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Uncovering the "Hidden Epidemic:"
Consumer Magazine Reporting on
HIV/AIDS and Other STDs
by
Kim Walsh-Childers, Ph.D.
Debbie Treise, Ph.D.
Alyse Gotthoffer
and
Lyn Ringer
Submitted to the Magazine Division for presentation at the AEJMC Conference in
Baltimore, MD, August 1998
The study on which this paper is based resulted from research commissioned by
the Henry J. Kaiser Family Foundation.
Kim Walsh-Childers, associate professor, 3044 Weimer Hall,
University of Florida, Gainesville, FL 32611 (o) 352-392-3924; (fax)
352-846-2673; (h) 352-472-5087; [log in to unmask]
Debbie Treise, associate professor, 2084 Weimer Hall, University
of Florida, Gainesville, FL 32611 (o) 352-392-9755; (fax)
352-846-3015; (h) 352-331-4176; [log in to unmask]
Alyse Gotthoffer, doctoral student, 2112 Weimer Hall, University
of Florida, Gainesville, FL 32611 (o) 352-392-0426; [log in to unmask]
Lyn Ringer, doctoral student, 2010 Weimer Hall, University of
Florida, Gainesville, FL 32611; (o) 352-392-4762; (h) 352-392-1206;
[log in to unmask]
Magazine coverage of STDs and HIV/AIDS, page
Uncovering the "Hidden Epidemic:"
Consumer Magazine Reporting on
HIV/AIDS and Other STDs
The paper describes the STD- and AIDS/HIV-related results of a content
analysis of 44 consumer magazines. There was significant variation in the extent
of coverage across the four magazine types analyzed. About 9 percent of all
sex-related items made some mention of STDs; about 14 percent mentioned HIV. The
women's and teen magazines were most likely to cover non-HIV STDs without
reference to specific diseases. In covering HIV/AIDS, the most common topic was
the sexual transmission of HIV.
Uncovering the "Hidden Epidemic:" Consumer Magazine Reporting on HIV/AIDS and
Other STDs
According to a 1997 report from the National Academy of Sciences' Institute of
Medicine, AIDS and other sexually transmitted diseases constitute an enormous
"hidden epidemic" in the United States. The report noted that some 12 million
new cases of STDs, including 3 million cases among teenagers, occur in the
United States each year, giving the United States the highest rates of curable
STDs in the industrialized world. In 1995, half of the top 10 most frequently
reported diseases in this country were STDs (Eng & Butler, 1997).
The IOM report also noted that the STD epidemic carries huge consequences, both
in terms of individual health and in financial costs. "The spectrum of health
consequences ranges from mild acute illness to serious long-term complications
such as cervical, liver, and other cancers and reproductive health problems"
(Eng & Butler, 1997, p. 10). In financial terms, the committee that produced the
IOM's report estimated the annual direct and indirect costs of the major STDs,
including HIV, at $17 billion (Eng & Butler, 1997).
The IOM panel concluded that two of the factors interfering with STD prevention
in the United States are "a reluctance to discuss sexual issues and the
resultant lack of awareness about STDs" and "the media's irresponsible treatment
of sex" (Donovan, 1997, pp. 1-2). The report argued that the mass media
currently are not helping health professionals to promote healthy sexual
behaviors but that they "can be extremely powerful allies in efforts to prevent
STDs by increasing knowledge and changing behavior" (Eng & Butler, 1997, p. 13).
This paper is intended to help us better judge how at least one type of mass
media - consumer magazines - may be contributing to public awareness and
understanding of STDs, including HIV, and thus what potential these magazines
have for helping to prevent STDs. The paper describes the STD- and
AIDS/HIV-related results of a content analysis of 50 consumer magazines.
The AID/HIV Epidemic in the United States
As of December 1996, there were 206,762 reported cases of adults and
adolescents living with AIDS among adults and adolescents and another 3,033
reported AIDS cases among children younger than 13; in addition, there were
75,274 reported cases of HIV infection among adults and adolescents and 1,390
reported cases of HIV infection among children (HIV/AIDS Surveillance Report,
1996). U.S. government health officials estimate that 40,000 to 80,000 Americans
become infected with HIV each year - an average of 110 to 220 every day. (Youth
& HIV/AIDS, 1996).
AIDS has become the sixth most common cause of death among 15 to 24 yearolds in
the United States (American Association for World Health, 1995). The number of
AIDS cases reported annually among U.S. adolescents has skyrocketed in the past
decade, from one case in 1981 to 588 cases in 1993, with 1,768 cumulative cases
of adolescent AIDS reported through June 1994 (Centers for Disease Control
[CDC], 1994). Perhaps more importantly, about 20 percent of all AIDS cases are
diagnosed in people 20-29 years old, and given the typical 10-year incubation
period for the disease, it is obvious that many of these people actually were
infected during their teen years (CDC, 1994). CDC figures also indicate that the
number of teens infected with HIV doubles every 14 months, and the rate of HIV
infection is increasing faster among 13- to 24-year-olds than in any other age
group. (CDC, 1993). According to a March 1996 special report by the Office of
National AIDS Policy, half of all new HIV infections occur among people younger
than 25, and 25% of new infections are among 13- to 21-year-olds. The report
notes that, at that rate, an average of two young people are infected every hour
of every day. Among teenagers, older teens, boys and minorities still are most
likely to be infected, but recent trends show that AIDS is spreading four times
faster among teenage girls than among teenage boys. By 1994, teen girls
accounted for 43 percent of all U.S. adolescent AIDS cases, more than tripling
the corresponding figure from 1987 (Youth & HIV/AIDS, 1996).
The Other Epidemic - non-HIV STDs
Although HIV/AIDS has attracted more public attention in the past decade -
probably not surprising given that it is fatal and incurable - other STDs are
far more prevalent. For instance, according to the CDC, each year there are
between 500,000 and 1 million new cases of human papilloma virus; though not
itself a fatal disease, HPV is linked to cervical cancer, which kills more than
4,500 women each year. Other incurable STDs include genital herpes
(200,000-500,000 cases annually) and sexually transmitted hepatitis B (53,000
cases annually) (Division of STD/HIV Prevention Annual Report, 1994).
