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Executive Summary

Safe Sex No Regrets


Implementation & Evaluation Report 2007/2008

Acknowledgements Thank you the following people and organisations for their contributions to the campaign implementation and evaluation: Department of Health NSW Department of Health WA Ms Lisa Bastian, Sexual Health and Blood Borne Virus Program Ms Alexa Wilkins, Sexual Health and Blood Borne Virus Program

FPWA Sexual Health Services Ms Rebecca Smith

Gatecrasher Advertising WA Ms Karen Adie Ms Kelly Dienaar

Peach Advertising NSW Western Australian AIDS Council Ms Trish Langdon Dr Simon Yam Ms Nadine Toussaint Ms Rachel Copson Mr Kale Dyer Ms Gail Jones

Western Australian Centre for Health Promotion Research Dr Graham Brown Ms Claire Nicholson

Crawford G, Brown G, Nicholson C, Yam S and Langdon T. 2008. Safe Sex No Regrets Implementation and Evaluation 2007-2008. Western Australian AIDS Council, Perth, Western Australia.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

Executive Summary
In December 2007, the Western Australian AIDS Council (WAAC) in conjunction with the Western Australian Department of Health and FPWA Sexual Health Services launched a social marketing campaign across Western Australia (WA). The Safe Sex No Regrets (SSNR) campaign was originally developed by New South Wales Health, in response to rising rates of HIV and sexually transmissible infections (STIs). Due to similar concerns, the Department of Health (WA) commissioned WAAC to reproduce the campaign in WA. The campaign objectives were to increase awareness of safe sexual practice and to increase the use of condoms to prevent HIV and STIs amongst heterosexual people under 30 years of age and homosexually active men under 45 years of age. The campaign evaluation aimed to investigate campaign recall and attitudes and behaviour regarding sexual health, STIs and condom use. Two hundred pre and post campaign surveys were administered to a cross section of the target group in the Perth metropolitan area by telephone with a further 50 venue based surveys administered in Perth nightspots post campaign. Post campaign, over 80% of respondents indicated they were sexually active, had sex with someone of the opposite sex and in a relationship with a regular partner. Respondents were more likely to be female, have lived in WA for the previous 3 months and identify as heterosexual. Over 50% of respondents indicated an annual household income of between $60,000 and $100, 000. Major findings from the telephone surveys showed a 30% increase in the number of the target group that had seen sexual health messages, from 55% pre campaign to 85% post campaign. Prompted recall demonstrated that 80% of the target group recalled seeing the SSNR campaign. Of those participating in venue surveys (post campaign), over 70% of respondents recalled seeing sexual health advertising. Prompted, 86% recalled seeing the SSNR advertisements. The most common location that the target group had seen the campaign was on television. Of those that recalled the ad, 80%-90% thought that the ad was believable, however over 70% indicated that the ads were not personally relevant. Those in regular relationships were less likely to see the ads as relevant compared to those in casual relationships. At the conclusion of the campaign more respondents agreed that condoms could effectively prevent the transmission of Chlamydia. Post campaign, respondents were more likely to use condoms with casual partners however 61% indicating never using condoms with casual partners and 60% indicated that they never used condoms with regular partners. Of those that were in casual relationships 100% or respondents indicated sometimes or often carrying condoms when they were out. Post campaign, 83.9% of respondents indicated that they hadnt been tested for STIs in the past six months with only 15.6% indicating that they had been tested. Of those that were in a casual relationship only, only 11.5% had been tested for STIs. Recommendations for future implementation of the campaign include a continued focus on television, greater evaluation in night venues and investigation of additional media strategies such as radio. Whilst there were a number of limitations of the campaign and its evaluation related to sample size and gender balance , overall evaluation indicated that campaign reach and salience was high however greater campaign exposure is required to achieve higher campaign cut through. With increasing rates of STIs in WA, consideration to further develop specific social marketing strategies focusing on condom use and testing as an adjunct to other strategies is warranted.
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

TABLE OF CONTENTS
Content 1.0 Introduction. 1.1 Rationale. 1.2 Campaign Objectives 1.3 Target Group 1.4 Key Messages.. 1.5 Campaign Development. 1.6 Campaign Implementation in WA.. 2.0 Process Evaluation. 3.0 Impact Evaluation.. 3.1 Methodology 3.2 Summary of Findings.. 3.3 Results. 3.3.1 Telephone. 3.3.2 Venues.. 4.0 Discussion. 5.0 Limitations. 6.0 Recommendations 7.0 Conclusion 8.0 References 9.0 Appendices. Page Number 5 5 5 6 6 6 6 7 9 9 10 12 12 30 34 39 40 40 41 42

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

1.0 Introduction
The Western Australian AIDS Council was contracted by the Sexual Health and Blood Borne Virus Program of the Department of Health (WA) (DoH) in 2007, to implement a mass media campaign, Safe Sex No Regrets. The Safe Sex No Regrets campaign was developed in 2003 by the New South Wales Department of Health (NSW Health), on the advice of the NSW Ministerial Advisory Committee in AIDS Strategy, in response to rising rates of HIV and notifiable sexually transmissible infections (STIs) since 1999. Due to similar concerns, the Department of Health (WA) sought permission to reproduce the campaign in WA.

1.1 Rationale
Recent Western Australian (WA) surveillance and epidemiological data shows WA has experienced a sustained increase in STI notifications including HIV since 2000 (DoH, 2007; Stancombe Research and Planning [SRP] 2005). There has not been a multifaceted mass media campaign focusing on condoms and STIs in WA for many years, and only recently have there been social marketing campaigns produced by the Sexual Health and Blood Born Virus Program (Wilkins & Mac 2005) related to Chlamydia. Chlamydia is the most commonly notified sexually transmitted infection (STI) in WA. Chlamydia notifications have continued to climb each year, with the highest rates observed in males and females aged 15 to 24 years (Wilkins & Mak 2005). These statistics prompted the Department of Health WA to launch a Chlamydia campaign in 2005. The aim of the campaign was to increase testing for Chlamydia in WA and to detect and treat undiagnosed infection (Wilkins & Mac 2005). Between 2000 and 2006, data showed for the first time since 1995, an increase of 15% in HIV notifications (DoH, 2007). Increases in other STIs, including syphilis and Chlamydia, have also been found, predominantly amongst homosexually active men. However significant increases in STIs have also been seen amongst the general population (DoH, 2007). Western Australia has also seen a recent increase in the number of overseas acquired HIV diagnoses, particularly among heterosexual men, linked to the resource sector boom and travel (DoH, 2007). Additionally the Australian Study of Health and Relationships (2003) notes that in regards to condom use during casual sex; on average 44.6% of heterosexual men always use a condom. A lower percentage was found amongst heterosexual women with an average of 35.6% always opting to use a condom. In comparison amongst, homosexual men, well over half always use condoms. The report showed an average of 76.8% of homosexual men consistently used a condom (Grulich, 2003). In response to these issues of increased notifications and misconceptions about STI transmission and consequences, the WA Department of Health commissioned the WA AIDS Council to implement the social marking campaign, launched in December 2007.

1.2 Campaign Objectives


Primary
To increase awareness of safe sexual practice. To increase the use of condoms to prevent HIV and STIs.

Secondary
To increase knowledge of HIV and STI prevention, early testing, detection and treatment. 5

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

1.3 Campaign Target Group


Sexually active people: Heterosexual people under 30 years of age and; Homosexually active men under 45 years of age.

1.4 Key Messages


Condoms are your best protection against HIV and STIs. Always use a condom with new or casual partners. HIV and STIs are on the increase for men and women in WA. Protecting yourself and your partners is everyones responsibility.

1.5 Campaign Development (NSW)


The original campaign developed by Peach Advertising on behalf of NSW Health aired for 10weeks in 2005. In 2004, NSW Health conducted market research and focus testing of proposed campaign materials with key target populations. Outcomes indicated that: Actual versus perceived awareness of HIV and other STIs was low. Effective campaigns need to use warm and reasonable tones to involve audiences and depict situations to which they can relate. It was important to present safe sex positively It was important to communicate a clear condom use reinforcement message which linked condom use with the prevention of HIV and other STIs.

The campaign was independently evaluated by Stancombe Research and Planning, whose report indicated excellent reach by the campaign and high levels of credibility with the target group.

1.6 Campaign Implementation in Western Australia


In 2006, the Department of Health (WA) Sexual Health and Blood Borne Virus Program sought permission from NSW Health to reproduce the campaign in Western Australia. The Western Australian AIDS Council was commissioned by the Department of Health (WA) to implement the campaign. The WA AIDS Council liaised with NSW Health to obtain their campaign materials and evaluation questions. Based on NSW implementation, Peach Advertising (NSW) were contracted to undertake the creative work and changes required for implementation in Western Australia. Gatecrasher Advertising (WA) was engaged to undertake the media buy and placement and advise on the timing and direction of the campaign. Television airtime was purchased on channels 7, 9 and 10, SBS and regionally GWN and WIN. Advertisements were placed in print media including XPRESS, Drum and Out in Perth. The campaign was also promoted through the use of Smart Cars, online activity through Groove FM, Nova, RTR, Google, Gaydar and RSVP. Venue ads were also placed in pubs and clubs, fitness centres and at University campuses. Their media schedule is attached as an appendix. Additionally to media purchased through Gatecrasher, the WA AIDS Council purchased media through the community newspaper group, created banner ads for email, created the Safe Sex No Regrets website, specific condoms packs and wallet cards as well as a large banner utilised for events including the UWA Red Party and PRIDE.
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

There were a number of challenges in implementing the campaign. 1. Working with agencies outside Western Australia to organise the creative and evaluation proved challenging with regard to timing, communication and cost; 2. Implementation was delayed due to the Federal election and proved more costly due to the pre Christmas advertising period. Due to this, television screening was implemented in small bursts to maintain a saturation point.

2.0 Process Evaluation


Process evaluation measures were used to track distribution and satisfaction with campaign resources. Gatecrasher tracked the placement and success of each strategy throughout the campaign. Their report attached as an appendix.

