and
  testing because where there is love there is acceptance”, said a male HIV positive
  respondent from Kampala

  Suggestions for improvement


  “...But not Go together know together, Know what?” as asked a male respondent in
  Mbarara.

  Selection of the best logo

  The FGD respondents were asked to choose their best logo among the three. Below is
  table showing the choices of the FGD respondents.


District                FGD                       Choice of Logo           Choice of Color

Kampala                 HIV Positives             Logo 3                   Red

                        Unaware of Status         Logo 3                   Red

Reasons for the Logo:
Logo 3 because the way they are holding hands they appear to be going somewhere and also
shows their decision to go and test for HIV together has already been made .

“I like it because it has a love symbol and where there is love between 2 people decision
making is easy” said a male HIV positive respondent.

The respondents also liked logo 3 most because the picture is easier to understand compared
to 1 and 2.

However they suggested that the phrase “Test for HIV together” be added.




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Reasons for the Color:
Red because it is bright and attractive, it can easily draw people’s attention hence spreading
the message faster.

“Red is associated with danger and can therefore be used to warn people that HIV is a killer
disease and they should avoid it.” Said a female HIV positive respondent

“The color of the blood they test is red, so if red is a used person can know that he/she is
being told to go for blood testing”, said a male HIV positive respondent

Arua                     HIV Positives               Logo 3                 Red

                         Unaware of Status           Logo 3                 Red

Reasons for the Logo:
All the two FGDS selected logo 3 as being their best logo because according to them the two
people in the logo have reached a common understanding, confidence, agreement to go for
HIV testing.
“This also gives us an encouragement and clear reason to go and test for HIV because they
look peaceful and in love” said a male respondent who is unaware of his status.
Reasons for the Color:
All they respondents chose red color for the logo because they felt red was attractive and
also since the logo deals with HIV testing ,red could show how deadly and serious the virus
is since red is blood.

Soroti                   HIV Positives               Logo 3                 Red

                         Unaware of Status           Logo 3                 Orange

Reasons for the Logo: was easy to understand compared to the rest
Reasons for the Color:
Orange: It is not connected to any political party
Red: Bright and beautiful. Show dangers so people will take note of the messages and act as
advised

Mbarara                  HIV Positives               Log 3                  Blue




                                                                                          16
                         Unaware of Status         Logo 3                Blue

Reasons for the Logo:
Portrays that couple are in love and are faithful to one another
Reasons for the Color:
Would make the logo look beautiful and the blue colour symbolises love among the married
couples.

Conclusion:
From the responses in all the 8 groups logo 3 was the most preferred among the 3; while Red
was the most preferred color




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Concepts Testing

Concept 1




Observation/Interpretation
All respondents agreed that they saw a couple proceeding to an HIV testing and
counselling centre. They observed that the couple looked tense and fearful as they
approached the health centre. The respondents also mentioned that the couple comes
back from the health centre happy and seemingly successful.


“These people seem to have doubts about their status and that is why they were walking
apart and have hands in the pocket as for the man” an HIV positive male respondent from
Arua mentioned.


To the respondents the man looked more relaxed compared to the woman.


“…his hands are in the pockets which meant that he was more relaxed compared to the
lady who had her hands clasped at the back”, mentioned a female respondent from Arua.


“It’s like the man said “if you love me, we go together for the test” a respondent who was
unaware of her status said.




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Respondents also mentioned that the couple was brought together by the testing
evidenced in their closeness to each other.


“The testing has cleared their doubts”, said a male respondent from Soroti.


Three respondents from Arua however said that it seemed that the news was not so good
on the woman’s side and the man was consoling her as they went home.


Call to Action


All the respondents mentioned that the poster was asking them to go for HIV testing and
counselling together so that they may clear their doubt about each others HIV status.


The respondents in Arua added that the poster was asking them to get counselling before
testing.


