Comparison of the Performance of Logistic Regression Model in the Presence and Absence of Mediation

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Abstract

Over the last decade major global efforts mounted to address the HIV epidemic has realized notable successes in combating the pandemic. Sub Saharan Africa (SSA) still remains a global epicenter of the disease, accounting for more than 70% of the global burden of infections. Despite wide spread use of various intervention strategies that act as mediation factors in Human Immunodeficiency Virus (HIV) prevention, HIV prevalence still remains a challenge especially in some geographic areas and populations. Therefore, how mediation factors interact with the prevailing HIV risk factors to cause an impact on its prevalence remains a question not answered. This study considered Exposure to HIV related media as a mediator variable in the relationship between HIV risk factors and HIV prevalence. Two logistic regression models, one in presence of mediation and another in absence of mediation were formulated and compared to establish the best performing model. Models were fitted to real data from the Kenya Population-based HIV Impact Assessment survey-2018 and model parameters were estimated using Maximum Likelihood Estimation in R. Results based on both Akaike’s Information Criterion and the McFadden’s R2 value revealed that the model formulated in presence of mediation performed better compared to that without mediation.

Most cited references 11

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Effectiveness of mass media interventions for HIV prevention, 1986-2013: a meta-analysis.

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This meta-analysis was conducted to synthesize evaluations of mass media-delivered HIV prevention interventions, assess the effectiveness of interventions in improving condom use and HIV-related knowledge, and identify moderators of effectiveness.

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The impact of a mass media campaign on personal risk perception, perceived self-efficacy and on other behavioural predictors.

S Agha (2003)

To determine whether an AIDS prevention mass media campaign influenced risk perception, self-efficacy and other behavioural predictors. We used household survey data collected from 2,213 sexually experienced male and female Kenyans aged 15-39. Respondents were administered a questionnaire asking them about their exposure to branded and generic mass media messages concerning HIV/AIDS and condom use. They were asked questions concerning their personal risk perception, self-efficacy, condom effectiveness, condom availability, and their embarrassment in obtaining condoms. Logistic regression analysis was used to determine the impact of exposure to mass media messages on these predictors of behaviour change. Those exposed to branded advertising messages were significantly more likely to consider themselves at higher risk of acquiring HIV and to believe in the severity of AIDS. Exposure to branded messages was also associated with a higher level of personal self-efficacy, a greater belief in the efficacy of condoms, a lower level of perceived difficulty in obtaining condoms and reduced embarrassment in purchasing condoms. Moreover, there was a dose-response relationship: a higher intensity of exposure to advertising was associated with more positive outcomes. Exposure to generic advertising messages was less frequently associated with positive health beliefs and these relationships were also weaker. Branded mass media campaigns that promote condom use as an attractive lifestyle choice are likely to contribute to the development of perceptions that are conducive to the adoption of condom use.