Analysis of the Impact of Social Marketing on the Reduction of Seroprevalence of Infection in Mali: Case of the NGO Wale in the Urban Commune of Ségou

This work aims to assess the importance of social marketing through communication in reducing the seroprevalence of HIV infection in the urban commune of Ségou. This analysis, based on both theoretical and empirical studies, involved a sample of one hundred and five (100) people made up of residents of the urban commune of Ségou and staff of the NGO Walé. The results of our research "The impact of social marketing on reducing hiv infection in Mali" show that the majority of respondents in the urban commune of Ségou (81%) are satisfied with the means of communication of social marketing to reduce the seroprevalence of HIV infection against 19% of unsusc satisfied for various reasons (4% due to the always high rate, 9% of cases of denial and 6% who find communication strategies insufficient).Of 81% of people who are satisfied with the means of social marketing communication used to reduce the seroprevalence of HIV/AIDS, 49% are men compared to 32% of women. Our results show that the use of social marketing techniques has a positive impact on the reduction of seroprevalence in the urban commune of Ségou.


Introduction:
The HIV pandemic is a scourge that affects every continent and whose poverty contributes greatly to progress. With more than 35 million deaths to date, HIV continues to be a major global public health problem.
In 2014, an estimated 34.3 to 41.4 million people were living with HIV worldwide. There has been an increase over previous years as a result of the increase in the number of people on antiretroviral therapy.
According to the WHO at the end of 2017, between 31.1 and 43.9 million people were living with HIV/AIDS today. As many as 1.8 million new cases are reported each year. Since the early 1980s, the disease has reportedly killed nearly 35 million people.
of new infections with the virus worldwide, in sub-Saharan Africa, three out of four new infections affect girls aged 15 to 19, and young women aged 15 to 24 are twice as likely to live with HIV as men.
In Mali, although its impact on the national economy is not assessed, HIV AIDS is an obstacle to economic development through the financial effects of its care and its social impact on communities. Its prevalence among the population aged 15 to 49 rose from 1.7% in 2001 to 1.1% in 2017 with disparities depending on the level of residence (1.9% in urban areas versus 0.9% in rural areas) and gender. The prevalence rate is higher for women than for men, at 1.3% and 0.8% respectively.
Unfortunately, these results highlight a reality that seriously hampers the fight against the disease. They demonstrate the weakness of the national response, which still depends heavily on (80%) external funding. The definition of the role of each actor (Ministry of Health and civil society) is also essential for a better national appropriation of this struggle. HIV pandemic is a scourge that affects every continent and.
However, the effectiveness of all these responses will lie in the use of appropriate social marketing management tools in the fight against AIDS. This leads us to reflect and ask the following question: How important social marketing is in reducing the seroprevalence of HIV infection.
To add to this problem, this paper will be organized as follows: The first will be devoted to the contextual framework, the literature and methodological review and the second part we will present the results and the conclusion.
individual has always tried to inform, persuade, influence, motivate, and gain the trust of new adherents to a set of ideas. In its broadest sense, social marketing is therefore a new approach to designing very old human projects. According to Kotler, advertising campaigns to promote social progress are not a new phenomenon. In Greco-Roman antiquity, campaigns were recorded to call for the liberation of slaves. During the industrial revolution, English civil society organized campaigns against incarceration for debt and child labour, as well as for women's right to vote. In the 19th century, the United States was agitated by movements for the abolition of slavery. Other movements such as the suffragette have led to the implementation of important social reforms.
Consumer advocacy campaigns have forced governments to regulate the quality of food and medicines. It was in 1971 that Kotler and Zaltman3 first used the concept of social marketing. Although the idea dates back to January 1969 in an article in the Journal of Marketing where Kotler and Lévy suggested expanding the application of the concept of commercial marketing to social causes: "Marketing is a human activity oriented towards the satisfaction of desires through exchange. The societal marketing perspective is a management orientation geared towards customer satisfaction and the long-term well-being of the consumer and the general public as a means of enabling the organization to achieve its objectives and meet its responsibilities." "These authors did not propose a new concept; rather, they aimed to bring into the concerns of theorists a practice that was taking place at that time, since museums, hospitals, politicians, or even, in developing countries especially, the promotion of birth control were being promoted." It must be said that the emergence of the concept of social marketing did not please everyone. Theorists and social workers are protesting against this expansion of the field of commercial marketing. The latter has rather bad press in that it would use 'deception' towards consumers. Ideas are "noble" entities. "You can produce goods and adapt them to the tastes of others for profit; to do the same with ideas will be seen as demagoguery, deceit, even prostitution." But this conception of things did not prevail and social marketing took off brilliantly. Today, it is used in several areas: health promotion, environmental protection, education, economics, domestic violence, human rights, racism, etc.
But what does the concept of social marketing cover? Social marketing uses commercial marketing techniques to solve social problems that are essentially based on behavioural change. According to Philip Kotler, social marketing is the design, implementation and control of programs designed to promote a social idea or practice to a target group. It is <<a social change management technique that includes the design, implementation and control of programs to increase the acceptability of an idea or action to one or more target groups." According to Andreasen, social marketing implements "the analysis, planning, delivery and evaluation of programs designed to influence the voluntary behaviour of the target audience to improve their well-being and that of society." Social marketing aims to influence and change social behaviour for the benefit of the target audience and society at large. It's within everyone's reach. It has nothing to do with education insofar as its ultimate goal is to influence behaviour. It may seek to change values and attitudes to influence behaviour. Social marketing recognizes many of the principles that apply to commercial marketing: assessing needs, identifying the target audience, developing products, and evaluating results. According to Kotler, social marketing <<usus the concepts of market segmentation, consumer research, development, communication, facilitation, stimulating and exchange theory to maximize the response of the target group." Commercial marketing is based on competition between companies while social marketing gives precedence to the well-being of its customers. Acting on behalf of the community, it is based not on desires, but the values and ideals of society; it is above all the marketing of the good. When commercial marketing plays on the pleasure of the smoker by offering him longer and tastier cigarettes, social marketing will engage him, in the name of a certain value, not to smoke. The success of social marketing is measured, not in terms of money, but in terms of qualitative change of the individual where society rediscovers its roots, its values, its humanism.