2.1 WA AIDS Council specific strategies


2.1.1 Website A specific website www.safesexnoregrets.com.au was created for the campaign. Unique visits to the website during the campaign can be seen below:
Month Jan 2008 Feb 2008 Mar 2008 Apr 2008 May 2008 Jun 2008 Jul 2008 Total Unique visitors 961 1055 475 494 548 499 330 4362 Number visits 1080 1272 552 571 675 639 376 5165 of Hits 11402 14676 7226 5941 6927 5591 3801 55564

Unfortunately, data from December and early January was lost due to external hosting malfunction. However, the highest number of visits to the site can be seen during the campaign period, dropping away post campaign in March 2008. 2.1.2. Additional Print Media Additional print media was placed in community newspapers throughout the campaign. Examples of advertisements are included as an appendix. 2.1.3 Condom Packs, Posters, brochures and booklets Resources were distributed throughout WA population health units, hospitals and health centres. Comments from health professionals related to the print materials included: Good, detailed information, much better than other brochures out there Wow, what fantastic resources - young and funky, just what we need Re the ads themselves, professionals indicated: Fine, nothing exciting, but great to see sexual health being advertised to a wide audience Campaign looks fantastic Campaign looks great

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

The table below indicates distribution of resources throughout WA.


SAFE SEX NO REGRETS Agency Exmouth Hospital FPWA Sexual Health Forum Communicable Disease Control Edith Cowan University (SW) WA Country Health, Goldfields Wooroloo Prison South West Accommodation Sexology Program B2 Clinic, Infectious Diseases Freedom Centre WAAC FPWA Cannington Community College RUAH Quarterly Forum World AIDS Day Kimberley Sexual Health Team Anglicare Kulin Health Nurse Murdoch University Gay Venues TAFE Murdoch University O Day Big Day Out UWA O'Day Curtin O'Day Venue Surveys UWA Medical Centre Big Day Out/Freedom Centre Broome Sexual Health South West Pop Health Nova Radio Coodanup Community College Royal Perth Hospital Kalgoorlie Population Health Carnarvon Hospital Carnarvon AMS Education Managers Forum Shenton College KAMS Parkerville Quarry Youth Services TOTAL condom packs wallet cards booklet Posters brochure 50 40 25 75 50 50 50 50 100 50 50 20 50 50 50 50 25 25 50 30 A3 ATSI 1 1 1 2 3 1 1 1 4 2 1 1 1 4 1 2 A3 gay 1 1 1 3 1 1 1 2 2 1 1 1 2 1 2 A3 hetero 1 1 1 1 1 3 1 1 1 6 2 1 1 1 3 1 1 2 A4 Hetero A4 gay A2 Hetero

25

25 25 25 25 50 25 25 25 25 25

50 25 25 25 25 100 10 25 10 25 25 25 30 25 25 25 20

2 2

2 2 2

1 2 8

100 100 100 50 50 100

10 10 50 25 25 25

50 50 50 80 10 25 50 25 25 25 25 25 20

25 50 50 50 50 15 50 100

1 1 1 1 3 3

1 1 1 1 1 2

1 1 1 1 1 2 3 2

500 50 50 50 50 1 2 2 2 1 4 1 50 1 1 2 2 2 2 4 1 53 1 1 29 11 1 14 7

65 25 535

20 25 1000

1000

50 100 50 1730

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

2.1.4 AIDSLine and Sexual Health Helpline AIDSLine recorded a 300% increase in the number of calls during the campaign period compared to the coinciding period 2006/2007 as well as from the previous three months. The most significant increase was in January and February 2008. The FPWA Sexual Health Helpline received 20 calls as a direct result of the campaign during the three month period. 2.1.5 Additional internet (and other) distribution The campaign was advertised on the Public Health website and the FPWA Sexual Health Services website, including a banner ad on the homepage for the duration of the campaign, details in the e-newsletter that is distributed to 300+ people, and sent out info via the Sexual Health Network (500+ members).

3.0 Impact Evaluation


Evaluation was conducted by the WA AIDS Council in conjunction with the WA Centre for Health Promotion Research. The evaluation sought to replicate the research conducted in NSW to enable some comparison to be conducted. The evaluation also sought to make some comparisons with the data presented in the Sex in Australia Study (2003) as well as the findings from the NSW and DoH (WA) Chlamydia campaigns. The evaluation reviewed the target groups perceptions of the campaign materials as well as their knowledge, attitudes and behaviour before and after the campaign was conducted. Following on from the NSW evaluation the questions targeted several key areas: What was the reach, cut through and salience of the campaign? How effective was the campaign in achieving its objectives?

3.1 Methodology
Replicating the NSW methodology, impact evaluation was conducted via telephone interviews which were utilised both pre and post campaign. Intercept surveys in venues frequented by the target audience were also utilised in the post campaign evaluation. Hello Customer Services were engaged to conduct the telephone surveys before and after the campaign on advice from the WA Centre for Health Promotion Research. Ethics approval was sought and granted from Curtin University of Technology to implement the evaluation. The evaluation of the campaign comprised 400 telephone interviews (combined pre and post Campaign), of approximately 15 minutes duration. Fifty venue based intercept surveys were also conducted post campaign. Pre-Campaign questionnaires were conducted in the week preceding the Campaign launch (November 2007) while post Campaign surveys were implemented between in February 2008. Intercept surveys were conducted over a two week period post campaign. Survey results were analysed by the WA Centre for Health Promotion Research at Curtin University of Technology.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

3.2 Summary of results


3.2.1 Demographics The pre- and post-campaign evaluation respondents comprised approximately 70% females and 30% males. One person identified as transgender in the pre-campaign evaluation. The majority of respondents had lived in WA for most of the last three months. Just under half of respondents (48.5%) were aged between 18 and 29 in both surveys. 3.2.2 Campaign recall Eighty five percent of the target group (18 to 30 year olds) recalled seeing any sexual health advertising after the campaign, compared to 55% before the campaign. When prompted, 80% of the target group recalled seeing the Safe Sex No Regrets campaign. More than ninety percent of the target group recalled seeing the campaign on TV. Ten percent of respondents were able to recall either the Safe Sex No Regrets slogan (n=10), or phrases that had been used in the advertisement (n=7). 3.2.3 Knowledge, attitudes and beliefs At the conclusion of the first round of Safe Sex No Regrets Campaign evaluation, respondents were more likely to agree that there is a high chance of catching an STI from unprotected sexual intercourse; however males and respondents who were not in regular relationships were less likely to agree with this statement. Respondents were also more likely to disagree that there is a low risk of contracting Chlamydia from unprotected sexual intercourse. Females were less likely to disagree with this statement, and comparing female responses from the pre-evaluation to the post-evaluation, they were more likely to disagree in the post-evaluation. In the post-evaluation, more respondents also disagreed with the statement It is not common to catch Herpes from unprotected sexual intercourse. Females were more likely to disagree with this statement, and again, comparing female responses from the pre-evaluation to the postevaluation, they were more likely to disagree in the post-evaluation. Respondents were more likely to disagree in the post evaluation that it is possible to tell if a sexual partner has an STI, however there were no significant differences for age, gender or relationship status. Respondents were also more likely to disagree with the statement I believe that you only get STIs from unprotected sexual intercourse with casual partners in the post-evaluation. Respondents under the age of thirty were less likely to agree with this statement; however across all ages people in relationships were less likely to agree. After the campaign respondents were less likely to agree that they trusted that if their sexual partner had an STI they will tell them. There were no significant differences for age, gender or relationship status. Respondents were also less likely to agree with the statement I wouldn't use a condom if the person Im with does not want to use one. Females and respondents in regular relationships were less likely to agree with this statement, and again, comparing female responses from the pre-evaluation to the post-evaluation, they were more likely to disagree in the postevaluation. Respondents were less likely to agree that cost condoms prevented them from buying condoms. They were also less likely to agree that STI testing is only for people who have multiple sex partners. There were no significant differences for age, gender or relationship status for either question. At the conclusion of the campaign more respondents agreed that condoms were effective at preventing the transmission of Chlamydia, with no significant differences for age, gender or

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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relationship status for either question. There was no significant difference for knowledge of the STI incidence. 3.2.4 Notes For ease of comparison, relationship status was condensed from casual only, casual and regular relationships and regular relationships only to casual relationship (for any casual partner) and regular relationship, denoted by other in tables (for no casual partner). Other denoted respondents who are in a regular relationship only, or not currently sexually active.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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3.3 Results
This section outlines the results of the Safe Sex No Regrets Campaign. Data was analysed using SPSS.

3.3.1 Telephone Surveys


Eligibility and Demographics
Respondents were asked a number of questions related to gender, age and location of the previous three months to ascertain their eligibility to participate. Demographics were also collected from respondents related to education, income, country of origin and cultural background. Gender In the pre and post survey periods females comprised 70% (n=140) and 70.5% (n=141) of the sample respectively. One person indicated there gender as trans in the pre survey period. Place of Residence Respondents were asked whether they had lived in WA for the majority of the previous three months prior to the survey. Pre campaign 97.5% and post campaign 95% answered yes. Age Ages were segmented reasonably uniformly over each age bracket with slightly higher numbers of participants aged 18-21 years and lower numbers of 22-24 year olds. For the purposes of the evaluation results and analysis, the age brackets have been condensed to those aged 18-29 and those aged 30 and older, with 48.5% aged under 30 for both survey periods and 51.5% aged over 30 across both time periods. The table below shows a breakdown of the ages of participants pre and post campaign. pre or post campaign survey pre post 41 (20.5%) 40 (20.0%) 21 (10.5%) 14 (7.0%) 35 (17.5%) 43 (21.5%) 36 (18.0%) 42 (21.0%) 34 (17.0%) 49 (24.5%) 33 (16.5%) 12 (6.0%) 200 (100.0%) 200 (100.0%)

Which of the following age groups do you belong too? 18-21 22-24 25-29 30-34 35-39 40-45 Total

Education Respondents were asked what the highest level of education attained. Results are indicated in the table below.
13%
H igh S c ho o l

15%
High School

36%
T ra de C e rt if ic a t e

37%
Trade Certificate

25%

G ra dua t e D e gre e P o s t G ra dua t e D e gre e

28%

Graduate Degree Post Graduate Degree

26%

20%

Education levels pre campaign

Education levels post campaign

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Sexual Identity The graph below indicates the breakdown of participants by sexual identity. Of all respondents, 91.5% identified as heterosexual pre campaign and 95.5% post campaign.
Pre Campaign Post Campaign

