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Psychological Analysis of Fear-Based Healthcare Messaging: Comparing HIV/AIDS and COVID-19 Through the Lens of Spiral Dynamics

Dr. Tomás Campbell [1], a member of the BPS Division of Clinical Psychology Faculty for HIV and Sexual Health, article "Towards more inclusive and Empowering Healthcare Campaigns" [2] presents a compelling analysis of the evolution of HIV/AIDS messaging over four decades, tracing a path from fear-based approaches to more empowering, inclusive strategies. This progression reflects significant advances in both medical understanding and psychological approaches to public health communication. 

The SDTEST® survey data on fears provides an excellent opportunity to examine how these evolving messaging strategies align with contemporary fear psychology and value systems as described by Spiral Dynamics theory.


Comparative Analysis of HIV/AIDS and COVID-19 Fear Prevalence


The SDTEST® survey "Fears" involving 3,679 participants across 105 countries reveals that HIV/AIDS now ranks relatively low at 4%, while COVID-19 ranks even lower at just 2%. Below is a abridged version of the survey results. The full results are available for free in the FAQ section after login or registration.


Strahovi

Država
Jezik
-
Mail
Preračun
Kritična vrednost koeficienta korelacije
Običajna distribucija, William Sealy Gosset (študent) r = 0.0315
Običajna distribucija, William Sealy Gosset (študent) r = 0.0315
Ne običajna porazdelitev, Spearman r = 0.0013
PorazdelitevNe
normalno
Ne
normalno
Ne
normalno
NormalnoNormalnoNormalnoNormalnoNormalno
Vsa vprašanja
Vsa vprašanja
Moj največji strah je
Moj največji strah je
Answer 1-
Šibko pozitivno
0.0518
Šibko pozitivno
0.0257
Šibko negativno
-0.0203
Šibko pozitivno
0.0942
Šibko pozitivno
0.0391
Šibko negativno
-0.0141
Šibko negativno
-0.1546
Answer 2-
Šibko pozitivno
0.0178
Šibko negativno
-0.0071
Šibko negativno
-0.0376
Šibko pozitivno
0.0631
Šibko pozitivno
0.0501
Šibko pozitivno
0.0133
Šibko negativno
-0.0955
Answer 3-
Šibko negativno
-0.0025
Šibko negativno
-0.0083
Šibko negativno
-0.0456
Šibko negativno
-0.0432
Šibko pozitivno
0.0498
Šibko pozitivno
0.0768
Šibko negativno
-0.0241
Answer 4-
Šibko pozitivno
0.0428
Šibko pozitivno
0.0297
Šibko negativno
-0.0259
Šibko pozitivno
0.0175
Šibko pozitivno
0.0374
Šibko pozitivno
0.0266
Šibko negativno
-0.1027
Answer 5-
Šibko pozitivno
0.0228
Šibko pozitivno
0.1240
Šibko pozitivno
0.0115
Šibko pozitivno
0.0735
Šibko pozitivno
0.0010
Šibko negativno
-0.0152
Šibko negativno
-0.1755
Answer 6-
Šibko negativno
-0.0021
Šibko pozitivno
0.0028
Šibko negativno
-0.0619
Šibko negativno
-0.0110
Šibko pozitivno
0.0269
Šibko pozitivno
0.0872
Šibko negativno
-0.0366
Answer 7-
Šibko pozitivno
0.0107
Šibko pozitivno
0.0313
Šibko negativno
-0.0667
Šibko negativno
-0.0310
Šibko pozitivno
0.0538
Šibko pozitivno
0.0715
Šibko negativno
-0.0532
Answer 8-
Šibko pozitivno
0.0653
Šibko pozitivno
0.0688
Šibko negativno
-0.0267
Šibko pozitivno
0.0117
Šibko pozitivno
0.0398
Šibko pozitivno
0.0185
Šibko negativno
-0.1345
Answer 9-
Šibko pozitivno
0.0740
Šibko pozitivno
0.1594
Šibko pozitivno
0.0050
Šibko pozitivno
0.0612
Šibko negativno
-0.0067
Šibko negativno
-0.0464
Šibko negativno
-0.1836
Answer 10-
Šibko pozitivno
0.0754
Šibko pozitivno
0.0624
Šibko negativno
-0.0144
Šibko pozitivno
0.0273
Šibko pozitivno
0.0336
Šibko negativno
-0.0107
Šibko negativno
-0.1359
Answer 11-
Šibko pozitivno
0.0626
Šibko pozitivno
0.0495
Šibko negativno
-0.0084
Šibko pozitivno
0.0094
Šibko pozitivno
0.0277
Šibko pozitivno
0.0251
Šibko negativno
-0.1276
Answer 12-
Šibko pozitivno
0.0429
Šibko pozitivno
0.0889
Šibko negativno
-0.0323
Šibko pozitivno
0.0317
Šibko pozitivno
0.0350
Šibko pozitivno
0.0265
Šibko negativno
-0.1531
Answer 13-
Šibko pozitivno
0.0705
Šibko pozitivno
0.0917
Šibko negativno
-0.0384
Šibko pozitivno
0.0287
Šibko pozitivno
0.0437
Šibko pozitivno
0.0151
Šibko negativno
-0.1634
Answer 14-
Šibko pozitivno
0.0812
Šibko pozitivno
0.0862
Šibko negativno
-0.0035
Šibko negativno
-0.0129
Šibko pozitivno
0.0076
Šibko pozitivno
0.0152
Šibko negativno
-0.1208
Answer 15-
Šibko pozitivno
0.0555
Šibko pozitivno
0.1235
Šibko negativno
-0.0340
Šibko pozitivno
0.0113
Šibko negativno
-0.0139
Šibko pozitivno
0.0261
Šibko negativno
-0.1160
Answer 16-
Šibko pozitivno
0.0715
Šibko pozitivno
0.0212
Šibko negativno
-0.0388
Šibko negativno
-0.0401
Šibko pozitivno
0.0745
Šibko pozitivno
0.0178
Šibko negativno
-0.0772


