Targeted social marketing of PrEP and the stigmatization of black sexual minority men

Authors

Sarah K. Calabrese, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.
David A. Kalwicz, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.
John F. Dovidio, Department of Psychology, Yale University, New Haven, CT, United States of America.
Sharanya Rao, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.
Djordje X. Modrakovic, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.
Cheriko A. Boone, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.
Manya Magnus, Department of Epidemiology, George Washington University, Washington, DC, United States of America.
Michael Kharfen, HIV/AIDS, Hepatitis, STD & TB Administration, DC Department of Health, Washington, DC, United States of America.
Viraj V. Patel, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United States of America.
Maria Cecilia Zea, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States of America.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

PloS one

Volume

18

Issue

5

DOI

10.1371/journal.pone.0285329

Abstract

Disparities in HIV incidence and PrEP uptake suggest a need to prioritize Black sexual minority men (SMM) in PrEP social marketing initiatives. However, images linking Black SMM to HIV and PrEP may inadvertently reinforce stigma. We examined HIV-negative/status-unknown Black SMM's responses to targeted PrEP advertisements using mixed methods, including an experiment embedded in a longitudinal online survey (Time 1: n = 96; Time 2 [eight weeks]: n = 73) and four focus groups (n = 18). The full factorial experiment included between-groups and within-subjects comparisons. For between-groups comparisons, each participant was randomly assigned to view one of 12 advertisements, which varied by couple composition (Black SMM couple/Black heterosexual couple/multiple diverse couples/no couples) and campaign (PrEPare for the Possibilities/PlaySure/PrEP4Love). We examined couple composition, campaign, and interaction effects on: advertisement judgments (Time 1), PrEP stigma (Time 1), PrEP motivation (Times 1 and 2), and PrEP behavior (Time 2). For within-subjects comparisons, each participant viewed all 12 advertisements, and we examined couple composition, campaign, and interaction effects on advertisement judgments (Time 2). Focus group participants discussed advertising preferences and responded to the same set of advertisements. For between-groups and within-subjects comparisons, we found significant couple composition effects but no or limited campaign and interaction effects on advertisement judgments. Advertisements featuring Black SMM exclusively were judged as more stigmatizing than advertisements without couples. Advertisements with diverse (vs. no) couples were considered more eye-catching and motivating. There were minimal effects of couple composition and campaign on PrEP stigma, motivation, and behavior. Focus group participants corroborated concerns about the potential for PrEP advertisements to be stigmatizing, suggesting advertisements featuring Black SMM exclusively could be alienating and fuel conspiracy theories. Focus group participants generally favored diverse and less sexualized advertisements, particularly for public spaces. Findings collectively highlight the potential for targeted PrEP advertisements to stigmatize Black SMM and support diverse representation.

APA Citation

Calabrese, Sarah K.; Kalwicz, David A.; Dovidio, John F.; Rao, Sharanya; Modrakovic, Djordje X.; Boone, Cheriko A.; Magnus, Manya; Kharfen, Michael; Patel, Viraj V.; and Zea, Maria Cecilia, "Targeted social marketing of PrEP and the stigmatization of black sexual minority men" (2023). GW Authored Works. Paper 2916.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2916

Department

Epidemiology