“Counselling is important and it can clear misconceptions as about the disease and
prepare the hearts for the results,” a HIV positive female respondent from Arua said.


The respondents in all the 8 FGDs also mentioned that the poster was asking them to
accept their results irrespective of their nature. According to them it was difficult to tell
whether the couple had tested positive or negative.


Likes/Dislikes
The respondents in Arua mentioned that they liked the way the couple came out of the
health centre; their closeness according to the respondents showed that going for HIV
testing and counselling together make the relationship better by bring the couple closer.




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“Even through it was hard to go and test together. These two people to go and test
together, they overcame it and went to the health centre and came out better” a female
respondent from Arua said.


The respondents from Arua, Soroti and Mbarara also mentioned that they liked the way
the couple in the concept came out of the health centre ready to help each other no
matter what the results were.


Respondents from Arua mentioned that they did not like the couple’s seeming hesitation
and fear to go and test in first picture which may discourage many couples from going to
test together because it presents HIV testing and counselling as a large mountain to climb
or difficult task.


“People who have not tested may fear if they realize that they have to go through that
fear and anxiety” a female respondent from Arua.



Concept 2




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Description and Interpretation
The respondents saw a couple that they described as being happy after testing together
for HIV. The respondents added that the couple had gotten to know their status and the
joy they had gives as assumption that they are HIV negative.


“It reminds me of when I tested with my girlfriend in high school and we were negative,
joy almost killed us”, said a male respondent from Kampala



Respondents emphasized that the couple is youthful and since they are HIV negative they
are happy that they can have a bright future as they support each other as seen in the
man supporting the girl who learns on him.


Call to Action


The respondents in the 8 groups mentioned that the poster was asking them to go and test
for HIV as a couple and get to know their status together. The respondents in Kampala
however added that the concept was asking every to test and know their HIV status
irrespective of their marital status.


They added that the poster was telling them to be smart or wise try going to test together
for HIV with their partners.


Likes and dislikes
However a respondent felt that the dress code of the lady in jeans was not they way many
dress in West Nile.




                                                                                       21
“That way of dressing is not acceptable according to the culture of the people in this
region. They will not differentiate between the man and the woman” an HIV positive
male respondent said.


However the respondents said that they did not like that the couple in question was
young and could not speak to the different categories of people.


“An older couple brings out the message better in terms of being “tested” for HIV
together and in life’s problems having stayed together for a long time,” a respondent in
the HIV positive category from said.



Concept 3




Description and interpretation


This concept was not easily understood by majority of the respondents in the; many
respondents found it complex to understand. However the respondents in Soroti seemed
to understand they mentioned that the man and the woman in the middle were a couple
who could have slept with any of the people they are connected and that the only way of
knowing their HIV status was for them to go for blood tests.


The many people on the poster confused many of the respondents.




                                                                                     22
Call to action
The respondents said that the concept was asking them to not to sleep with any one
without going to test because one person can spread HIV to the whole community.

They also said that the concept was asking them not to have many sexual partners even if
they are HIV positive or not.




Concept 4




Description and Interpretation


The respondents in all the groups mentioned that said that they saw a happy couple who
were coming from the health centre in the background after testing for HIV. They also
that the couple was smiling and in love judged by the man is holding the lady


The respondents also mentioned that the couple in the picture was happy with their
results as shown with the smiles on their faces. To the respondents the couple must have
tested negative.


“There seems to be a sense of achievement in the picture and poster as a whole,” an HIV
positive male respondent from Arua commented.




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“The people in the back ground seem to be in a counseling session waiting to be tested”
said a male HIV positive respondent from Kampala.

The respondents further mentioned that the poster was showing them the benefits of
testing together; building trust and love between couples as shown by the one in picture.


Call to Action
The respondents mentioned that the concept was asking them to go and test for HIV with
their partners.

“Even the good looking ones can be HIV positive, they should also go and test.”, said a
male respondent from Soroti.




