While sub-Saharan Africa contributes only 11% of the world’s population, the region alone carries a disproportionate burden of HIV, making it the epicenter of the epidemic in the world. According to UNAIDS, Sub-Saharan Africa remains the worst constituency globally. Where in 2017 alone – 71% of the people living with HIV across the region was recorded, and a further 65% peak of new infections. The World Health Organisation also states that the African Region accounted for almost two thirds of the global total of new HIV infections in 2018. The statistics are indeed overwhelming, and something needs to be done to curb the prevalence of HIV, especially amongst young people.
In his article of how digital and social media strategies can play a part in addressing the widespread of HIV, with a particular focus on Nigeria, Dr. Sabastine Wakdok highlighted that for the country which is considered the demographic colossal of Sub-Saharan Africa – with an estimated population of 200 million – more effort is needed for the inclusion of young people. As referenced from his article, titled “Role of Digital & Social Media Strategies- HIV” Dr. Wakdok summarised the 2019 survey by NAIIS and UNAIDS – where in the prevalence of HIV in the general population stands at 1.5%. However, those aged 18 to 24 years have a higher HIV prevalence of 3.3%.
These figures are rather worrisome and unacceptable from a public health perspective, for a country with almost 200 million people in which about 50% of its population would be below 25 years by 2030. Therefore, its substantial workforce falls within the age category which is befallen by the HIV pandemic invariably leading to loss of ‘man-hours’ due to chronic ill-health as well as the huge financial burden placed on an already weakened and overburdened healthcare system in Nigeria.
Wakdok suggested that for Nigeria to succeed in fighting the war against the dreaded HIV epidemic in this subpopulation, a combination of strategies using digital and social media must be carefully implemented alongside the current traditional approach of television, radio and print media.
Available data suggest that the most commonly used social media platforms amongst urban age groups 18-24 years in Nigeria are: Facebook (49.8%), Twitter (24.4%), Instagram (11.3%), YouTube (2.2%), and R3 Snapchat (2%). For the suburban and rural age groups 18-24 years in Nigeria, Facebook users account for over 60%. YouTube and twitter lag behind in the rural population. The market research also shows that of the two leading digital and social media platforms in Nigeria which are Facebook (27m users) and Instagram (6.5m users). About 33% of the Facebook users were aged 18-24 years while about 34% of the Instagram users were aged 18-24 years.
The young population aged 18-24 years have aired out their frustrations in multiple arenas during National testing campaigns saying they are often not understood. Their peculiarity is often ignored, and their sexual and reproductive needs are lumped up with that of the general population. Their grievances suggest that they feel a lack of personalization, thereby making it very difficult to penetrate these target audience. Every customer desire a personal approach to any form of marketing even with public service.
For a successful marketing approach to be effective and generate clientele as well as customer retention with regards to uptake of HIV prevention and treatment services by these young ‘hard to penetrate’ population in Nigeria, the country must implement the strategic approach that imbibes social influencers as HIV ambassadors, seeding and Viral Campaigns on HIV Awareness and Connected Customers, Social Interactions and social listening among other things.
Social Influencers as “HIV Ambassadors”
Influencer style in advertising has continued to gain a lot of traction in digital and social media marketing. Influencers are Instagram, Facebook, Twitter, YouTube users who have established credibility and audience and who can persuade others by their trustworthiness and authenticity. Applying to the case under review, Nigeria should map out the key social influencers that these young age groups adore and follow. As evidence has suggested that these young groups go to any length in adhering to what these social influencers do. Therefore, key social influencers that have large followership on these platforms like Instagram and Facebook among young Nigerians such as music pop stars, movie actors, footballers and renowned athletes can be approached to serve as “HIV Ambassadors”. These HIV ambassadors have a special way of connecting with the young people and will assist in delivering short and standardized contents on HIV prevention services which speaks to abstinence, use of condoms and discouraging intravenous drug use by teenagers and young adults.
Also, seeding and Viral Campaigns on HIV Awareness approach is one that can help Nigeria to reach out to millions of young people via digital and social media platforms like Facebook, Twitter, and Instagram whereby shared HIV prevention messages through paid, earned or owned media can be spread quickly amongst the younger population. These channels can serve as a means of information on where products like condoms can be made available. The seeding campaigns tend to be done by normal or regular people which can go viral as the HIV prevention messages and campaigns move along the chain of communication. The flow of communication can be either one-step or two-step approach. In the case of one-step, the products and services will be sent by NACA to key persons who after using such services will pass to the larger crowd on their platforms. In the case of two-step, the first seeds will in turn channel communication through a second step. Likewise, influencer campaigns can be used, and this adds more quality due to the value influencers bring as discussed under social influencers earlier.
Connected Customers, Social Interactions and social listening
There is increasing emphasis on companies in the marketing world to understand the antecedents and consequences of customer-to-customer (C2C) interactions which is one of the most important strategic approaches of customer management in recent years. This interest is driven by modern digital and social media channels online that enable customers which in this case are the young Nigerians to be connected in numerous new ways as well as organisations such as National Agency for the Control of AIDS, Nigeria to access rich C2C data through the phenomenon of “connected customers and social interactions”. Through the use of digital and social media platforms like Facebook, Twitter, Instagram and others, the social marketing and communications unit of HIV/AIDS control organisations can harness the enormous amount of rich data that maps out the daily interactions of these target population in terms of listening and monitoring their trending conversations and behavioural attributes on issues surrounding risky behaviours and how best to device means to address this unique set of subgroups. In doing so, they can tailor targeted health-seeking adverts that speak to these subgroups based on the data that came from the trending issues they voiced out on their preferred digital and social media platforms. These channels can also help the country’s HIV/AIDS control organisation to track the so-called “hot zones” in the country where high risky behaviours are seen to be prevalent thereby channeling the limited resources dedicated to the fight against HIV/AIDS in Nigeria as well as sharing this data with international development partners.
Also, the connected customer approach can be used to pass down vital information on HIV prevention and treatment services amongst these subgroups in a ‘language’ that they easily understand through their peers who have used such services and found it reliable and trustworthy.
To conclude, Dr. Wakdok’s article highlighted the impact of the crises on the peak of infections among the youth, stating that very little is being done to spread the awareness to ease the HIV burden in the country, with the hope for this study to inspire the Nigerian government and increase fast-tracked action. The study and its recommendation are merely based on his research and the experiences and discernments of people who wrestles with these challenges, added with the information from think-tankers working on HIV/AIDS globally.
Therefore, a very big opportunity avails the country to use this same approach positively by situating individuals or icons including those within their age brackets to guide them into informed choices in terms of knowing their HIV status by posting their HIV status social media pages as well as condemning all forms of risky behaviours like intravenous drug use, avoidance of premarital sex and proper use of condoms amongst a host of others. The probability will be higher for the young Nigerians to follow these actions as evidenced by successes of ‘social proof’ in marketing to customers. The overall effect will be an increased opportunity to reduce new infections and to further prevent the spread of HIV amongst this difficult and hard to penetrate subgroup.
Dr. Sabastine Wakdok is a Family Medicine Physician. He has an MBA from Oxford, and an MSc in Public Policy from University College London (UCL), and a Certificate in International Management from Stanford University. He has over 14 years of working history in healthcare. His research interest includes Global health policy, governance, health financing and systems and HIV/AIDS prevention and treatment.