Other STDs, including chlamydia (an estimated 4 million cases annually),
gonorrhea (800,000 cases annually), syphilis (101,000 cases annually), (Division
of STD/HIV Prevention Annual Report, 1995) trichomoniasis (3 million cases
annually) (Division of STD/HIV Prevention Annual Report, 1993) and pelvic
inflammatory diseases (1 million cases per year) (Donovan, 1997) can be cured.
However, because people infected with these diseases, especially women,
initially may have no obvious symptoms, these diseases often cause serious
health consequences, including infertility, ectopic pregnancies, stillbirth of
the fetuses of infected women and other major health problems for babies
infected in utero or during delivery (Donovan, 1997; Eng & Butler, 1997).
As noted earlier, STDs are costly not only in health terms but in financial
terms as well. The IOM panel estimated that the seven major non-HIV STDs -
chlamydia, gonorrhea, syphilis, chancroid, genital herpes, HPV, and hepatitis B
- cost the nation $10 billion annually in direct expenditures on medical
services and indirect costs of lost productivity. HIV infections and AIDS add
another $7 billion a year in economic consequences (Donovan, 1997; Eng & Butler,
1997).
The Unknown Epidemic
Despite the frequent occurrences and significant costs of STDs, research has
shown that most Americans know relatively little about STDs other than HIV. A
1995 Gallup Organization survey revealed that 26% of adults and 42% of teens
could not name an STD other than HIV/AIDS. Among the STDs that were named,
gonorrhea was the most common - mentioned by 51 percent of adults and 34 percent
of teens; 45 percent of adults and 20 percent of teens mentioned syphilis. Fewer
than a third (29 percent of adults, 23 percent of teens) named genital herpes,
and only 5 percent of adults and 8 percent of teens named HPV. Twelve percent of
adults and 3 percent of teens mentioned chlamydia, the fastest-spreading STD.
(ASHA, 1995).
The survey also showed that, while teens knew somewhat more facts about STDs
than did adults, knowledge was low among both groups. About 12 percent of teens,
compared to 4 percent of adults, accurately estimated the prevalence of non-HIV
STDs, which health experts believe infect about 20 percent of people in the
United States. More than half of the adults, 57 percent, compared to 45 percent
of teens, dramatically underestimated STD incidence as infecting one of every
100 people, or fewer. More than 80 percent of teens, compared to two-thirds of
adults, knew that some non-HIV STDs are incurable (ASHA, 1995).
In contrast, public awareness of and knowledge about HIV/AIDS appear to be
quite high. Researchers have found that, by 1991, awareness of AIDS among U.S.
adults was "virtually universal," (Brown, 1991, p. 668). Researchers also have
found that most Americans know that HIV is transmitted through sexual
intercourse, sharing needles and contaminated blood transfusions (Knox, 1991).
On the other hand, research has demonstrated convincingly that, particularly
among adolescents, knowledge of HIV/AIDS is not necessarily linked to
individuals' ability to assess accurately their risk of contracting HIV (Baldwin
& Baldwin, 1988; Edgar, Freimuth, & Hammond, 1988; McDermott, Hawkins, Moore, &
Cittadino, 1987). Nonetheless, it seems logical to argue that awareness and some
understanding of sexually transmitted diseases, including HIV, are necessary,
albeit not sufficient, for individual to take protective measures against these
diseases.
Mass Media as HIV/STD Information Sources
The Institute of Medicine Report argues that the mass media are not involved in
promoting healthy sexual behavior but adds that the media could be "extremely
powerful allies in efforts to prevent STDs by increasing knowledge and changing
behavior," (Eng & Butler, 1997, p. 13). While it certainly may be true that the
mass media, by and large, have not actively worked to increase public
understanding of STDs, several studies have demonstrated that mass media are
important sources of information on HIV/AIDS, STDs and other sexual health
topics. For instance, the Gallup Organization survey about STDs indicated that
28 percent of adults and 11 percent of teens said they had learned about STDs
first from books, magazines or television, making mass media the second most
important initial source of STD information, after schools. In addition,
one-fourth of the teens surveyed and more than two-thirds of the adults said
they books, magazines and TV are current sources of information about STDs
(ASHA, 1995). Weinsteim, Forsen and Atwood (1991) reported that 80 percent of
teens and young adults they surveyed reported learning about AIDS from
television; 77 percent had learned about AIDS from newspapers. Numerous other
researchers also have demonstrated that the mass media have played a crucial
role in informing the public about HIV/AIDS (Fennell, 1989, 1990; Helgerson &
Petersen, 1988; McDermott, 1987; Price, et al., 1985).
Other research illustrates that magazines may be important sources of
information on sexual health issues, including STDs. For instance, a 1997 survey
commissioned by the Henry J. Kaiser Family Foundation revealed that 75 percent
of adult men and women rated magazines an "important" source of information
about birth control, STDs, HIV/AIDS and other sexual health issues. Half of
those people agreed that the information magazines provide on these subject is
information they are not likely to get from other sources (Walsh-Childers,
Treise & Gotthoffer, 1997). In addition, a Kaiser Foundation survey of teenagers
showed that 12 percent of teens (5 percent of boys and 19 percent of girls) said
they have learned a lot about pregnancy and birth control from magazines. A 1985
study revealed that high school students who received AIDS information from
magazines knew more about the disease than those who had not (Price, Desmond &
Kukulka, 1985). However, studies of magazines popular with teenagers also have
shown that discussion of teens' risk of AIDS and of "safe sex" behaviors such as
condom use are rare (Endres, 1990; Stephenson, & Walsh-Childers, 1993; Wysocki,
& Harrison, 1991).
Research Questions
Because this study was intended to be a broadly descriptive and exploratory
analysis of the sexual health and sex-related content of consumer magazines, no
hypotheses were advanced. However, in regard to STDs and AIDS, there were a
number of broad research questions:
y To what extent do consumer magazines cover sexually transmitted
diseases - in general and as specific diseases?
y Are STDs, including AIDS/HIV, covered differently in magazines
targeted to different audiences - (men, women, teens,
African-Americans)? If so, what are the differences?
y When magazines cover STDs and HIV/AIDS, what kinds of information do
they include?
y How, if at all, has coverage of STDs, including HIV/AIDS, changed
over the past decade?