“The poster is also saying that we should test for HIV and know the truth so that we can
be free and enjoy our lives with our wives” a female HIV negative respondent said.


The respondents also said that the poster was asking them to have one sexual partner and
remain faithful to them.


Likes


The respondents mentioned that they liked the couple in the poster because they seemed
to be the ideal couple. They also mentioned that they liked this couple compared to the
couple that was in concept 2 because these seemed older and would appeal to people
more.


Respondents also liked phrase “we did it” which meant that the couple had done
something heroic in going for HIV testing and counselling together.




                                                                                       24
  “It seems like the couple is saying that “we did it” so you also can do it” to us” a
  respondent who was unaware of his status said.


  However 2 respondents from Arua who did not know their status felt that the concept
  may mislead many to think that after testing, the results will always lead people to be
  happy like those.


  “How you react after ’doing it” will always depend on the results. People do not fear
  testing together but they fear the consequences they may have to face if the result turn
  out in a way that they are HIV positive” they argued.




  Selection of the best Concept

  The FGD respondents were asked to choose their best concepts among the four. Below is
  table showing the choices of the FGD respondents.


District              FGD                                 Choice of Concept

Kampala               HIV Positives                       Concept 1 &

                      Unaware of Status                   Concept 1 & 4

Arua                  HIV Positives                       Concept 1

                      Unaware of Status                   Concept 1

Soroti                HIV Positives                       Concept 1

                      Unaware of Status                   Concept 1

Mbarara               HIV Positives                       Concept 1

                      Unaware of Status                   Concept 1


  As shown in the table concept 1 was the most preferred concept among the 4 The
  respondents who preferred concept 1 did so because it was easily understood,




                                                                                       25
communicated the greatest benefits of testing for HIV and depicts a really life picture
compared to the other concepts.


The concept according to the respondents in Mbarara, Soroti and Kampala best
communicates to couples by encouraging them to go for HIV counselling and testing
together irrespective of how the results may turn out.




                                                                                    26
Appendix

FGD Discussion Questions:

Group Discussion Questions

   1. What do you understand by the phrase Couple Counseling and Testing?
   2. Why should couples test for HIV together?
   3. What are some of the reasons that prevent couples from testing for HIV together?


Questions about each of the logos

   1. Please tell me what you see in this picture. What does it look like to you?
   2. What is this logo asking you to do?
   3. Have you seen this logo before? If yes where have you seen it?


Selection of the best logo
This question will be asked in order to identify which logo is preferred by the
respondents


   1. Of the logos which one do you like most and why?



FGD Discussion Questions for each of the developed concepts:

Questions for each of the Concepts
   1. Please tell me what you see in this picture. What does it look like to you?
   2. What about the people in the picture? What do you think they are doing?
   3. Do you think this poster is asking you to do anything in particular? What
   4. Do the people in the picture remind you of your friends, or are these people
       different from your friends? Why?
   5. Are there any words or phrases that you do not understand? What are they?
   6. Now, in your own words, what do you think this poster is saying?




                                                                                    27
   7. Is there anything about the picture or the writing that might offend or confuse
       some people? What?
   8. Is there anything on this poster that you really like or dislike? What?




Selection of concepts
These questions will be asked in order to identify which concept is preferred by the
respondents


   1. Which of these three concepts most captures your attention?
   2. Which of these three concepts most clearly communicates that it wants you to go
       for couples HIV counselling and testing?
   3. Which of these three concepts do you relate to the most?
   4. Which of these concepts communicates the strongest benefit of testing for HIV
       together with a couple?
   5. Which of these three concepts do you think would most likely convince couples
       to go for HIV counselling and testing together?


Matrix ranking
This will be filled in for each concept by the Research Assistants after the group
discussion

Matrix Rankings                                Low                              High

                                               0         1       2       3      4

Draws attention of the audience

Message is clear; understandable & relevant

Relates to the target audience

Believable to the target audience




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