90 80 70 60 50 40 30 20 10 0 Heterosexual LGH Bisexual Trans Refused/Missing

Household Income Participants were also asked about their pre tax household income. Respectively, 53.5% and 62.8% of those surveyed pre and post campaign had a household income of between $60, 000 and $100,000. Ten percent and 13.5% respectively either preferred not to say or were unsure. Those that had a household income of less than $20,000 pre and post campaign comprised 5.5%and 6.5% respectively. Over a quarter of those survey pre and post campaign had a household income of more than $100,000 (pre 25%, post 27.1%) Country of Origin Respondents were asked what country they were born in. In the pre campaign survey, 76% of respondents were born in Australia, 13.5% from the UK, 2.5% in New Zealand. The remaining 8% comprised countries such as Japan, America, India and South Africa. Post campaign, 78.5% of respondents indicated that they were born in Australia, 9.5% from the UK, 3% from New Zealand, 3% from South Africa and the remaining 6% from countries such as Malaysia, El Salvador, Canada and Serbia. Cultural Background Respondents were asked what their cultural background was. In the pre campaign survey, 65.5% of respondents indicated and ethic background of English, 2.5% Greek, 2% German, 4% Italian, 2.5% Irish and 3.5% Scottish. The remaining 20% comprised backgrounds such as Aboriginal, Spanish, Dutch, Indian, and Japanese. Post campaign, 66% of respondents indicated that they identified with a cultural background of English. 9.5% indicated that they were Caucasian. Other responses included Anglo-Indian, Scottish, English/Malaysian and West Indian/Dutch.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Unprompted Awareness of AD Campaigns


Any Sexual Health Message Just under half of respondents (n=86) recalled seeing some form of sexual health advertising during the pre campaign survey period (43%). Of those surveyed during the post campaign period however; almost 70% of respondents (n=139) could recall seeing some form of sexual health advertising unprompted. Those in the younger age bracket (under 30) were more likely across both time periods to have seen some form of sexual health advertising (pre-54.8%, post-82.5%). The under 30 age group also showed significantly higher recall than the over 30 age group for post campaign unprompted recall (under 30 post-82.5%, over 30 post-57.3%). Location When asked the location of the message, TV was overwhelmingly the most common response across both the pre and post survey periods. Over 80% of participants surveyed in the post campaign period indicated that they could recall seeing sexual health advertising on television; a 30% increase from pre campaign. The next most frequent responses were billboards, the radio and bars and clubs. Nearly 5% of those surveyed that indicated they had seen some form of sexual health advertising were unable to remember the location.

80.00 70.00 60.00 50.00 40.00 30.00 20.00 10.00 0.00


M ov ie s ill bo ar ds M ag az in es m em be r sp ap er s R ad eb si cl ub s lu bs te s TV io

Pre Post

/C

* Respondents were able to select more than one answer for this question.

Of those that recalled seeing advertising on television, those aged less than 30 years were more likely to have seen ads on TV post campaign than those in the older age bracket. Recall for the over 30 age bracket for TV however was still high post campaign, comprising nearly 45% of those that had seen some advertising on TV. Those aged less than 30 years were also more likely to have seen sexual health advertising in bars and clubs and at the cinema.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

Yo ut h/ he al th

ar s

ew

on 't

re

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The table below provide a breakdown of results from pre and post campaign by age. Age split into under 30 and 30 and over TV TV Bars or clubs Bars or clubs Movies Movies 18 to 29 30 to 45 18 to 29 30 to 45 18 to 29 30 to 45 pre 22 (22.7%) 20 (19.4%) 6 (6.2%) 0 (.0%) 0 (.0%) 1(1.0%) post 66 (68.0%) 46 (44.7%) 5 (5.2%) 4 (3.9%) 1(1.0%) 1(1.0%)

Message Of those that recalled seeing some form of sexual health advertising (unprompted), the main messages they recalled were related to condoms/safe sex. Pre campaign, unprompted recall of this message was 40% whilst post campaign unprompted recall of the condoms/safe sex message was over 70% (72.3%). Other messages recalled were Safe Sex No Regrets*(pre-2.5%, post- 0.7%), or other**, another message related to sexual and reproductive health (pre-57.5%, post-27%). * The Safe Sex No Regrets TV ad had been played a few times on the final days of the telephone survey. ** Some of the other messages recalled were use condoms, safe sex, Chlamydia, STIs, cervical cancer/cervical cancer vaccine/pap smears, erectile dysfunction/erectile dysfunction remedies, safe sex overseas, sexual harassment and National Condom Day. Of those that recalled seeing a sexual health message most were unable to recall a slogan pre campaign. Post campaign, five respondents correctly identified the Safe Sex No Regrets slogan, and a further nine (5.5%) recalled slogans that sound similar to text used in the campaign. The tables below outline the variety of messages recalled pre and post campaign. Pre Missing Valid Repeating condom many times during the ad* I could get ...x(an STI)x...condoms* Watch out for Chlamydia! Drama down under Get real, Get tested Herpes Its a silent disease As simple as to catch If it's Not on it's Not on!! Practice safe sex Pap smears 5 minutes every 2 years Up the nose and away you go Don't know/Don't remember Total Frequency 125 1 1 1 1 1 1 1 1 2 1 1 1 1 61 200 Percent 62.5% .5% .5% .5% .5% .5% .5% .5% .5% 1.0% .5% .5% .5% .5% 30.5% 100.0%

* The Safe Sex No Regrets TV ad had been played a few times on the final days of the pre campaign telephone survey.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Post
Valid

Safe Sex No Regrets Anyone can carry condoms Anyone can get an STI Anyone can pick up condoms Anyone can pick up Herpes Crossed out sexual diseases put condoms underneath Heading out to pick up woman turns to Herpes Pickup a condom instead Tonight I'm going to get Syphilis turns to condoms Tonight I'm picking Chlamydia Other Don't know/Don't remember Anyone can get condoms Easy to pick up Other - safe sex Total

Frequency 5 1 1 1 1 1 1 1 1 1 3 106 4 1 9 137

Percent 3.6% .7% .7% .7% .7% .7% .7% .7% .7% .7% 2.2% 77.4% 2.9% .7% 6.6% 100.0%

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Prompted Awareness of AD Campaigns Ad 1


Two girls and a guy are seen dancing in a nightclub environment. They are smiling and laughing and seem to be enjoying themselves. As the music plays, across the bottom of the screen the following tagline is shown: Tonight Im picking up Chlamydia The word Chlamydia slowly dissolves to be replaced by the word condoms. Prompted Recall Post campaign, participants were asked to recall whether they had seen or heard of the incarnation of the Safe Sex No Regrets advertisement (outlined above) over the previous months. Of those surveyed, 78% (n=156) could recall personally seeing the advertisement. Of those that had seen the ad, there was an almost equivalent level of recall for both the 18-29 year old age bracket (83.5%) and those aged over 30 years (79.6%). Of those that had seen the ad, females (83.7%), were more likely to have seen the ad than males (76.3%). Respondents were asked where they had seen the ads. The overwhelming majority has seen the ad on television (89.8%), however other responses included radio*, billboards*, magazines, bars or clubs, movies, newspaper, or they were unable to recall.
*The ads were not presented on the radio or on billboards.

There was no real difference in location that the ad was seen for the different age brackets, with both the over and under 30 age brackets seeing the ad most frequently on television. Campaign Message When asked for the main message of the ad, 89.1% reported Condoms/Safe Sex. The remainder of participants thought that the main message related to some other sexual health message related to STIs. Of those that could recall a slogan for the campaign, 10 respondents correctly identified the SSNR slogan and a further 7 (4.4%) recalled slogans that sound similar to text used in the campaign. These included: Anyone can pick up Chlamydia, Dont take home Chlamydia, Tonight Im getting syphilis-turns to condoms Tonight Im picking up Chlamydia What are you taking home tonight, Tonight Im going to pick up a condom. A further six respondents recalled a safe sex slogan not related to the campaign specifically. Believability Overall, of those that recalled the ad, 89.9% though that the ad was believable. There was no significant difference when analysed by relationship status, gender or age (p = > .05). Relevance Those that had seen the ad were asked how relevant the ads were to them personally. Overall, of those that had seen the ad, 70.7% (n=111) indicated they didnt think the ad was personally relevant. When this was broken down by relationship status, those that had casual partners (66.7%) were significantly more likely to find the ads personally relevant than those in regular relationships (24%) (p = 0.00). Significantly more males (43.6%) than females (24.6%) were likely to find the ads personally relevant (p = .024), and those aged under 30 years (44.2%) were significantly more likely to find the ads personally relevant than those aged 30-45 years (15%) (p = 0.00).
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Ad 2
A group of young guys and girls on a pier at sunset are seen in very casual clothes. They are smiling and laughing and seem to be enjoying themselves. As the music plays, across the bottom of the screen the following tagline is shown: Anyone can get infected The word infected slowly dissolved to be replaced by the word condoms. Prompted Recall Post campaign, participants were asked to recall whether they had seen or heard of the incarnation of the Safe Sex No Regrets advertisement (outlined above) over the last couple of months. Of those surveyed, 27.5% (n=55) could recall personally seeing the advertisement. Four people (2%) indicated that they were unsure. Of those that could recall seeing this ad, 25% could recall seeing it on TV. There was no response regarding the location of this ad from 75% of respondents. Message When asked for the main message of the ad, 24.5% reported Condoms/Safe Sex. The remainder of participants didnt know or were unable to remember. Of those that could recall seeing this version of the ad, the majority could not remember a slogan (81.8%). Slogans that were mentioned included Safe Sex No Regrets (3.7%), Tonight Im getting syphilis turns to condoms (1.8%), The words changing (1.8%), Other safe sex messages (9.1%). Believability and Relevance Of those that had seen this incarnation of the Safe Sex No Regrets advertisements, 89% thought that the ad was believable, whilst 35.2% thought that the ads were personally relevant.

Ad 3
Two guys are seen dancing in a nightclub or party environment. They are smiling and laughing and seem to be enjoying themselves. As the music plays, across the bottom of the screen the following tagline is shown: Tonight Im picking up syphilis The word syphilis slowly dissolved to be replaced by the work condoms. Prompted Recall Post campaign, participants were asked to recall whether they had seen or heard of the incarnation of the Safe Sex No Regrets advertisement (outlined above) over the last couple of months. Of those surveyed, 54.5% (n=109) could recall personally seeing the advertisement. Four people (2%) indicated that they were unsure. Of those that could recall seeing this ad, 97.3% could recall seeing it on TV. One respondent recalled seeing it at the movies and two respondents were unable to remember the location of the campaign. Message When asked for the main message of the ad, 94.2% reported Condoms/Safe Sex. The remainder of participants indicated another sexual health message (5.8%). Of those that could recall seeing this incarnation of the ad, the majority could not remember/didnt know a slogan (83.8%). Slogans that were mentioned included Safe Sex No Regrets (7.6%), Tonight Im getting syphilis turns to condoms (1%), Anyone can carry condoms (1%), Other safe sex messages (5.6%) and other (1%). Believability and Relevance Of those that had seen this incarnation of the Safe Sex No Regrets advertisements, 87.3% thought that the ad was believable, whilst 26.4% thought that the ads were personally relevant.
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

18

Attitudes/Beliefs towards Sex and STIs


Participants were asked a series of questions related to their attitudes toward sex and STIs. There is a high chance of catching an STI from unprotected sexual intercourse Over 90% of those surveyed pre campaign believed there is a high chance of catching an STI from unprotected sexual intercourse. Post campaign, this significantly increased to 97% (x2 p = .021/Likelihood ratio 0.16).
100 80 60 40 20 0 Disagree Neutral Pre Post Agree

p = .021 (Likelihood ratio 0.16) a 2 cells (33.3%) have expected count less than 5. The minimum expected count is 3.48. *One respondent in the pre-survey did not give an answer for this question and was excluded from analysis.