Methods
The results discussed in this paper are based on analysis of items of
editorial content in 46 consumer magazines. The majority of the paper concerns
analyses of issues randomly selected from the 12 months preceding the beginning
of the study, including June, August and October 1995 and January, April and May
1996. Magazines coded for the current year study included the four major teen
magazines, 22 of the most popular women's magazines, two bride's magazines, two
parent-oriented magazines, 10 magazines either targeted specifically to men or
with particularly high male readership, seven magazines targeted to
African-Americans and three health and fitness magazines. Additional results
include analyses of items from 16 teen and women's magazines from randomly
selected issues chosen from the previous 10 years - from June 1986.
For each part of the study (current year and retrospective), the same
issues from each magazine were coded. In other words, for the current year
analysis, coders examined the June, August and October 1995 and January, April
and May 1996 issues of each of the 46 magazines. For the retrospective analysis,
the additional nine years were divided into three-year blocks (June 1986 - May
1989, June 1989 - May 1992, and June 1992 - May 1995). Then, using a table of
random numbers, the researchers randomly selected 10 months/issues from each
three-year block.
If a magazine was published more frequently than once each month, the issue
coded was that published the first full week of the selected month. In some
cases, magazines combined issues for two months (i.e. an April/May issue); if
both of those months had been selected for sampling, only the one issue was
coded. This strategy was chosen as the best way of fairly representing the
amount of reproductive and sexual health information, on average, to which
readers of the magazine would be exposed.
Every effort was made to find copies of every selected issue of every magazine
included in the study, and the magazines coded were located in libraries in
Florida, Alabama, Massachusetts, Califonia and New York, were purchased from the
magazine publishing companies or, in a few cases, were coded at the magazines'
New York City offices. Some issues originally selected for the sample could not
be located through any of these methods. However, there is no reason to believe
that anything distinguishes the issues that could not be located from those
included in the analysis.
Eight trained coders analyzed the magazines. Items were coded if they
concerned any reproductive or sexual health issue directly related to sexual
activity. In addition, items that focused primarily on other sexual topics (i.e.
articles offering advice on how to improve the reader's sexual performance) were
coded for mention of a wide variety of reproductive health topics. The coders
also measured the length in column inches of each coded item, including text and
accompanying graphics, and categorized each item according to its type (i.e.
feature article, question-and-answer column, news mention, letter to the editor,
etc.). A sample of 10 percent of the sample issues were selected for blind
double coding, meaning that the coders did not know which issues were also being
analyzed by another coder; this procedure producing an overall intercoder
agreement rate of 86%.
Results
The results reported here will cover the content analysis of 44 magazines
targeted to teens, men, women and African-Americans. Six magazines (the health
magazines and those targeted to parents and brides) are excluded from the report
for purposes of brevity.
Across all items coded - which included only items related to sex or sexual
health - about 34 percent of those in the women's magazines, 28 percent of those
in the men's magazines, 42 percent of those in the teen magazines and 42 percent
of those in the African-American magazines were coded as focusing on any sexual
health topic (contraception, pregnancy, STDs, etc.). The remainder of the coded
items were focused on other sex-related issues - (sexual activity in general,
sexual techniques, sexual decision-making, etc.).
Magazine coverage of STDs and HIV/AIDS, page
Table 1 - Women's, Men's, Teen, and African-American Magazines: Main Focus of
Articles as Percent of All Sex-Related Coverage
Main Focus
of Article
Women's
% of all coded articles
n=327
Men's
% of all coded
articles
n=96
Teen
% of all coded
articles
n=39
African-American
% of all coded articles
n=34
Contraception
6
7
5
*
Pregnancy (planned/unintended)
12
2
13
24
Abortion
7
1
*
3
Emergency contraception
*
*
3
*
STDs (non-HIV)
2
3
8
9
HIV/AIDS
4
14
8
3
Multiple sexual health topics
3
1
5
3
Other sexual topics
65
71
56
56
Unable to code
1
1
3
3
Total articles coded
100%
100%
100%
100%
*Less than 1 percent
As Table 1 shows, articles focused on STDs other than HIV were relatively
rare in any of the magazine types, but articles focused on HIV were somewhat
more common, particularly in the men's magazines. HIV was the most often covered
sexual health topic in men's magazines, and HIV and other STDs were the second
most common focus of items in teen magazines. However, in women's magazines, the
two topics combined accounted for only 6 percent of the items. In the magazines
targeting African-Americans, other STDs were the focus of three times as many
items as HIV/AIDS.
Although relatively few articles focused on STDs as a main topic, STDs were
mentioned fairly often. Across all magazine types, nearly one of every 10 items
made some mention of STDs without specifying a particular disease, and about one
of every 20 items mentioned STD prevention. Teen magazines actually paid more
significant attention to STDs than any other type of magazine, with more than
one-fourth of all items mentioning STDs in general. More than six percent of
teen magazine items mentioned STD symptoms, prevention and the risk of getting
an STD, and nearly 5 percent of all items mentioned the health consequences of
STDs.
Table 2 - Mentions of STDs Other than HIV/AIDS in Women's, Men's, Teen and
African-American Magazines
STDs
(non-HIV/
AIDS)
Women's
Men's
Teen
African-American
% of ALL coded articles
n=327
% of articles mentioning
STDs
n=18
% of ALL coded articles
n=96
% of articles mentioning
STDs
n=8
% of ALL coded articles
n=39
% of articles mentioning
STDs
n=13
% of ALL coded articles
n=34
% of articles mentioning
STDs
n=5
Chlamydia
*
6
2
25
*
*
*
*
Gonorrhea
*
*
3
38
*
*
*
*
Hepatitis B
*
6
1
13
*
*
*
*
Herpes
1
17
6
75
5
15
5
40
HPV
*
*
1
13
5
15
*
*
PID
*
6
*
*
*
*
*
*
Syphilis
*
*
3
38
*
*
5
40
Tricho-moniasis
*
6
*
*
*
*
*
*
Non-Specific
5
67
3
38
31
92
40
40
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
specific STDs
in a single article. Articles mentioning STDs are a subset of both sexual health
and
other sexual topic articles.