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This modest fear prevalence contrasts sharply with the historical positioning of HIV/AIDS as a primary existential threat during the 1980s-90s. As the article aptly notes, early HIV/AIDS campaigns relied heavily on fear-based messaging, leveraging protection-motivation theory to drive behavioral change through graphic depictions of mortality and disease. The current survey results suggest these diseases have been partially normalized in the public consciousness, supporting the article's observation that medical advancements have transformed HIV from a death sentence to a manageable chronic condition.


When examining broader fear contexts, it's noteworthy that personal concerns about "illness of relatives and children" (11%) and general "illness" (8%) outrank specific disease fears like HIV/AIDS or COVID-19. This pattern indicates that abstract illness threats generate more anxiety than particular diseases that have been subject to extensive public education campaigns. This finding aligns with the article's discussion of how healthcare messaging has evolved toward destigmatization and normalization, particularly for HIV/AIDS.


Spiral Dynamics Correlations: Understanding Value Systems and Fear Responses


The correlation data between disease fears and Spiral Dynamics stages provides fascinating insights into how different value systems engage with health threats. HIV/AIDS shows a positive correlation (0.0662) with Orange-level thinking, which represents achievement-oriented, strategic value systems. This alignment makes psychological sense, as Orange thinking prioritizes personal agency and risk management. Individuals operating from this value system may respond more actively to diseases perceived as consequences of personal behavior choices.


Conversely, HIV/AIDS fears correlate negatively with Yellow (-0.0516) and more strongly with Turquoise (-0.1776) value systems. These second-tier thinking systems in Spiral Dynamics represent more complex, integrative worldviews that may contextualize disease within a broader systemic understanding. The stronger negative correlation with Turquoise thinking is particularly notable, as this holistic perspective tends to integrate mortality and vulnerability into a comprehensive worldview, potentially reducing fear responses to specific conditions.