Relationship status When analysed by relationship, significantly more respondents in regular relationships (98.7%) were likely to agree (n=152), than those in casual relationships (88%, n=26) (x2 p = .004(Likelihood .017)).
100 Percentage 80 60 40 20 0 Casual Sexual Activity Regular/Other Neutral Agree

x2 p = .004(Likelihood .017) b 2 cells (50.0%) have expected count less than 5. The minimum expected count is .73. * One respondent excluded from analysis

Gender When analysed by gender, females were significantly more likely than males to agree with this statement (x2 p = .000 (Likelihood ratio .000)).
120 100 80 60 40 20 0 Male Female Neutral Agree

x2 p = .000 (Likelihood ratio .000) b 2 cells (50.0%) have expected count less than 5. The minimum expected count is 1.46. * One respondent excluded from analysis

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

Percentage

19

You should always use a condom with casual partners Prior to the implementation of the campaign, 93% of participants agreed that condoms should always be used for sexual intercourse with casual partners . This number increased to 96 % post campaign. Additionally, post campaign, the number of respondents who disagreed with this statement decreased by two percent. No significant difference was detected from pre to post campaign (x2 p = > .05). pre or post survey You should always use a condom for sexual Disagree intercourse with casual partners. Neutral Agree Total pre 7 (3.5%) 7 (3.5%) 185 (93.0%) 199 (100.0%) post 3 (1.5%) 5 (2.5%) 192 (96.0%) 200 (100.0%)

x2 p = > .05 *One respondent in the pre-survey did not give an answer for this question and was excluded from analysis.

There is a low risk of getting Chlamydia from unprotected sexual intercourse Pre campaign 74.3% of those surveyed did not agree with the statement that there is a low risk of getting Chlamydia from unprotected sexual intercourse (n=142). Post campaign this significantly increased by more than ten percent, to 87.4% (x2 p = .004). The number of participants who disagreed with this statement declined by almost half, from 13.1%, to seven percent.
100 Percentage 80 60 40 20 0 Disagree Neutral Agree Pre Post

x2 p = .004 *Eight respondents in the pre-survey and one respondent in the post survey did not give an answer for this question and were excluded from analysis.

Gender When assessed according to gender a significantly greater number of females (90.7%) than males (79.7%) disagreed with this statement (.x2 p = .006 (likelihood ratio .010)).
100 80 60 40 20 0 Pre Post Pre Post

Percentage

Disagree Neutral Agree

Male

Female

Males x2 p = >.05, females x2 p = .009 a 2 cells (33.3%) have expected count less than 5. The minimum expected count is 3.26

In both males and females there was an increase, post campaign, in those who disagreed with this statement. Females who disagreed significantly increased from 77.9% to 90.7%. There was no significant increase for males from pre to post campaign (x2 p = >.05).
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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It is not common to catch Herpes from unprotected sexual intercourse. Among those surveyed pre campaign just over 70% disagreed that it is not common to catch Herpes from unprotected sexual intercourse. There was a significant increase, post campaign to 84.2%, post campaign (x2 p = .011). The percentage of participants who agreed with this statement declined by over half after the campaign was implemented. pre or post survey It is not common to catch Herpes from Disagree unprotected sexual intercourse. Neutral Agree Total pre 138 (71.9%) 33 (17.2%) 21 (10.9%) 192 (100.0%) post 165 (84.2%) 21 (10.7%) 10 (5.1%) 196 (100.0%)

x2 p = .011 *Four respondents in the pre-survey and eight respondents in the post-survey did not give an answer for this question and were excluded from analysis.

Age When assessed according to age, slightly more of those respondents aged 18 to 20 were likely to disagree (87.1%, n=81) than those aged over 30 (81.6%, n=84). This increase was not significant.
100 Percentage 80 60 40 20 0 Pre Post Disagree 18 to 29yrs 30 to 45yrs Neutral Agree

x2 p = .05 (Likelihood ratio .031) a 1 cells (16.7%) have expected count less than 5. The minimum expected count is 4.74.

Gender When assessed according to gender, significantly more females (90.6%) than males (68.4%) disagreed with this statement (x2 p = .000 (likelihood ratio .000)). a 1 cells (16.7%) have expected count less
than 5. The minimum expected count is 2.91.

In both males and females there was an increase, post campaign, in those who disagreed with this statement. Females who disagreed significantly increased from 75.6% (n=102) to 90.6% (n=126). The percentage of males who disagreed increased from 62.5% (n=35) to 68.4% (n=39). Post campaign there was also a decline in the percentage of males and females who agreed with this statement.
100 80 60 40 20 0 Pre Post Pre Post

Percentage

Disagree Neutral Agree

Male
.

Female

Males x2 p = >.05, females x2 p = .003 a 2 cells (33.3%) have expected count less than 5. The minimum expected count is 4.46.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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I believe you can tell if your sexual partner has an STI When asked whether you can tell if your sexual partner has an STI, pre campaign, significantly more respondents (75%) disagreed with this statement pre and post campaign (88.4%) (x2 p = .002). * There was no significant difference between relationship status, age or gender for this question.
100% 80% 60% 40% 20% 0% Disagree Neutral Agree Pre Post

x2 p = .002* *Four respondents in the pre-survey did not give an answer for this question and were excluded from analysis.

I believe that HIV is the only STI to worry about When asked whether HIV is the only STI to worry about pre campaign, 95% disagreed with this statement. Post campaign this percentage increased to 96%. No significant difference was detected between the two survey periods (x2 p = > .05). pre or post survey HIV is the only STI to worry about pre 189 (95.0%) 1 (0.5%) 9 (4.5%) 199 (100.0%) post 191 (96.0%) 1 (0.5%) 7 (3.5%) 199 (100.0%) total 380 (95.5%) 2 (0.5%) 16 (4%) 398 (100.0%)

Disagree Neutral Agree

Total

x2 p = > .05 *One respondent in the pre-survey did not give an answer for this question and was excluded from analysis.

I believe that using a condom is an excellent way of preventing STIs When asked whether they believe that using a condom is an excellent way of preventing STIs, pre campaign, 87.4% (n=174) agreed, whilst post campaign this increased to 92% (n=184). No significant difference was detected between the two survey periods (x2 p = > .05). *One respondent in the
pre-survey did not give an answer for this question and was excluded from analysis.

I believe that you only get STIs from unprotected sexual intercourse with casual partners When asked whether they believe that you only get STIs from unprotected sexual intercourse with casual partners, significantly more respondents disagreed with this statement (x2 p = .003). Pre campaign, 61.7% (n=121) disagreed with the statement, whilst post campaign this increased to 77% (n=154).
100 80 60 40 20 0 Disagree Neutral Pre Post Agree

x2 p = .003 *Four respondents in the pre-survey did not give an answer for this question and were excluded from analysis.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

Percentage

22

Relationship When analysed by relationship status, there was a significant difference in the number of those in casual versus regular relationships that were likely to disagree with this statement (x2 p = .037). Of respondents in casual relationships, 96.2 % disagreed that you only get STIs from unprotected sexual intercourse with casual partners. Of those in regular relationships 73.9% of respondents disagreed with this statement.
120 100 80 60 40 20 0 Disagree Neutral Casual Sexual Activity Regular/Other
x2 p = .037

Percentage

Agree

Age When analysed by age, more people aged under 30 (n=97) were likely to disagree (83.5%) with the statement than those aged over thirty years (n=103, 70.9%) (x2 p = .011).

Percentage

100 80 60 40 20 0 18 to 29yrs Disagree Neutral 30 to 45 yrs Agree

x2 p = .011

I trust that if my sexual partner has an STI they will tell me. When asked whether I trust that if my sexual partner has an STI they will tell me, there was a significant difference in responses pre and post campaign (x2 p = .022*). Pre campaign, 31.5% (n=62) disagreed which increased to 44.7%, whilst 55.3% agreed (n=109) pre campaign which decreased to 43.2% (n=86).
*Three respondents in the pre-survey did not give an answer for this question and were excluded from analysis. * There was no significant difference between relationship status, age or gender for this question.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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I wouldn't use a condom if the person Im with does not want to use one. When asked whether they wouldnt use a condom if the person Im with doesnt want to use one, there was a significant difference in responses pre and post campaign (x2 p = .026). Significantly more respondents were likely to disagree with this statement with 69.6% (n=133) disagreeing pre campaign which increased to 80.3% (n=159). Pre campaign 17.8% agreed (n=34) and 12.6% (n=24) were neutral. Post campaign, 9.1% agreed (n=18) and 10.6% (n=21) were neutral.

100 Percentage 80 60 40 20 0 Disagree Neutral Agree Pre Post

x2 p = .026 *Eight respondents in the pre-survey did not give an answer for this question and were excluded from analysis.

Relationship When analysed by relationship status, those in regular relationships were more significantly more likely to disagree with the statement I wouldnt use a condom if the person Im with doesnt want to use one than those in casual relationships (x2 p = .003 (Likelihood ratio .011)). Of those in casual relationships, 61.5 percent of respondents disagreed (n=16), whilst of those in regular relationships more than 80% (n=123) disagreed with this statement. Those in casual relationships were more likely to be neutral on this statement.

Relationship Status

Regular/Other Casual Sexual Activity Post Pre Post Pre

Female

Agree Neutral Disagree

Male

20

40

60

80

100

Percentage
a 2 cells (33.3%) have expected count less than 5. The minimum expected count is 2.64.