Table 2 shows the frequency with which specific STDs were mentioned in the
four magazine types, as a percentage of all items coded and as a percentage of
only those articles in which some STD-related topic was mentioned. As the table
shows, men's magazine items named the widest variety of specific STDs, and only
men's magazines mentioned gonorrhea, the second most commonly occurring STD in
the United States. Although one-third of teen magazine items coded mentioned
STDs, these magazines named only two STDs specifically: herpes and HPV. The most
frequently mentioned STD was herpes, named in 17 percent of all women's magazine
items mentioning STDs, in three of the four items in men's magazines, in two of
13 teen magazine items and two of 5 items in African-American magazines.
African-American-targeted magazines named only two specific STDs, herpes and
HPV, but 31 percent of all coded items in these magazines mentioned STDs in a
general way.
Table 3 - Mentions of STD-Related Topics in Women's, Men's, Teen and
African-American Magazines
STDs
(non-HIV/
AIDS)
Women's
Men's
Teen
African-American
% of ALL coded articles
n=327
% of articles mentioning
STDs
n=18
% of ALL coded articles
n=96
% of articles mentioning
STDs
n=8
% of ALL coded articles
n=39
% of articles mentioning
STDs
n=13
% of ALL coded articles
n=34
% of articles mentioning
STDs
n=5
Prevention
2
33
4
50
5
15
*
*
Symptoms
1
11
2
25
5
15
*
*
Treatment
1
11
4
50
3
8
5
40
Health consequences
2
22
1
13
*
*
*
*
Rate of spread
1
11
*
*
3
8
*
*
Risk
3
39
2
25
5
15
*
*
Enhancement of HIV risk
*
*
*
*
*
*
*
*
Emotional consequences
*
*
*
*
*
*
*
*
Social consequences
*
*
*
*
*
*
*
*
Financial consequences
*
*
*
*
*
*
*
*
Female responsibility
*
*
*
*
*
*
*
*
Male responsibility
*
*
*
*
3
8
*
*
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
STD-related topics in a single article. Articles mentioning STDs are a subset of
both sexual health and other sexual topic articles.
Table 3 shows the frequency of mention of a variety of topics related to
non-HIV STDs, both as a percentage of all coded items and as a percentage of
those items in which some STD topic was mentioned. As the table shows, many
potentially important topics were not mentioned at all in any of the magazines,
including the emotional, social and financial consequences of contracting a
sexually transmitted disease. In addition, none of the coded items mentioned the
increased likelihood of contracting HIV for people who have certain STDs. In
general, prevention was the topic most likely to be mentioned, although none of
the items in the African-American magazines included this topic. Only five items
in these magazines mentioned any STD topic; treatment was mentioned in two of
those articles. Other than specific STDs, treatment was the only coded issue
included in the African-American magazines.
The coders also analyzed the items included in the study for mention of
numerous topics related to HIV and AIDS. The results of that analysis are shown
in Table 4. As the table shows, more than one in five of the coded items in the
teen magazines and men's magazines mentioned HIV/AIDS. About 11 percent of the
women's magazine items and 6 percent of the African-American magazine items
mentioned HIV/AIDS.
Across all magazine types, 6.8 percent of the items mentioned the risk of
contracting HIV; men's magazines were most likely to include this topic in their
reproductive health coverage.
Magazine coverage of STDs and HIV/AIDS, page
Table 4 - Mentions of HIV/AIDS-Related Topics in Women's, Men's, Teen and
African-American Magazines
HIV/AIDS
topics
Women's
Men's
Teen
African-American
% of ALL coded articles
n=327
% of articles mentioning
HIV/AIDS
n=37
% of ALL coded articles
n=96
% of articles mentioning
HIV/AIDS
n=20
% of ALL coded articles
n=39
% of articles mentioning
HIV/AIDS
n=8
% of ALL coded articles
n=34
% of articles mentioning
HIV/AIDS
n=5
Sexual transmission
8
57
9
40
21
100
10
80
Non-sexual transmission
2
16
7
30
*
*
2
20
Prevention:
condoms
3
19
5
20
3
13
*
*
Prevention: spermicides
1
5
*
*
*
*
*
*
Prevention: abstinence
1
8
*
*
*
*
*
*
Prevention: education
2
14
6
25
3
13
2
20
Testing
4
27
5
20
3
13
2
20
Treatment
2
11
11
50
*
*
2
20
Legislative/
judicial policy
1
5
1
5
*
*
*
*
Rates
2
19
6
25
*
*
2
20
Risk
2
16
11
50
8
38
*
*
Emotional consequences
2
14
2
10
3
13
2
20
Social consequences
1
5
*
*
*
*
*
*
Financial consequences
*
*
*
*
3
13
*
*
Female responsibility
2
14
1
5
*
*
*
*
Male responsibility
1
11
1
5
*
*
*
*
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
HIV/AIDS-related topics in a single article. Articles mentioning HIV/AIDS are a
subset of both sexual health and other sexual topic articles.
The fact that HIV/AIDS can be transmitted through sexual intercourse was
mentioned frequently in the items including any mention of HIV/AIDS; all teen
magazine items mentioning HIV/AIDS included this fact. Non-sexual transmission
was mentioned less frequently in all magazine types and not at all in the teen
magazine items. The frequency of appearance of other HIV/AIDS topics varied
across the magazine types. In the women's magazines, testing was the second most
common topic (27 percent of items mentioning HIV), followed by HIV incidence
rates and the use of condoms to prevent the spread of HIV (about one of every
five items mentioning HIV). The only coded topic not mentioned in any of the
women's magazine items was the financial consequences of HIV/AIDS.