Review of previous studies on the subject
Reducing the seroprevalence of HIV infection has been the subject of much research because of the importance of HIV infection. Studies in many countries have shown that many factors are involved in the spread of HIV. Discovered in the United States in 1983, the Human Immunodeficiency Virus (HIV) is now one of the world's greatest murderers. More than twenty-three million deaths worldwide are directly attributable to it, of which nineteen million are in sub-Saharan Africa alone; it is also in this part of the world that more than two-thirds of the 33 million people living with the virus reside (UNAIDS, 2008). In addition to this already alarming picture, the effects of the disease do not stop in the medical field. Beyond the health sector, what makes HIV/AIDS special is its impact on development. Indeed, the disease affects adults in their most sexually active years that coincide with their most productive years. Without HIV/AIDS, these people would have little chance of dying from another cause. For example, HIV/AIDS affects development by: 1-The symptoms of the disease were discovered in the first subjects in 1981, the name AIDS was adopted in 1982, but it was not until 1983 that the virus responsible for AIDS could be identified.
2-Before the HIV/AIDS epidemic, mortality in sub-Saharan Africa was mainly concentrated in the 0-5 age groups due to infant and over-50 mortality.
after age 50 and therefore does not affect the age group of people counted in the HIV/AIDS prevalence rate) which account for 9% of deaths, malignancies, and diabetes with 3.5% and less than 1% of total deaths, respectively. The labor intermediary is the key factor in production in Africa. Through it, disease undermines three pillars of development: economic growth, human capital, and the investment climate. Macroeconomic calculations have assessed the impact of AIDS on the economies of developing countries: one to two points of GDP growth (gross domestic product) is lost when 10% of the population is infected (Couderc and Ventelou, 2005). This is huge for a continent where half the population lives below the poverty line and which must achieve an economic growth rate of 5% per year just to maintain the status quo. HIV/AIDS exacerbates poverty and contributes to growing inequalities between the developed and developing worlds. The consequences of HIV/AIDS on development are undeniable, so it must be seen as a development problem in its own right. Currently, there is no vaccine for HIV/AIDS, and the most effective treatments that involve ART of antiretroviral drugs are inaccessible to the vast majority of the groups most at risk of infection. This means that the only effective way to combat the evolution of the epidemic for these countries is through prevention. The purpose of this article is precise to identify the various factors that influence or could influence the spread of HIV/AIDS, as well as the different channels through which this impact passes, particularly in sub-Saharan Africa. The HIV/AIDS epidemic is driven by a range of socio-economic, socio-cultural, and epidemiological determinants. These determinants are numerous, complex, interact with each other, and have a double causal link with the HIV/AIDS epidemic. This is precisely one of the reasons why the epidemic has evolved worse than even in the most pessimistic projections.
Indeed, the epidemic is spreading because economic, socio-cultural, and epidemiological conditions favor it. In turn, as described above, it aggravates these conditions, notably through its impact on the workforce, institutions, and even diseases. This leads to a vicious cycle of the HIV/AIDS epidemic in poor countries. While much work has been devoted to the economics of HIV/AIDS over the past decade, most of it consists of impact studies and assessments of the impact of the epidemic on various aspects of economic life. The analysis of the determinants of the epidemic seems equally relevant to us. Although the resources allocated to the fight against HIV/AIDS are far from sufficient, much could already be done from such an amount to control the epidemic provided that resources are allocated where they are used in the most effective way.
The Importance of the Environment In September 1999, UNAIDS 6 conducted a study to explain the difference in the rates of spread of the HIV/AIDS epidemic in Central and West Africa (where prevalence was relatively low) and in East and Southern Africa (where prevalence was much higher). This study found that differences in behavior alone are not sufficient to explain differences in HIV prevalence rates. Behavioral differences even seem to be more than offset by differences in the risk of transmission of the virus. Although the median age at first sexual intercourse was lower in southern and eastern Africa and the age difference between partners is greater than in Central and West Africa, changes in partners and male contact with sex workers were more common in Central and West Africa than in southern and eastern Africa. Condom use during casual contact was low at all sites. On the other hand, with the exception of chlamydia, communicable sexual diseases were much more common at the sites of Kisumu (Kenya) and Ndola (Zambia) than in Cotonou (Benin) and Yaounde (Cameroon). Moreover, in Cotonou and Yaounde, virtually all men reported being circumcised, compared to only 10% in Ndola and less than 30% in Kisumu.
Stillwagon (2000) agrees as it is wary of the "exceptional nation" of the African HIV/AIDS epidemic. For her, it is important to focus on sanitary and economic conditions when studying the determinants of the epidemic. Thus, gender discrimination, malnutrition, and parasitosis, lack of hygiene and care for STIs are of the utmost importance, especially as these characteristics are also found in other parts of the world facing an emerging HIV/AIDS epidemic.
Finally, Bonnel (2000) points to the political-legal climate as one of the catalysts for the epidemic, which is at the same time a variable on which HIV will have a negative impact. In most countries facing a widespread epidemic, the spread of HIV/AIDS goes hand in hand with high rates of poverty and therefore deplorable living conditions, high income and gender inequalities, incomplete epidemiological transition resulting in the high prevalence of infectious diseases, and still inadequate knowledge of the epidemic (UNDP, 2003).
For example, in the implementation of prevention programs, social marketing tools such as Information, Education and Communication Strategies (IEC) and Communication for Behavioural Change (CCC) are generally used.
What should be these social marketing tools to reduce the seroprevalence of HIV infection in the Walé NGO area of intervention? Chart I: Representation of respondents from the urban commune of Ségou by gender The male sex was the most represented among respondents in the urban commune of Ségou with 62% against 38% of women.