Gender In both males and females there was an increase, post campaign, in those who disagreed with this statement. Overall females were significantly more likely to disagree with the statement than males (x2 p = .022). Females who disagreed increased from 75.9% to 88.6%, post campaign. The percentage of males who disagreed increased from 54.4% (n=31) to 60.3% (n=35). There was no significant change for males from pre to post survey (x2 p = >.05).
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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The cost of condoms stops me from buying them. When asked whether the cost of condoms stops me from buying them, pre campaign, 81.6% disagreed, 9.2% agreed and 9.2% were neutral. Post campaign 89.8% disagreed, 3.6% agreed and 6.6% were neutral. * There is only a weak association for this variable. There was no significant difference between relationship status, age or gender for this question(x2 p = .041).* pre or post survey The cost of condoms stops me from Disagree buying them Neutral Agree Total pre 160 (81.6%) 18 (9.2%) 18 (9.2%) 196 (100.0%) post 176 (89.8%) 13 (6.6%) 7 (3.6%) 196 (100.0%)

(x2 p = .041)* *Three respondents in the pre-survey and four respondents in the post-survey did not give an answer for this question and were excluded from analysis.

STI testing is only for people who have multiple sex partners. When asked whether STI testing is only for people who have multiple sex partners}, there was a significant difference pre and post campaign (x2 p = .010)*. Pre campaign, 67.9% disagreed, which increased to 80.2%, post campaign. Those that agreed decreased from 20.4% to 10.2%, and the numbers that were neutral decreased by half from pre to post campaign survey period. * There was
no significant difference between relationship status, age or gender for this question.

pre or post survey STI testing is only for people who have Disagree multiple sex partners Neutral Agree Total

pre 133 (67.9%) 23 (11.7%) 40 (20.4%) 196 (100.0%)

post 158 (80.2%) 19 (9.6%) 20 (10.2%) 197 (100.0%)

x2 p = .010* *Three respondents in the pre-survey did not give an answer for this question and were excluded from analysis.

Condom use for preventing Chlamydia, Herpes and HIV Respondents were asked to agree or disagree with statements regarding condom effectiveness to prevent Chlamydia, Herpes and HIV. There was a significant increase in the number of people that agreed with this statement pre and post campaign for Chlamydia (x2 p = .008). Pre campaign, 75.4% (n=150) responded in the affirmative, which increased to 85%, post campaign. The number that indicated they were unsure decreased from 18.6% (n=37) to 14% (n=28), post campaign.

Post HIV Pre Dont know Herpes Post Pre Post Pre 0 20 40 60 80 100 No Yes Chlamydia

Percentage
Chlamydia (x2 p = .008), Herpes and HIV (x2 p = > .05) *No significant difference between relationship status, age or gender

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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However there was no significant difference for herpes and HIV (x2 p = > .05). When asked whether you believe that condoms are effective at preventing herpes, pre campaign, 68.3% (n=136) responded in the affirmative, which increased to 72.9% (n=145), post campaign responded in the affirmative, 12.6% said no (n=25) and 14.6% (n=29) were unsure. Pre campaign, 82.9% (n=165) responded in the affirmative, when asked whether you believe that condoms are effective at preventing HIV, which increased to 88.9% (n=176), post campaign. Rates of Chlamydia, Herpes and HIV in WA Respondents were asked to agree or disagree with statements regarding the rates of Chlamydia, herpes and HIV in WA. There was no significant shift in the number that thought the rates of each were increasing, decreasing or staying the same, pre and post campaign (x2 p = > .05). Pre campaign 57% (n=114) thought that Chlamydia was increasing, 3% decreasing (n=6) and 28% (n=56) staying the same. Twenty four respondents (12%) were unsure. Post campaign 59.8% (n=119) thought that it was increasing, 3.5% decreasing (n=7) and 30.7% (n=61) staying the same. Twelve respondents (6 %) were unsure.

Post HIV Pre

Herpes

Post

Pre

Dont know Staying the same Decreasing Increasing

Chlamydia

Post

Pre 0 20 40 Percentage 60 80

In relation to herpes, pre campaign 42% (n=84) thought that it was increasing, 7.0% decreasing (n=14) and 36% (n=72) staying the same. Thirty respondents (15%) were unsure. Post campaign 46.2% (n=92) thought that it was increasing, 5.5% decreasing (n=11) and 41.7% (n=83) staying the same. Thirteen respondents (6.5 %) were unsure. In relation to HIV, pre campaign 38.5% (n=77) thought that it was increasing, 15.5% decreasing (n=31) and 34.5% (n=69) staying the same. Twenty three respondents (11.5%) were unsure. Post campaign 41.1% (n=81) thought that it was increasing, 15.2% decreasing (n=30) and 38.1% (n=75) staying the same. Eleven respondents (5.6 %) were unsure.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Sexual risk behaviour


Participants were asked a series of questions related to their sexual risk behaviour. Sexual Activity When asked whether they had engaged in sexual intercourse in the previous six months (pre campaign) , 88.5% of participants had been sexually active, 11% indicated no sexual activity in that time period and 0.5% was unsure. Post campaign, 89% had been sexually active, 10% had not and one respondent indicated they didnt know.

90 80 70 60 50 40 30 20 10 0 Pre Campaign Post Campaign Unsure Sexually Active in past 6 months Not Sexually Active in past 6 months

Participants were asked about who they had engaged in sexual activity with. Pre campaign, 83.5% (n=167) had sex only with someone of the opposite sex, 3% (n=6) indicated having sex only with someone of the same sex and 2% (n=4) with someone of the same sex and someone of the opposite sex. Post campaign, 88% (n=176) had sex only with someone of the opposite sex, 1.5% (n=3) indicated having sex only with someone of the same sex and 0.5% (n=1) with someone of the same sex and someone of the opposite sex. There were 23 and 20 responses missing from the pre and post
campaign surveys respectively.

90 80 70 60 50 40 30 20 10 0
Pre Campaign Post Campaign

only opposite sex only same sex opposite and same sex

Casual or regular sexual activity Participants were asked if the sex had been with a regular or casual partner. The majority of those surveyed in the pre campaign period were in a relationship with a regular partner (83%, n=147), whilst 8.5% indicated a casual only relationship and 8.5% indicated both regular and casual partners.
Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Post campaign, 85.5% of those surveyed indicated that they were in a regular relationship (n= 153). Those that identifying a casual only relationship comprised 8.4% and 6.1% identified that they had both regular and casual partners.

90 80 70 60 50 40 30 20 10 0 Pre Campaign Post Campaign

Regular Casual Both regular and casual

Condom use with casual partners Respondents were asked whether they had used condoms for sexual intercourse with a casual partner. Pre campaign, of all those that had sex, 29.9% indicated that they had mostly used condoms, 13.6% indicated sometimes and 56.5% indicated that they never used condoms with casual partners. Post campaign, of all those that had sex, 25.8% indicated that they had mostly used condoms, 13.2% indicated sometimes and 61% indicated that they never used condoms with casual partners. Twenty three and 41 respondents from the pre and post surveys respectively were not included in the
sample.

Pre campaign, of those that had sex with casual partners in this time period, 65.6% indicated that they had mostly used condoms, 13.8% indicated sometimes and 20.6+% indicated that they never used condoms with casual partners. Post campaign, 70% indicated that they had mostly used condoms and 30% indicated that they sometimes used condoms with casual partners. One and six
respondents from the pre and post surveys respectively were not included in the sample.

Condom use and sexual intercourse with a regular partner Participants were asked whether they used condoms with a regular partner. Pre campaign, 19.4% indicated that they mostly used condoms, 5.6% indicated they sometimes used condoms as 75% indicated that they never used condoms with casual partners. Post campaign, 28% indicated that they mostly used condoms, 12.8% sometimes and 59.1% indicated that they never use condoms with regular partners. When looking at those that had indicated casual sex, pre-campaign, 65.5% indicated that they mostly used condoms with regular partners, 13.8% sometimes and 20.7% never. Post campaign, 36% of those indicating casual partners, indicated that they mostly used condoms with regula partners, 20% indicated sometimes and 44% indicated that they never used condoms with regular partners. Carrying condoms Respondents were asked whether they carried condoms whilst they were out. Pre campaign, 11.6% indicated that they often carried condoms (n= 23), whilst 82.9% of participants indicated that they never carried condoms (n=165). Post campaign, 20.1% indicated that they often carried condoms (n= 40), whilst 79.9% of participants indicated that they sometimes carried condoms (n=159). No respondents indicated never carrying condoms.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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With regard to casual only, 33.3% of respondents (pre campaign) indicated often carrying condoms whilst 40% indicated never carrying condoms (n=12). Post campaign 61.5% of respondents (n=16) indicated often carrying condoms while 38.5% indicated sometimes carrying condoms. No respondents indicated never carrying condoms. STI check ups Respondents were asked whether they had been for a check up for sexually transmitted infections (STIs) at a GP or Sexual Health Clinic in the last 6 months. Pre campaign, 76.9% (n=153) of respondents indicated that they had not been for as STI test, whilst 22.6% (n=45) indicated they had been tested last six months. Post campaign, 83.9% (n=167) of respondents indicated that they hadnt been tested for STIs in the past six months with only 15.6% indicating that they had been tested. Of those that were in a casual relationship only, 26.7% had been tested pre campaign whilst only 11.5% had been tested post campaign.

90 80 70 60 50 40 30 20 10 0 Pre campaign Post campagin

STI testing No STI testing Casual testing

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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3.3.2 Venues surveys


Fifty surveys were conducted with patrons of pubs and clubs in and around the metropolitan of Perth. The surveys did not ask individuals questions related to their sexual behaviour; however the remainder of the questions were the same as the telephone survey. Questions related to country of origin, cultural background, education and household income were also excluded.

Location
The table below shows the breakdown of the surveys conducted by location. The Captain Stirling (34%) and the Ocean Beach Hotel (32%) were the most frequently surveyed locations.

Location Valid Captain Stirling Clancy's Fremantle Claremont Hotel Flying Scotsman Ocean Beach Hotel Paddington Ale House Total

Frequency 17 5 2 6 16 4 50

Valid Percent 34.0 10.0 4.0 12.0 32.0 8.0 100.0

Eligibility and Demographics


Respondents were asked a number of questions to ascertain their eligibility to participate in the survey related to gender, age and place of residence for the previous three months. Females comprised 44% (n=22) and males 56% (n=28) of the sample respectively. Participants were asked whether they had lived in Western Australia (WA) for the majority of the previous three months to the survey. All participants surveyed had been in WA for that period. The table below shows a breakdown of the ages of participants. The ages were diversely split over each age bracket with the highest numbers aged between 18-24 years. For the purposes of the evaluation results and analysis, the age brackets have been condensed to those aged 18-29 and those aged 30 and older, with 80% aged under 30 and 20% aged over 30. Which of the following age groups do you belong to? Valid 18 - 21 22 - 24 25 - 29 30 - 34 35 - 39 40 - 45 Total Frequency 17 14 9 5 4 1 50 Valid Percent 34.0 28.0 18.0 10.0 8.0 2.0 100.0

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Unprompted Awareness of AD Campaigns


Any Sexual Health Message Over 70% of respondents (72%, n=36) recalled seeing some form of sexual health advertising during the survey period. When asked the location of the message, over half of respondents (52.9%, n=27) had seen sexual health ads on TV. The next most frequent responses were bars and clubs (17.6%, n=9)), radio (11.8%), billboards (7.8%), magazines (5.9%), newspapers (2%) and youth/health group videos (2%).
* Respondents were able to select more than one answer to this question.