In the men's magazines, treatment of HIV and the risks of contracting the
disease were the most commonly included topics, appearing in half of the
articles mentioning HIV. One-fourth of the items mentioning HIV/AIDS included
some discussion of the incidence rates, and one-fourth included mention of
preventing the spread of HIV through education. Men's magazine items included no
mention of prevention with spermicides or through sexual abstinence or of the
social or financial consequences of HIV/AIDS.
Considering all coded items, teen magazines were most likely to mention the
sexual transmission of HIV; 21 percent of all coded items mentioned this fact.
More than one-third of the teen magazine items mentioning HIV/AIDS included some
information about the risk of contracting the disease. In addition, the use of
condoms for prevention of HIV, prevention education, HIV testing, and the
emotional and financial consequences of HIV/AIDS each was mentioned once.
Only five items in the African-American magazines mentioned anything about
HIV/AIDS. Of those five items, four mentioned the sexual transmission of HIV.
Non-sexual transmission, prevention through education, testing, treatment,
incidence rates and the emotional consequences of HIV/AIDS each were mentioned
once. The results of this analysis suggest that African-American magazines are
paying little attention to HIV, despite the high percentages of HIV/AIDS cases
among African-Americans. About 11 percent of all items mentioned the sexual
transmission of HIV, but no items dealt with prevention of HIV/AIDS through the
use of condoms, spermicides or abstinence from sex.
One interesting finding is the prevalence of coverage of treatment options in
men's magazines; more than 15 percent of all items in men's magazines mentioned
treatment options. Surprisingly, however, prevention of HIV received relatively
little attention, even in items specifically about HIV/AIDS. Fewer than 3
percent of all items in men's magazines mentioned using condoms to prevent
contracting HIV, and no items mentioned the use of spermicides or abstinence.
Even in items specifically about HIV/AIDS, only about 8 percent mentioned the
use of condoms to protect oneself from HIV.
Retrospective analysis
In addition to the analysis of items from the current year (defined as July
1995 to June 1996), the coders analyzed sex- and sexual-health-related items in
a sample of women's and teen magazines from the past 10 years, from July 1986 to
June 1996. Throughout the period, coverage of STDs in general appears to have
remained about the same in women's and in teen magazines. As Table 5 shows,
non-HIV STDs were the main focus of 4 percent the sex-related items in women's
magazines from 1986-1989, 5 percent of the sex-related items in 1990-1992 and 4
percent during the period from 1993-1996. During the same period, it's fair to
say that STDs received almost twice as much emphasis in teen magazines. Non-HIV
STDs were the main focus of 10 percent of the coded items in teen magazines from
1986-1989, and 9 percent of the coded items during the 1990-1992 and 1993-1996
periods.
Table 5 - STDs and HIV/AIDS as the main focus of magazine articles in women's
and teen magazines, 1986-1996
Main Focus of Item
1986-1989
1990-1992
1993-1996
% of all coded items
% of all coded items
% of all coded items
Women's (n=254)
Teen (n=41)
Women's (n=264)
Teen (n=53)
Women's (n=456)
Teen (n=89)
STDs
(non-HIV)
4
10
5
9
4
9
HIV/AIDS
8
2
7
12
6
8
Table 6 gives an indication of the patterns of coverage of specific STDs in
women's magazines over that 10-year period, and Table 7 shows the frequency with
which teen magazines mentioned specific STDs during the 10 years.
Table 6 - Mentions of STDs Other than HIV/AIDS in Women's
Magazines, 1986-1996
STDs
(non-HIV/
AIDS)
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=254
% of articles mentioning
STDs
n=39
% of ALL coded articles
n=264
% of articles mentioning
STDs
n=34
% of ALL coded articles
n=456
% of articles mentioning
STDs
n=58
Chlamydia
3
21
2
21
3
26
Gonorrhea
2
15
3
27
3
22
Hepatitis B
*
*
1
12
2
16
Herpes
4
26
4
35
2
19
HPV
1
10
2
21
1
9
PID
2
13
2
15
1
9
Syphilis
2
13
2
18
1
9
Tricho-moniasis
*
*
1
9
1
5
Non-Specific
5
36
5
41
7
59
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
specific
STDs in a single article. Articles mentioning STDs are a subset of both sexual
health
and other sexual topic articles.
As Table 6 shows, the patterns of discussion of specific STDs seem to have
remained relatively consistent in women's magazines over the decade. The
percentage of all coded items mentioning any STD topic was 15 percent during
1986-1989 and about 13 percent during 1990-1992 and 1993-1996. In all three time
periods, the magazines were most likely to mention STDs in general, and but the
tendency to refer to STDs in general has increased. During the earliest period,
just more than one-third of the items discussing STDs in any way mentioned
non-specific STDs, but by the latest period, almost 60 percent of the articles
including STD information mentioned STDs in general terms. When specific
diseases were named, herpes, gonorrhea and chlamydia were mentioned in the
highest percentages of all articles in the three time periods. The specific STDs
least likely to be mentioned were trichomoniasis, (all three time periods),
hepatitis B (during the two earliest time periods), and HPV, pelvic inflammatory
disease and syphilis during the latest period.
Magazine coverage of STDs and HIV/AIDS, page
Table 7 - Mentions of STDs Other than HIV/AIDS in Teen Magazines, 1986-1996
STDs
(non-HIV/
AIDS)
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=41
% of articles mentioning
STDs
n=7
% of ALL coded articles
n=53
% of articles mentioning
STDs
n=21
% of ALL coded articles
n=89
% of articles mentioning
STDs
n=31
Chlamydia
2
14
5
14
6
19
Gonorrhea
2
14
3
10
4
13
Hepatitis B
*
*
5
14
1
3
Herpes
*
*
5
14
6
19
HPV
*
*
6
19
8
26
PID
*
*
*
*
1
3
Syphilis
*
*
3
10
*
*
Tricho-moniasis
*
*
*
*
2
7
Non-Specific
7
57
28
91
28
90
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
specific STDs in a single
article. Articles mentioning STDs are a subset of both sexual health and other
sexual topic articles.
