Persuasive conversations increase HIV prevention uptake by 29%

Medical male circumcision (MMC) is a low-cost, effective HIV prevention method, reducing female-to-male transmission by about 60%. But getting men to circumcise requires more than making services available. Many men do not follow through by booking for an MMC procedure, despite clearly indicating an intention to do so.

In South Africa, men are mobilised for MMC through mass media campaigns or social mobilisers and are then directed to a contact centre. Our research revealed that these conversations could be informed by a number of behavioural economic insights to get men to follow through on their commitments to circumcise.

We piloted two evidence-based interventions that focused on improving the persuasiveness of contact-centre calls (nationally) and social mobilisation conversations (in Kwa-Zulu Natal province).

In our contact-centre pilot, we revised scripts and objection-handling guides. In our social mobilisation pilot, we revised conversation guides and pocket brochures. We incorporated many well-known persuasive devices into these materials such as personalisation, social proof, self-generation and messenger effect

After randomly stratifying contact-centre agents and social mobilisers into two groups, (test and control groups), we found that the number of calls converted into booked appointments for MMC increased by 21%. In our social mobilisation pilot we found that the number of social mobilisation conversations converted into bookings being increased by 25% relative to the control group. We also confirmed that actual procedures had increased by 29%. Most importantly, we were able to validate these results statistically. This means we can be sure that these increases were due to our intervention rather than just by chance.

Were these results to be realised on a national scale, we estimate that this would result in nearly 50,000 extra bookings per year, and at least 31,000 extra clinically confirmed procedures per year. This offers robust evidence that behavioural insights effectively increases uptake of MMC services and suggests it may be useful in increasing the uptake of other health services.