Message Of those that recalled seeing some form of sexual health advertising (unprompted), the main messages they recalled were related to condoms/safe sex with 75.8% of respondents recalling this message. Of those that recalled seeing a sexual health message most were unable to recall a slogan (86%). Messages that were recalled included: No Regrets, Anyone can getcondoms, tonight Im picking up condoms, Im going to pick up clam/condoms, How easy is it to get condoms, and not all you get .

Prompted Awareness of AD Campaigns


Prompted Recall Post campaign, participants were asked to recall whether they had seen or heard of the incarnation of the Safe Sex No Regrets advertisement (outlined above) over the last couple of months. Of those surveyed, 86% (n=43) could recall personally seeing the advertisement. Respondents were asked where they had seen the ads. The overwhelming majority has seen the ad on television (71.2%). Other responses included on billboards*(5.8%), in magazines (3.8%), in bars or clubs (15.4%), at the movies (1.9%), or they were unable to recall (1.9%).
*The ads were not presented on billboards. Respondents were able to select more than one answer to this question.

Campaign Message When asked for the main message of the ad, 81.4% reported Condoms/Safe Sex (n=35). The remainder indicated other messages. Of those that could recall a slogan for the campaign, 8 respondents could identify some form of sexual health message. Ten respondents (20%) could remember either the safe Sex No Regrets slogan or some variation including: Tonight Im picking up Chlamydia/condoms Tonight Im going to pick up a condom I'm going to pick up Chlamydia/condoms 86% were either unable to recall or missing from the sample. Believability and Relevance Of those that had seen the Safe Sex No Regrets advertisements, 90.7% thought that the ad was believable, whilst 62.8% thought that the ads were personally relevant.

Safe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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Attitudes/Beliefs towards Sex and STIs


Participants were asked a series of questions related to their attitudes and beliefs towards sex and sexually transmitted infections. There is a high chance of catching an STI from unprotected sexual intercourse Eighty two percent of those surveyed believed there is a high chance of catching an STI from unprotected sexual intercourse (n=41). Ten percent (n=5) disagreed with this statement. Females (95.5%, n=21) were slightly more likely than males (71.4%, n=20) to agree with this statement. You should always use a condom for sexual intercourse with casual partners When asked whether you should always use a condom for sexual intercourse with casual partners, 96% agreed with this statement (n=48). Females (100%, n=22) were more likely than males (92.9%, n=26) to agree with this statement. Males were also more likely to disagree (3.6%) or neither agree or disagree (3.6%). There is a low risk of getting Chlamydia from unprotected sexual intercourse Seventy eight percent of those surveyed didnt believe there is a low risk of getting Chlamydia from unprotected sexual intercourse (n=39). Ten percent (n=5) agreed with this statement. Four percent did not know and 8% neither agreed nor disagreed. Females (86.4%, n=19) were slightly more likely than males (71.4%, n=20) to disagree with this statement. Females were also slightly less likely than males to agree (f=9.1%, m=10.7%) or neither agree or disagree (f=0.0%, m=14.3%). It is not common to catch Herpes from unprotected sexual intercourse When asked to respond to the statement It is not common to catch Herpes from unprotected sexual intercourse, 74% disagreed with this statement (n=37). Six participants (12%) indicated that they didnt know and 4% (n=2) neither agreed nor disagreed. Females (77.3%, n=17) were slightly more likely than males (71.4%, n=20) to disagree with this statement. Males were more likely to agree (10.7%) than females (9.1%) or neither agree or disagree (m=7.1%, f=0.0%). Three male and three female respondents indicated that they didnt know. You can tell if your sexual partner has an STI Ninety percent of those surveyed did not believe that you can tell if your sexual partner has an STI (n=45). Two percent (n=1) agreed with this statement. Two percent did not know and 3% neither agreed nor disagreed. Females (90.9%, n=20) were slightly more likely than males (89.3%, n=25) to disagree with this statement. Females were also slightly more likely than males to agree (f=4.5%, m=0%) whilst males were slightly more likely to neither agree nor disagree (f=4.5%, m=7.1%). HIV is the only STI to worry about When asked to respond to the statement HIV is the only STI to worry about, 96% disagreed with this statement (n=48). Two participants (4%) agreed with this statement. Females (9.1%, n=2) were slightly more likely than males (0%, n=0) to agree with this statement. Males were more likely to disagree (100%, n=28) with this statement than females (90.9%, n=20). Using a condom is an excellent way of preventing STIs Ninety percent of those surveyed agreed that using a condom is an excellent way of preventing STIs (n=45). Six percent (n=3) disagreed with this statement. Four percent neither agreed nor disagreed with this statement (n=2). Males (96.4%, n=27) were more likely than females (81.8%, n=18) to agree with this statement. Females were slightly more likely than males to disagree (f=9.1%, m=3.6%) and more likely to neither agree nor disagree (f=9.1%, m=0%). You only get STIs from unprotected sexual intercourse with casual partners Responding to the statement you only get STIs from unprotected sexual intercourse with casual partners, 86% disagreed with this statement (n=43), whilst 14% agreed with this statement. Two participants (4%) agreed with this statement. Females (86.4%, n=22) were slightly more likely than males (85.7%, n=28) to disagree with this statement.
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I trust that if my partner had an STI that they would tell me Sixty six percent of those surveyed disagreed that they trust if their sexual partner had an STI that they would tell them (n=33). Twenty percent (n=10) agreed with this statement. Twelve percent neither agreed nor disagreed (n=6) and one respondent didnt know. Males (67.9%, n=19) were more likely than females (63.6%, n=14) to disagree with this statement. Males were also slightly more likely than females to neither agree nor disagree (f=9.1%, m=14.3%). I wouldnt use a condom if the person Im with doesnt want to use one When asked to respond to the statement I wouldn't use a condom if the person I'm with does not want to use one, 84% disagreed with this statement (n=42), whilst 6% agreed with this statement. Four participants (8%) neither agreed nor disagreed with this statement. Females (95.5%, n=21) were more likely than males (75%, n=21) to disagree with this statement. Males were more likely than females to agree with this statement (10.7%, n=3). The cost of condoms stops me from buying them Ninety six percent of those surveyed disagreed that the cost of condoms stops me from buying them (n=48). Females (100%, n=22) were more likely than males (92.9%, n=26) to disagree with this. STI testing is only for people who have multiple sex partners When asked to respond to the statement STI testing is only for people who have multiple sex partners, 90% disagreed with this statement (n=45), whilst 8% agreed with this statement and one respondent was unsure. Females (95.5%, n=21) were more likely than males (85.7%, n=24) to disagree with this statement. Males were more likely than females to agree with this statement. Condom effectiveness Participants were more likely to think that condoms were effective at preventing Chlamydia and HIV than herpes. Eighty six percent agreed that Condoms are effective at preventing Chlamydia (n=43), 84% agreed that Condoms are effective at preventing HIV (n=43) and 74% of those surveyed agreed that Condoms are effective at preventing Herpes (n=37). Overall Males were more likely than females to agree with these statements. Rates of Chlamydia, Herpes and HIV in WA Respondents were asked about rates of three STIs in Western Australia. Respondents were asked to indicate if they felt that rates were increasing, decreasing or remaining the same in WA. With regard to Chlamydia, 78% (n=39) thought that it was increasing, 2% decreasing and 8% (n=4) staying the same. Six respondents (12%) were unsure. Females (90.9%, n=20)) were more likely than males (67.9%, n=19) to think that rates were increasing, whilst males were more likely to think rates were decreasing (3.6%), staying the same (10.3%), or were unsure (17.5%, n=5). In relation to herpes, 62% (n=31) thought that it was increasing, 4% decreasing and 22% (n=11) staying the same. Six respondents (12%) were unsure. Females (72.7%, n=16) were more likely than males (53.6%, n=15) to think that rates were increasing or staying the same (f=22.7%, m=21.4%), whilst males were more likely to think rates were decreasing (7.1%), or were unsure (17.9 %,). With respect to HIV, 48% (n=24) thought that it was increasing, 14% decreasing and 28% (n=14) staying the same. Five respondents (10%) were unsure. Females (63.6%, n=14) were more likely than males (35.7%, n=10) to think that rates were increasing, whilst males were more likely to think rates were decreasing (14.3%), staying the same (35.7%), or were unsure( 14.5%, n=4).