As Table 7 shows, teen magazines became more likely to include discussion
of STDs and more likely to mention specific STDs over the study period. During
the earliest period, only two specific STDs - chlamydia and gonorrhea - were
named, each of them in one of the seven items containing any mention of STDs,
and only 7 percent of all coded articles included any mention of STDs. By the
second period, 1990-1992, six specific diseases were named in the 21 items
coded, and seven were named during the latest period. During the middle period,
nearly 40 percent of all articles coded mentioned STDs, and of the 1993-1996
items, about 35 percent mentioned STDs. The diseases most likely to be mentioned
were chlamydia and HPV.
Magazine coverage of STDs and HIV/AIDS, page
Table 8 - Mentions of STD-Related Topics in Women's Magazines, 1986-1996
STDs
(non-HIV/
AIDS)
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=254
% of articles mentioning
STDs
n=39
% of ALL coded articles
n=264
% of articles mentioning
STDs
n=34
% of ALL coded articles
n=456
% of articles mentioning
STDs
n=58
Prevention
4
26
3
24
2
41
Symptoms
2
15
4
32
2
19
Treatment
1
8
4
35
2
16
Health consequences
2
15
2
18
2
19
Rate of spread
1
8
3
24
2
21
Risk
3
18
3
27
5
38
Enhancement of HIV risk
*
3
*
3
*
2
Emotional consequences
3
5
1
9
1
5
Social consequences
*
*
*
3
1
5
Financial consequences
*
*
*
*
*
3
Female responsibility
*
*
1
6
*
2
Male responsibility
*
*
1
6
*
2
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
STD-related topics in a single article. Articles mentioning STDs are a subset of
both sexual health and other sexual topic articles.
Table 8 shows the frequency of mentions of STD-related topics in women's
magazines over the decade. The magazines appear to have included more discussion
of STD-related topics in the middle and later periods, as compared to the
earliest articles. Prevention and the risk of contracting an STD were the most
likely to be mentioned during the latest period, while in the middle period,
coverage seems to have focused on symptoms and treatment of STDs.
Table 9 - Mentions of STD-Related Topics in Teen Magazines, 1986-1996
STDs
(non-HIV/
AIDS)
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=41
% of articles mentioning
STDs
n=7
% of ALL coded articles
n=53
% of articles mentioning
STDs
n=21
% of ALL coded articles
n=89
% of articles mentioning
STDs
n=31
Prevention
4
29
8
24
6
19
Symptoms
5
43
3
10
5
16
Treatment
2
14
3
10
5
16
Health consequences
2
14
5
14
3
10
Rate of spread
*
*
*
*
3
10
Risk
2
14
3
10
8
26
Enhancement of HIV risk
*
*
3
10
*
*
Emotional consequences
*
*
*
3
*
1
Social consequences
*
*
2
5
*
*
Financial consequences
*
*
*
*
*
*
Female responsibility
*
*
2
5
3
10
Male responsibility
*
*
*
*
2
7
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
STD-related topics in a single
article. Articles mentioning STDs are a subset of both sexual health and other
sexual topic articles.
Table 9 shows the patterns of STD information included in teen magazines
over the 10-year period. The data suggest that although the percentages of all
coded articles that included STD information were similar across the study
period, teen magazines covered an increasing number of STD-related topics in the
later periods. There is no clear pattern of attention to any particular topic,
although prevention appears to have been the topic included most consistently.
Table 10 - Mentions of HIV/AIDS-Related Topics in Women's Magazines, 1986-1996
HIV/AIDS-
related
topics
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=254
% of articles mentioning
HIV/AIDS
n=46
% of ALL coded articles
n=264
% of articles mentioning
HIV/AIDS
n=53
% of ALL coded articles
n=456
% of articles mentioning
HIV/AIDS
n=73
Sexual transmission
12
72
13
72
10
69
Non-sexual transmission
5
33
5
26
3
22
Prevention:
condoms
6
37
4
25
4
27
Prevention: spermicides
4
22
2
11
1
8
Prevention: abstinence
3
20
1
8
1
8
Prevention: education
5
28
3
19
3
18
Testing
4
24
4
21
4
27
Treatment
3
15
2
11
2
12
Legislative/
judicial policy
1
4
*
*
1
7
Rates
4
26
3
15
2
15
Risk
6
37
5
30
4
27
Emotional consequences
3
20
1
8
3
21
Social consequences
3
17
2
9
2
15
Financial consequences
1
7
1
4
1
8
Female responsibility
2
11
2
11
2
16
Male responsibility
1
9
1
6
1
7
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
HIV/AIDS-related topics in a single article. Articles mentioning HIV/AIDS are a
subset of both sexual health and other sexual topic articles.
Table 10 shows the frequency of inclusion of HIV-related topics in women's
magazines over the 10-year period. Patterns of AIDS coverage in women's
magazines seem to have changed somewhat over the decade, with greatest attention
to topics such as prevention (through the use of condoms, spermicides and
abstinence and through education), rates of increase and the risk of contracting
the disease during the late 1980s. By the 1990s, attention to all of these
issues in coverage mentioning HIV/AIDS had decreased significantly, though all
continued to be mentioned in some articles.
A somewhat different pattern emerged in the analysis of teen magazines'
coverage of HIV/AIDS over the decade. Teen magazines have given considerable
editorial attention to HIV/AIDS during this period, with 25-30 percent of all
sex-related articles during the study period including some mention of HIV.
Sexual transmission of HIV was consistently the most mentioned topic, appearing
in 16-20 percent of all coded articles during the period. Like the women's
magazines, teen magazines appear to have paid somewhat less attention to
prevention methods during the later years. The value of spermicides for
preventing HIV transmission was mentioned only once in the sample, in one of the
articles from the late 1980s, and, somewhat surprisingly, abstinence as a way of
preventing HIV was mentioned in only four of the 51 articles coded and in none
of the articles published from 1993-1996. On the other hand, the magazines seem
to have become increasingly likely to include some mention of the risks of
contracting HIV, which was included in 2 percent of all 1986-1989 articles, 6
percent of all 1990-1992 articles and 11 percent of all coded articles from
1993-1996.