Analysis and comments
We wanted to comment and discuss in the following pattern: 2.2.1. The difficulties of the study During our study, despite good will, we faced difficulties that are of various natures: For the respondents of the urban commune of Ségou, we were confronted with their unavailability because of their daily occupations, and the outright refusal of some to answer our questionnaire for various reasons.

Sociodemographic Characteristics
→ the study population is more male (62% male) than the general population of the urban commune of Ségou 50.05% male according to RGPH 2009. This difference can be explained by the fact that men have been much more available and open to answering our questionnaire during our visit than women. → the 18-27 age group was the most represented among respondents in the urban commune of Ségou, with 49%. This may be because young people are very interested in HIV/AIDS issues to better protect themselves against this pandemic than adults. According to EDS-Burundi 2010, HIV prevalence among young people aged 15 to 24 is more than three times higher among urban youth (1.4%) young people living in rural areas (0.4%). It is, therefore, necessary to intensify more advanced communication actions for this age group to better reduce HIV seroprevalence. Our results show that the use of social marketing techniques has a positive impact on the reduction of seroprevalence in the urban commune of Ségou. We believe that the success of the use of social marketing techniques in the fight against HIV/AIDS can be widespread in the fight against other pandemics such as COVID19 in Mali. We believe that the success of the use of social marketing in the fight against HIV/AIDS can be widespread in the fight against other pandemics such as COVID19.