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4.0 Discussion
Demographics
Overall the majority of evaluation respondents in both periods were female and this has had a significant impact across many of the surveys questions. For less biased results, greater measures will need to be taken to ensure an adequate gender and age balance should the campaign evaluation be undertaken again. The larger number of females agreeing to take part in the telephone surveys is consistent with the number of participants in the WA 2007 Chlamydia campaign (Comtesse and Mak, 2007) however considerably different to the NSW Campaign which included males as two thirds of its participants, however the NSW research did also interview a large proportion of homosexual males specifically as part of their sample. The majority of those surveyed in the WA sample identified as heterosexual, consistent with the findings of the 2003 Sex in Australia study which indicated the proportion of the population who reported identifying as homosexual or bisexual was low and that 91.4 percent of men and 84.9 percent of women indicated they were exclusively heterosexual in terms of attraction and lifetime experience (SRP, 2005, Smith et al., 2003). Those that identified as same sex attracted were higher in the NSW research which is due in part to a larger sample and may potentially be attributed to a larger gay scene in Sydney than in Perth. There were no major revelations with relation to cultural background and country of origin, with the majority of respondents identifying as Australian with European heritage, indicative of the high level of understanding and believability of the ads which are predominantly aimed at those with an English speaking background. Whilst the different incarnations were aimed at heterosexual, homosexual and indigenous audiences, it is the view of the researchers that for the purposes of the WA campaign that these incarnations represented diversity as opposed to specific strategies targeting different population groups. This is also evidenced by responses from Aboriginal health workers who indicated that the aboriginal people in the posters didnt look like they were from WA, but it was good that aboriginal people were included in mainstream ads. With relation to education and income, over 75% of those surveyed had an annual household income of over $60, 000. This is significantly higher than the figures from the Sex In Australia research which indicated around 40% or respondents to have an annual household income greater than $52, 000 (de Visser et al, 2003). It may be postulated that this is to do with generally higher wages in Western Australia attached to the resource boom. Around 30% of respondents had a tertiary qualification. Over 50% of respondents had completed high school or a trade certificate as their highest form of formal education. This may have impacted responses to some attitude questions as for many of those surveyed, health education messages may not have been provided to them post high school and for some depending on the type of secondary school they attended, sexual health and relationship education may have been limited as sexual health education is not mandatory in secondary schools in Western Australia. The majority of those surveyed indicated that they were in a regular relationship. This is consistent with findings from the Sex in Australia study which showed that 85.3% of Australian men and 89.5% of women were in a regular heterosexual relationship (Rissel et al, 2003). This has shown to influence the relevance of the ads and the way in which individuals will respond to the attitudinal questions. This may be due in part t the fact that over 50% of those surveyed were between the ages of 30 and 45 years which is often the time that regular relationships develop and are cemented. This affected the responses for many of the questions as those in regular relationships were less likely to see the ads as relevant to them and less likely to identify with many of the attitudinal questions. Those surveyed in the night venues were likely to have been younger and less likely to have been in a regular relationship than those that completed the telephone surveys.
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Campaign recall
Reach The campaign achieved good reach with over 80% of the target audience recalled having seen the campaign. This is a higher level of recall than in the NSW evaluation, (approximately 60%) which may be attributed to other competing messages in NSW. However, across both states, television was the biggest location of recall (SRP, 2005). Based on unprompted recall, there was a 30% increase in the number of respondents that had seen any sexual health message post campaign indicating the high general campaign reach. Unprompted recall of the campaign was slightly lower amongst those surveyed in venues compared to respondent by telephone. Television was still the most commonly recalled location for seeing the ads. Prompted recall amongst venue based respondents was higher than telephone respondents. Respondents from venues were more likely to have seen the campaign advertising in pubs and clubs, indicating a higher level of attendance at such venues. This higher level of recall of the venues based advertising may mean that those surveyed by telephone who in general were in regular relationships were less likely to frequent night spots and therefore less likely to see this form of advertising. Another conclusion that may be drawn is that those attending nightspots are looking to pick up and therefore are more susceptible to the campaign messages. As the ad was unable to be shown to respondents, descriptions of the television advertisement and incarnations of the posters and brochures were used instead including the use of show cards. As evidenced by the results, those surveyed in venues has greater promoted awareness of the campaign which may also be due to the use of show cards related to the campaign. Cut through Evaluation results indicated that the campaign messages had some cut through. This is indicated by messages recalled such as Use condoms and Safe Sex which are overall in line with the campaign however broader than the actual campaign slogan. This may indicate greater general awareness of other campaigns such as the Department of Health WA Chlamydia campaign or the Gardasil cervical cancer vaccine campaign, both of which had been in the market prior to the launch of the Safe Sex No Regrets campaign. This is highlighted by a number of the messages recalled through unprompted awareness realting to these two campaigns. It is also shown by suggestions from the target group that they heard this campaign on the radio, when in fact this was not one of the media strategies. The Department of Health Chlamydia campaign was however, aired on radio, so it is pleasing to see general sexual health awareness from respondents. Greater cut though may be achieved through longer screening on the primary location of recall, television. This is a decision that is impacted by timing and cost, however further investigation is warranted. It is not surprising that television is the most frequently recalled location that respondents recalled given that it was screened across channels, and the evaluation was conducted just after the completion of the campaign. Supporting materials may be required to maintain message recall when the campaign is not screed in high recall settings. The more specific campaign messages and slogans may show higher levels of recall should the campaign be implemented again, however the results to date are useful given the limited frequency of exposure achieved within the campaign budget. In night venue surveys, promoted and unprompted recall indicated condoms/safe sex was the campaign message. Unprompted recall of around 70% was consistent with the telephone based surveys, as was promoted recall of these messages at over 80%. Salience The campaign reminded people about the risks of transmission of sexually transmitted infections and the effectiveness of using condoms to prevent STIs, particularly Chlamydia and HIV. Most respondents believed that the campaign message were believable however there were generally
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low levels of perceived personal relevance. It is thought that one of the key reasons for this is that the vast majority of people surveyed were in regular relationships and therefore whilst they may have seen the ads as generally relevant, they didnt see them as personally relevant. Overall the ads were viewed by the target group as credible which reflects the results of the NSW campaign which also showed high levels of salience (SRP, 2005). Based on these results, if there are subsequent rounds of the campaign, the evaluation question could to be re-worded to do you think that the campaign is relevant to your age group which is felt would achieve higher affirmative responses. Respondents in the venues based survey were more slightly more likely to perceive the campaign as believable and 30% more likely to see the ads as relevant, than those that were surveyed by telephone. This may be due in pat to the nightclub feel of the campaign and younger, more single demographic of those surveyed through venues.

Knowledge, attitudes and beliefs


Participants were asked a series of questions related to their attitudes and beliefs towards sex and sexually transmitted infections. It would appear that the campaign has been more successful in reinforcing existing knowledge than providing high levels of new information to the target group, consistent with findings from NSW (SRP, 2005). Respondents had generally high levels of knowledge and awareness of issues related to STIs and sexual health. In general females were more likely to have higher levels of correct knowledge, whilst men were more likely to have more liberal attitudes to statements regarding condoms, STIs and casual sex than female respondents. These findings are consistent with the Sex in Australia study which indicated that women had significantly higher knowledge of STIs and BBVs than men and that in general men were more liberal with views toward sex (Rissel et al, 2003). Responses to the questions reported in the NSW evaluation showed little attitudinal difference from pre to post campaign. The evaluation showed overall high levels of agreement with a broad range of attitudes measures, particularly the relationship between the use of condoms and sex with casual partners. This is generally reflected in the WA campaign results. As with the WA research, few participants in the NSW study thought that they could tell if their partner had an STI, that HIV was the only STI to worry about, or that the price of condoms was a barrier to purchase (SRP, 2005). In the WA study, knowledge related to STI transmission was higher for Chlamydia than herpes, whist knowledge and awareness related to HIV was mixed. This is different to findings from the Sex in Australia research which indicated generally lower levels of knowledge related to Chlamydia and Herpes than HIV, however similar with respect to higher levels of awareness amongst females than males (Grulich et al, 2003). Attitudes toward condom effectiveness was high, with respondents more likely to believe that condoms are effective for Chlamydia and HIV than herpes, and that condoms should be used for sex with casual partners. Over 95% of venue based respondents agreed that you should always use a condom for sex with a casual partner which is consistent with the findings from the telephone survey. The high level of awareness regarding Chlamydia may be attributed in part to the implementation of the Chlamydia campaign which contributed to overall high levels of market awareness related to that STI in particular. This is also borne out by the fact that respondents had generally higher levels of awareness with relation to rates of Chlamydia than HIV or herpes. Respondents were more likely to agree that rates of Chlamydia were increasing compared to herpes or HIV. Overall venues based respondents showed high levels of agreement that condoms are effective to prevent Chlamydia, herpes and HIV. Participants were more likely to think that condoms were
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effective at preventing Chlamydia and HIV than herpes, which is consistent with the findings from the telephone surveys. Those in venues based surveys were more likely to think that there is a low risk of acquiring Chlamydia from unprotected sex, with a consistent number of females with the telephone surveys more likely to disagree. They were also slightly more likely to disagree that there is a low risk of acquiring herpes from unprotected sex. More females than males disagreed with this statement. Those in venues were slightly less likely than telephone respondents to think that using a condom is an excellent way to prevent STI transmission, and less likely to disagree that you only get STIs from unprotected sex with casual partners. Those in venues were more likely to disagree that they trusted their sexual partner to tell them if they had and STI than those in the telephone sample. Those surveyed in venues were more likely to disagree that the cost of condoms were likely to prevent purchase. Of note is that participants were more likely to think that rates of HIV were decreasing than Chlamydia or herpes. This could be due o low levels of public awareness regarding HIV in WA in recent years. Interestingly, females were more likely than males to disagree that there is low risk of contracting Chlamydia or herpes from unprotected sex, which may have something to do in part with lower levels of concern related to Chlamydia and herpes than an STI such as HIV. These results serve to indicate that the campaign has reinforced existing beliefs and attitudes which when correct as is primarily the case here is a positive outcome. Those in the venues surveys were more likely to think that rates of Chlamydia, herpes and HIV were increasing than those in the phone sample. They were also more likely to be unsure of their response to this question than the phone survey respondents and less likely to think rates were staying the same. Similar numbers of respondents were likely to think rates of HIV were decreasing. Overall there was a high level of consistency of answers amongst those surveyed in venues with responses from the telephone respondents. Those in venues were less likely to believe that there is a high chance of getting an STI from unprotected sex than telephone respondents, however as with the telephone survey, females were more likely to agree with this statement. Respondents in relationship were more likely to agree that there is a high chance of catching an STI from unprotected sexual intercourse. This may in part be due to the notion that only promiscuous people get STIs and promiscuous people have casual unprotected sex. Those in casual relationships may not like to think that they are at risk, or may be practising sex with condoms so may be less likely to agree. In fact, those in casual relationships were more likely to have used condoms pre and post campaign. Women more than men were also likely to agree with this statement, supporting the previous statement that men have generally more liberal view than women with relation to sex and lower levels of knowledge and awareness. The majority of respondents disagreed with the statement I believe that you only get STIs from unprotected sexual intercourse with casual partners post-evaluation. Respondents under the age of thirty were more likely to disagree with this statement as were those that were in a casual relationship. This is most likely due to the fact that the question directly questions their own behaviour which they may choose to overlook. After the campaign respondents were less likely to agree that they trusted that if their sexual partner had an STI they will tell them. There were no significant differences for age, gender or relationship status. Respondents were also less likely to agree with the statement I wouldn't use a condom if the person Im with does not want to use one. Females and respondents in regular relationships were less likely to agree with this statement, and again, comparing female responses from the pre-evaluation to the post-evaluation, they were more likely to disagree in the postSafe Sex No Regrets Campaign WA 2007/2008_________________________________________WA AIDS Council

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evaluation. Females were also more likely to be in a regularly relationship and as evidenced by research from the Sex in Australia study, more likely to expect their partners to not have sex with other people (Rissel et al 2003). Participants in casual relationships may be more likely to consider sex without a condom if it meant the difference between having or not having sex. When asked to respond to the statement I wouldn't use a condom if the person I'm with does not want to use one, higher numbers of those surveyed in venues were likely to disagree with this statement than those in the telephone sample. In both samples females were more likely to disagree with this statement. This may be due to lower numbers of those surveyed in venues being in regular relationships and therefore more likely to use condoms which is consistent with the findings from this study regarding condom use and relationship status. Those in the venues based surveys were more likely to disagree that you can tell if your sexual partner has an STI, while there was a high level of disagreement across both samples when asked whether HIV is the only STI of concern. There was a high level of disagreement with the statement that STI testing is only for people with multiple sex partners across the telephone and venues surveys. Those surveyed n venues showed higher levels of disagreement with this statement than those in the telephone surveys. This may be due to the fact that those in telephone based surveys were more likely to be in regular relationships and therefore less likely to have multiple partners. Venues based respondents were less likely to provide a neutral answer to this question.