For COVID-19, the correlation pattern differs significantly. The positive correlation with Green thinking (0.0637) suggests that communitarian, egalitarian value systems may experience heightened concern about highly communicable diseases that threaten community well-being. This aligns with the article's discussion of how modern healthcare campaigns increasingly emphasize collective responsibility and community protection. The negative correlations with Blue (-0.0342), Orange (-0.0409), and Turquoise (-0.0748) value systems suggest varied psychological responses across the spiral.


Implications for Evolving Healthcare Messaging


The article chronicles a shift from fear-based campaigns toward empowerment and behavioral strategies, noting how psychological frameworks like self-efficacy theory and social norm theory have informed this evolution. The SDTEST® data supports the efficacy of this shift by demonstrating relatively low fear ratings for HIV/AIDS despite its historical stigma. This suggests that destigmatizing, empowering messaging approaches may have successfully normalized the condition in public consciousness.


The varying correlations between fears and Spiral Dynamics stages also validate the article's emphasis on intersectionality and tailored messaging. Different value systems appear to process disease threats through distinct psychological frameworks, which has significant implications for public health communication. The article notes that "campaigns are now much more carefully designed to address diverse populations," which aligns with the need to consider value system diversity in designing effective interventions.


Advancing Psychologically Informed Healthcare Communications


The relatively weak correlation between disease fears and specific Spiral Dynamics stages (with the critical value of the correlation coefficient for a normal distribution, by William Sealy Gosset (Student) r = 0.0323) suggests that fears of HIV/AIDS and COVID-19 transcend value systems but manifest differently within them. This finding supports the article's conclusion that messaging must "remain effective, compassionate, and mindful of nuance." The positive correlation between HIV/AIDS fears and Orange thinking, contrasted with COVID-19's positive correlation with Green thinking, demonstrates how different diseases activate different value concerns.


The article's discussion of digital and social media platforms as vectors for modern healthcare messaging presents opportunities for even more targeted value-specific communications. Understanding the psychological frameworks through which different Spiral Dynamics stages process health information could enable micro-targeted campaigns that resonate more effectively with diverse audiences. For instance, messaging aimed at Orange-dominant thinkers might emphasize personal agency and achievement in health management, while Green-focused messaging might highlight community protection and collective responsibility.


Conclusion


The evolution of HIV/AIDS messaging described in the article reflects a sophisticated understanding of psychological principles, moving from protection-motivation theory toward self-efficacy and social norm approaches. The SDTEST® data validates this progression by showing relatively modest contemporary fear responses to HIV/AIDS despite its historical stigmatization. The correlation patterns between disease fears and Spiral Dynamics stages provide valuable insights for further refining healthcare communications to resonate with different value systems.


The comparative data between HIV/AIDS and COVID-19 fears, particularly their different correlation patterns with Spiral Dynamics stages, suggests that disease characteristics interact with value systems to produce distinct psychological responses. As the article argues, effective healthcare campaigns must continue to evolve based on evidence rather than prejudice. The SDTEST® data offers this evidence, demonstrating how fears of specific conditions correlate with different psychological frameworks and value systems.


This integration of fear psychology, mathematical correlation, and Spiral Dynamics theory provides a robust foundation for developing increasingly sophisticated, psychologically informed healthcare messaging strategies that can effectively engage diverse populations across the spiral of human development.



Sources

[1] https://www.linkedin.com/in/tomas-campbell-40202785/
[2] https://www.bps.org.uk/blog/towards-more-inclusive-and-empowering-healthcare-campaigns


2025.02.28
Valerii Kosenko
Lastnik izdelka SaaS SDTEST®

Valerii je leta 1993 pridobil izobrazbo socialnega pedagoga-psihologa in od takrat svoje znanje uporablja pri vodenju projektov.
Valerii je leta 2013 pridobil magisterij in kvalifikacijo projektnega in programskega vodje. Med magistrskim študijem se je seznanil s Projektnim načrtom (GPM Deutsche Gesellschaft für Projektmanagement e. V.) in Spiralno dinamiko.
Valerii je avtor raziskovanja negotovosti V.U.C.A. koncept z uporabo spiralne dinamike in matematične statistike v psihologiji ter 38 mednarodnih anket.
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