Magazine coverage of STDs and HIV/AIDS, page
Table 11 - Mentions of HIV/AIDS-Related Topics in Teen Magazines,
1986-1996
HIV/AIDS-
related
topics
1986-1989
1990-1992
1993-1996
% of ALL coded articles
n=41
% of articles mentioning
HIV/AIDS
n=10
% of ALL coded articles
n=53
% of articles mentioning
HIV/AIDS
n=16
% of ALL coded articles
n=89
% of articles mentioning
HIV/AIDS
n=25
Sexual transmission
16
90
18
75
20
80
Non-sexual transmission
2
10
5
19
3
12
Prevention:
condoms
4
20
5
19
4
16
Prevention: spermicides
2
10
*
*
*
*
Prevention: abstinence
2
10
5
19
*
*
Prevention: education
2
10
5
19
2
8
Testing
2
10
2
6
1
4
Treatment
*
*
2
6
*
*
Legislative/
judicial policy
*
*
2
6
*
*
Rates
2
10
6
25
1
4
Risk
2
10
6
25
11
44
Emotional consequences
2
10
5
19
2
8
Social consequences
*
*
*
*
1
4
Financial consequences
*
*
*
*
1
4
Female responsibility
*
*
5
19
2
8
Male responsibility
*
*
2
6
1
4
*Less than 1 percent. Totals may exceed 100% due to mentions of multiple
HIV/AIDS-related topics in a single article. Articles mentioning HIV/AIDS are a
subset of both sexual health and other sexual topic articles.
Discussion and Conclusions
The research questions this paper attempted to answer were these:
y To what extent do consumer magazines cover sexually transmitted
diseases - in general and as specific diseases?
y Are STDs, including AIDS/HIV, covered differently in magazines
targeted to different audiences - (men, women, teens,
African-Americans)? If so, what are the differences?
y When magazines cover STDs and HIV/AIDS, what kinds of information do
they include?
y How, if at all, has coverage of STDs, including HIV/AIDS, changed
over the past decade?
The answer to the first question - based only on the analysis of current-year
magazine issues - appears to depend largely on the answer to the second; that
is, there is significant variation in the extent of coverage across the four
magazine types analyzed for this study. In women's magazines, STDs and AIDS/HIV
combined are the focus of no more than 6 percent of the sex-related articles,
and these articles, of course, are an even smaller percentage of all the
articles included in these magazines. In comparison, 65 percent of the
sex-related articles in women's magazines were focused on non-sexual health
issues such as sexual performance ("What Your Man Really Wants In Bed"), lack of
sexual desire, sexual fantasies, etc. In magazines targeted to
African-Americans, STDs other than HIV were the focus of 9 percent of the
sex-related articles, but only 3 percent of the articles focused on HIV, despite
the disproportionate effect HIV has had on African-American communities in the
United States. The reverse pattern was evident in the men's magazines, in which
14 percent of the sex-related items focused on HIV, but only 3 percent focused
on other STDs. In teen magazines, STDs and HIV/AIDS each were the focus of 8
percent of the sex-related articles.
For some magazine types, the results are somewhat more encouraging when one
defines coverage of these diseases as all editorial mentions of the diseases,
regardless of the focus of the article. Across all magazine types, about 9
percent of all sex-related items made some mention of STDs, and about 14 percent
included some mention of HIV. In teen magazines, one-third of the sex-related
articles mentioned non-HIV STDs, while about 20 percent mentioned HIV, and in
African-American-targeted magazines, about 15 percent of the sex-related items
mentioned HIV and other STDs. However, in women's magazines, less than 6 percent
of sex-related items mentioned non-HIV STDs at all, although more than one of
every 10 sex-related items mentioned HIV. In men's magazines, 8 percent of the
items mentioned non-HIV STDs, while more than 20 percent mentioned HIV.
The third research question asked what kinds of information about HIV and
other STDs were included in magazines. The women's and teen magazines were most
likely to cover non-HIV STDs as a general issue, without reference to specific
diseases. The men's magazines, in contrast, devoted the greatest amount of
attention to herpes and also paid significant attention to gonorrhea and
syphilis. African-American magazines named only two specific STDs - herpes and
syphilis. Women's magazines, more than any other type, included discussion of
the risks of contracting an STD, while men's magazines appear to have paid more
attention to treatment options.
In covering HIV/AIDS, the most common topic across all magazine types was the
sexual transmission of HIV. Women's magazines included the broadest range of
topics related to HIV, with testing, rates of incidence and prevention through
condom use receiving relatively frequent mentions. Men's magazines covered fewer
topics and included more discussion of treatment options, while teen magazines
focused on the risk of contracting HIV. Surprisingly, none of the teen magazine
items mentioned prevention of HIV through sexual abstinence.
HIV was mentioned in only five items in African-American magazines, so it's
not surprising that the range of topics covered was the smallest. It is
interesting, however, that none of the items in African-American magazines
mentioned prevention of HIV through condom or spermicide use or through
abstinence; only education was mentioned as a prevention measure. This result
would seem to indicate that African-American magazines are not playing much of a
role in educating their readers about a deadly disease that is affecting them in
disproportionate numbers. Of course, magazines specifically targeted to
African-Americans are not the only magazines African-Americans read, so there
certainly are alternative sources of HIV information for them. Nonetheless, it
seems somewhat odd that a disease that has had such a devastating impact on some
segments of the African-American community would receive so little attention
from these magazines.
Finally, the fourth research question asked how coverage of STDs, including
HIV, has changed over the past 10 years. The answers are available only in
connection with women's and teen magazines. The results show that patterns of
discussion of specific STDs have remained about the same in women's magazines
over the decade, with herpes, gonorrhea and chlamydia most likely to be
mentioned in all three time periods. By the mid-1990s, women's magazines had
become more likely to include some topics, including STD prevention, the risk of
contracting STDs and the rate of spread. A more disturbing finding is that
women's magazines seem to be paying less attention in the later years to several
critical HIV-related topics, including prevention through condom and spermicide
use, abstinence or education. This finding seems particularly unusual given that
HIV incidence rates among women have been increasing faster than in any other
population segments in the United States.
