MARCH Outcome Evaluation
over the same time frame that were not attributed to the MARCH intervention. This was witnessed by the observed positive temporal changes in a number of indicators when data were compared between the non-exposed outcome survey respondents and those at baseline, reflecting the synergistic effect of multiple campaigns and interventions that operate at various levels in the study areas.
It is well known that the epidemiological and social contexts of HIV differed between Addis Ababa and West Hararghe. The HIV epidemic has already been matured in Addis Ababa where prevalence levels of consistently exceeding 10% have been reported over the past decade or so. Though epidemiological data are scarce, a rural community such as West Hararghe is expected to have HIV prevalence levels often not exceeding 2%, as revealed by the nationwide Demographic and Health Survey (DHS) as well as ANC-based HIV sentinel surveillance studies. Furthermore, the general levels of HIV/AIDS related knowledge, attitudes and sexual behaviours are different between these two populations. The population of Addis Ababa obviously have come across more HIV preventive messages and also has several alternative sources than that of West Hararghe. Other socio-economic attributes such as educational levels, religion, economic status, traditional belief system, etc also considerably differ between these two populations. How, if at all, these factors may have affected the likelihood of success of the MARCH intervention in these populations is unknown. Nevertheless, our analysis indicated the presence of more positive changes in certain groups of intervention participants than in the others in both of the study areas. Whereas more positive changes were recorded among females, married and older participants than the other groups in Addis Ababa, it appeared that males were more likely than their female counterparts to have exhibited positive changes as a result of participating in the MARCH in West Hararghe. These findings may reflect (1) a better ability of the MARCH intervention to address the particular concerns of some sections of the population in the two areas or (2) a greater receptivity to the intervention among certain groups than others. This evaluation research, however, did not allow us to tease out which distinct components of the intervention were involved in these changes, and, as a
Addis Ababa and West Hararghe