Sexual Behaviour
Participants were generally likely to have been sexual active in the six moths prior to the campaign, with someone of the opposite sex and within a regular relationship. Only around 1% had engaged in sex with someone of the same sex as themselves. Just over 10% of respondents had not been sexually active in the six moth period prior to the implementation of the campaign. Those that identified sex with casual partners comprised just over 8% and just over 6% indicated sex with both casual and regular partners. These figures are supported by the Sex in Australia figures which show that nearly 90% of respondents were in a regular, heterosexual relationship and between 3% and 5% of respondents having concurrent partners (Rissel et al, 2003). With regard to condom use, frequency of condom use varies depending on the relationship between sexual partners, with consistent condom use rare. These findings are supported by the Sex in Australia study as well as the NSW evaluation (de Visser et al, 2003, SRP, 2005). The NSW study showed that very little behaviour change occurred across the three items under investigation. No more than 40% of those surveyed agreed that they usually or always, carry condoms went out, use condoms for sex with regular partners or for sex with a casual partner (SRP, 2005). Within the WA study, post campaign only 20% indicated that they carried often condoms when out, which is similar to the NSW findings of 26% and is not surprising given that they majority of respondents were in a regular relationship (SRP, 2005). Casual respondents indicated they were significantly more likely to carry condoms than those in regular relationships. However, nearly 100% of respondents post campaign indicated that they sometimes carried condoms. Within the WA sample, post campaign, over half of all respondents indicated never using condoms with casual partners. Of those in casual relationships, post campaign, 70% indicated that they mostly used condoms which increased from 65% pre campaign. Participants were also surveyed as to whether they used condoms with a regular partner. Over 50% of those surveyed indicated never using condoms with regular partners however those that were in casual relationships were more likely to use condoms with regular partners. Sex in Australia findings indicated that for vaginal intercourse, consistent condom use was more likely with casual partners than with regular partners; 7.1 percent always used condoms with regular live-in partners, 22.5
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percent with regular non-live-in partners and 41.4 percent with casual partners (de Visser et al, 2003). Findings from the current study indicated 28% mostly used condoms with regular partners and 36% indicated that they mostly used condoms with casual partners. These findings are consistent with the Sex in Australia study which showed that fewer than half of the people who were sexually active in the year prior to being interviewed had used a condom in the past year. Findings also indicated that condom use was significantly more likely among those who had more than one sexual partner in the past year, and that consistent condom use was more likely with casual partners that with regular partners (de Visser et al, 2003).
Finally, respondents were asked whether they had been for a check up for sexually transmitted infections (STIs) at a GP or Sexual Health Clinic in the last 6 months. Those in casual relationships were slightly more likely to have been tested, however overall testing rates were low at less than 20%. This is an obvious area of concern as many STIs are asymptomatic and can have serious long term consequences without intervention. This may indicate an area of serious need regarding a general call to action for STI testing particularly with the addition of inconsistent condom use highlighted by the current and previous areas of research. Currently the only dedicated campaign addressing this area is the current Department of Health (WA) Chlamydia campaign.

No sexual behaviour questions were asked of those surveyed in night venues. It was decided that the survey questions would need to be modified and that individuals may not feel comfortable answering these questions in public and with a researcher. It is likely that there would be disparity between results garnered with this group compared to those interviewed by telephone.

5.0 Limitations
There were a number of limitations of the evaluation conducted which much be taken in to consideration when reviewing the results. The sample size was small and there was also some difficulty getting respondents for the 18-30 year old category and equal numbers across the categories. The gender balance was also uneven with approximately 70% of evaluation respondents being female. As such the generalisability of the results is limited. The evaluation was also cross sectional, meaning there was no way to determine whether shifts in attitudes and behaviour were related to the campaign. The evaluation was also only conducted in the metropolitan area so generalising it to regional areas is difficult. Recall of campaigns may have been higher in regional areas as towns are generally smaller and the opportunities for advertising such messages limited compared to Perth. There are fewer television stations and venues for advertising so the opportunity to see the campaign may actually have been increased. Due to the small numbers it was also difficult to draw significant conclusions from pre and post campaign shifts across many categories, with the notable exceptions of campaign recall. The ability to measure significance of results for gender, age and relationship status across behaviour and attitudes was also limited. The venues based surveys were conducted post campaign only and so we are unable to assess market change with relation to ad recall in this environment. Sexual behaviour questions were not administered in this environment so comparisons to the telephone survey data with relation to these questions were unable to be conducted. As the ad was unable to be shown to respondents, descriptions of the television advertisement and incarnations of the posters and brochures were used with telephone respondents and venues based respondents were able to view incarnations of the ads via the use of show cards. As evidenced by the results, those surveyed in venues has greater promoted awareness of the campaign which may also be due to the use of show cards related to the campaign. Better ads descriptions are needed for the telephone surveys should evaluation be conducted in the future.

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6.0 Recommendations
6.1 Campaign
It is recommended that this campaign be rolled out again to continue the high level of market saturation and recall amongst the target group and to maintain the impetus that the campaign rollout has created. Greater emphasis on the television component is warranted given the high levels of recall through this medium. Another medium to consider is radio, which been successful with the WA Department of Healths Chlamydia campaign. Additionally, young people nominated radio as a preferred method for receiving health information in the evaluation of the same campaign. Additional buzz through associated activities related to the campaign and during the campaign period will also assist with the campaign cut through. With regard to the look and feel of the campaign it has a limited shelf life and would probably only be appropriate to roll out on another one to two occasions before the creative loses its credibility. It is also most appropriate for screening during summer months and connected to the pub and club scene as the campaign creative indicates. There may be opportunity for a WA specific or national campaign to then be developed. Campaigns need to identify and develop specific strategies for males based on lower levels of awareness and knowledge and more relaxed attitudes towards condom use. Ongoing public knowledge across a variety of settings is required to complement this campaign and reinforce key messages. The opportunity to influence behaviour through a social marketing campaign such as Safe Sex No Regrets is limited, however to create a greater sense of behaviour reinforcement or call to action, greater frequency of exposure of the campaign is required.

6.2 Evaluation
With relation to recommendations for the next Safe Sex No Regrets evaluation it is suggested to: Narrow the age group to 18 30 year olds. Target a smaller phone sample 100 participants Increase the number of male participants Increase the venues sample as many as possible/logistical as this is the key target group as identified through the campaign creative. For the venues, include a one page self complete questionnaire to cover sexual identity and sexual risk behaviour questions. Include questions on number of sexual partners and keep only the knowledge, attitudes & behaviours questions in which there has been a significant shift. The questions on STI rates can be excluded from the next survey. Demographics questions can also be condensed to education, income and country of birth.

7.0 Conclusion
The implementation and evaluation of the 2007/2008 Safe Sex No Regrets Campaign has demonstrated the feasibility of a WA mass media campaign targeting 18-30 years related to sexual health. The evaluation has engendered relevant and valuable feedback on message recall as well as sexual behaviour and attitudes towards condoms use and STIs. The evaluation has also shown the opportunities for reach and cut through provided by the use of television and venue based advertising. The high level of recall based on a short campaign timeframe with limited budget highlights the value of social marketing as a supporting strategy for health promotion initiatives in the community. Whilst not useful on its on to change behavior, the opportunity to increase a collective community consciousness regarding sexual health and condom use is valuable. With increasing rates of sexually transmitted infections within WA, consideration to further develop specific social marketing strategies focusing on condom use and testing as an adjunct to other strategies is warranted.
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8.0 References
Comtesse, S and D. Mak. 2007. 2007 Chlamydia Campaign Evaluation Report. Department of Health, Western Australia. Kwan, K & Combs, B. 2008. STI, BBV & HIV Epidemiology Update, Period Ending 1st Quarter 2008. Epidemiology and Surveillance Program, Department of Health, Perth, WA. Department of Health, Health Protection Group, Communicable Disease Control Directorate 2007a, The Epidemiology of Notifiable Sexually Transmitted Infections and Blood-Borne Viruses in Western Australia 1995 to 2005, Department of Health, Western Australia. de Visser, R. O., A. M. A. Smith, C. E. Rissel, J. Richters and A. E. Grulich. 2003. Safer sex and condom use among a representative sample of adults. Australian and New Zealand Journal of Public Health 27 (2): 223-29. Grulich, A. E., R. O. de Visser, A. M. A. Smith, C. E. Rissel and J. Ritchers. 2003. Homosexual experience and recent homosexual encounters. Australian and New Zealand Journal of Public Health 27 (2): 155-63. Grulich, A. E., R. O. de Visser, A. M. A. Smith, C. E. Rissel and J. Richters. 2003. Knowledge about sexually transmissible infections and blood-borne viruses in a representative sample of adults. Australian and New Zealand Journal of Public Health 27 (2): 230-33. Rissel, C.E., J. Ritchers, A. E. Grulich, R. O. de Visser and A. M. A. Smith. 2003. Attitudes towards sex in a representative sample of adults. Australian and New Zealand Journal of Public Health 27 (2): 11823. Smith, A. M. A., C. E. Rissel, J. Ritchers, A. E. Grulich and R. O. de Visser. 2003. Sexual identity, sexual attraction and sexual experience among a representative sample of adults. Australian and New Zealand Journal of Public Health 27 (2): 138-45. Rissel, C.E., J. Ritchers, A. E. Grulich, R. O. de Visser and A. M. A. Smith. 2003. Selected characteristics of regular sexual relationships. Australian and New Zealand Journal of Public Health 27 (2): 124-30. Stancombe Research and Planning. 2005. Pre and Post Evaluation of the NSW safe sex campaign 2005, SRP. Sydney: SRP. Wilkins, A and D. Mak. 2005. 2005 Chlamydia Campaign Evaluation Report. Department of Health, Western Australia.

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