Teen magazines have given considerable attention to HIV/AIDS issues over the
past 10 years, suggesting that the magazines' editors recognize the
vulnerability of their readers to the deadly disease and are trying to provide
them with information that will help them avoid infection. However, like the
women's magazines, teen magazines seem to have lost interest in providing
information about prevention, with no items mentioning spermicides or abstinence
in the latest period and fewer references to the use of condoms for prevention.
Coverage of STDs also has shifted somewhat during the decade. Mentions of
gonorrhea, chlamydia, genital warts (HPV) and herpes all increased rather
steadily, and the magazines also were more likely to discuss the risk of
contracting an STD during the latest period. However, discussion of symptoms and
prevention dropped off during the period, again raising concern that an
important source of sexual health information for teens is now failing to
address - or at least addressing less regularly - information they need to
protect themselves from these life-altering and in some cases life-threatening
diseases.
Study Limitations
It is important to note the wide variation in the number of magazines
included in each magazine type category - from two magazines each for the
parents' and brides' categories to 26 magazines for the women's category in the
current year analysis. Because there were so many fewer magazines issues coded
in some categories, compared to other categories, caution is called for in
comparing coverage across magazine types.
It also is important to keep in mind that the data presented here reflect
only magazines' coverage of sex-related topics. Of course, all of the magazines
include in every issue editorial content that has nothing to do with sex. Thus,
these data in some ways actually may overrepresent the actual amount of space or
editorial attention to STDs, including HIV.
It would be difficult, however, to overemphasize the importance of ensuring
that the public receives accurate and useful information about HIV and other
sexually transmitted diseases, whether through magazines or some other
information source. The key conclusion the authors of this study have reached is
that there is almost certainly room for improvement in the role consumer
magazines are playing in providing that information.
Magazine coverage of STDs and HIV/AIDS, page
References
American Association for World Health (1995). World AIDS Day 1995 -- Shared
Rights, Shared Responsibilities. Washington, D.C.: American Association for
World Health.
American Social Health Association (1995). Gallup study: Teens know more than
adults about STDs, but STD knowledge among both groups is low. Located at
http://sunsite.unc.edu/ASHA/press/galteen091495.html.
Baldwin, J.D., & Baldwin, J.I. (1988). Factors affecting AIDS related sexual
risk-taking behavior among college students. Journal of Sex Research, 25,
181-196.
Brown, W. (1991). An AIDS prevention campaign: Effects on attitudes, beliefs
and communication behavior. American Behavioral Scientist, 34, 666-678.
Centers for Disease Control and Prevention. (1993). Facts about adolescents and
HIV/AIDS. Atlanta, GA: Centers for Disease Control.
Centers for Disease Control and Prevention. (1994). Facts about adolescents and
HIV/AIDS. Atlanta, GA: Centers for Disease Control.
Division of STD/HIV Prevention Annual Report. (1994). Atlanta, GA:Division of
STD/HIV Prevention, Centers for Disease Control and Prevention (CDC)..
Donovan, Patricia. (1997). Confronting a hidden epidemic: The Institute of
Medicine's Report on Sexually Transmitted Diseases. Family Planning
Perspectives, 29:2. Located at http://206.215.210.5/pubs/journals/2908797.html.
Edgar, Timothy, Freimuth, Vicki, and Hammond, Sharon. (1988). Communicating the
risk of AIDS to college students: The problem of motivating change. Health
Education Research, 3, 59-65.
Endres, Kathleen L. (1990). Refocusing science news to reach a specialized
audience: AIDS coverage, mobilizing information and teen magazines. Paper
presented at the annual convention of the Association for Education in
Journalism and Mass Communication, Minneapolis, MN, August 9-12.
Eng, Thomas R., and Butler, William T. (1997). The Hidden Epidemic: Confronting
Sexually Transmitted Diseases. Washington, D.C.: National Academy Press.
Fennell, Reginald. (1989). Knowledge, attitudes and homophobia of selected
college students regarding Acquired Immunodeficiency Syndrome. The Ohio State
University. UMI Dissertation Information Service, Ann Arbor, MI.
Fennell, Reginald. (1990). Knowledge, attitudes and beliefs of students
regarding AIDS: A review. Health Education, 21:4, 20-26.
Helgerson, S.D., Petersen, L.R., and the AIDS Education Study Group. (1988).
Acquired Immunodeficiency Syndrome and secondary school students: Their
knowledge is limited and they want to learn more. Pediatrics, 31:3, 350-355.
HIV/AIDS Surveillance Report, 8:2. (1996). Centers for Disease Control,
National Center for HIV, STD and TB Prevention. Located at
http://www.cdc.gov/nchstp/hiv_aids/stats/hivsur82.pdf.
Klein, J.D., Brown, J.D., Walsh-Childers, K., Oliveri, J., Porter, C., &
Dykers, C. (1993). "Adolescents' risky behavior and mass media use." Pediatrics,
92:1, 24-31.
Knox, Richard A. (1991, June 17). Most favor bigger U.S. role in AIDS fight.
Boston Globe, pp. 1, 22-23.
McDermott, R., Hawkins, M., Moore, J., and Cittadino, S. (1987). AIDS awareness
and information sources among selected university students. Journal of American
College Health, 35, 222-226.
Price, J.H., Desmond, S., and Kukulka, G. (1985). High school students'
perceptions and misperceptions of AIDS. Journal of School Health, 55:3, 107-109.
Stephenson, Tracy, and Walsh-Childers, Kim (1993). Missed opportunities:
Coverage of Magic Johnson and AIDS in magazines popular with teenagers. Paper
presented at annual conference of the International Communication Association,
Washington, D.C.
Weinstein, Estelle, Rosen, Efrem, and Atwood, Joan. (1991). Adolescents'
knowledge of AIDS and behavior change: Implications for education. Journal of
Health Education, 22:5, 313-318.
Wysocki, Diane, and Harrison, Rebecca. (1991). AIDS and the media: A look at
how periodicals influence childen and teenagers in their knowledge of AIDS.
Journal of Health Education, 22:1, 20-23.
Youth & HIV/AIDS: An American Agenda (March, 1996). A report to the President.
Washington, D.C.: Office of National AIDS Policy.
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