Biomedical HIV prevention messaging among adolescents

Abstract Adolescents and young adults are disproportionately affected by HIV in the USA, accounting for nearly 1 in 5 new infections in the United States. Recently, approval of oral and injectable PrEP for individuals weighing less than 35 kg have increased biomedical HIV prevention options available to adolescents. However, implementation of biomedical HIV prevention among youth faces numerous barriers, including low awareness of PrEP and limited knowledge of who PrEP is for and how it works. Youth-focused messaging on biomedical HIV prevention is nearly nonexistent, leaving adolescents with incomplete knowledge about biomedical HIV prevention methods. In addition, lessons learned from the rollout of other biomedical prevention methods indicate that unclear public health messaging contributed to these methods’ adoption among different populations. As PrEP remains underutilized among adolescents, it is critical to understand and address biomedical HIV prevention perspectives and knowledge among youth. Further, this study proposes to employ a novel health communication messaging approach that seeks to address youth’s awareness regarding multiple methods of biomedical HIV prevention. In Aim 1, using an online survey, we will gain a comprehensive understanding of biomedical HIV prevention-related knowledge, social norms and attitudes, and behavioral intent among a nationwide sample of youth age 13-21. In Aim 2, we will develop 8 brief youth-centered video vignettes aimed at presenting one or more complementary biomedical prevention methods. These video messages will be delivered through narrative storytelling formats that are appealing for youth (e.g., brief social media videos). We will obtain feedback about the video vignettes from youth and adult stakeholders at multiple timepoints during video production and integrate this feedback into the final cuts. In Aim 3, we will test the effectiveness of our messages in a randomized controlled trial with 525 youth, which will compare the video messages against an information-only control (e.g., publicly available information from public health agencies on HIV biomedical prevention). Post-test outcomes include acceptability and intentions, beliefs, PrEP initiation and other proxies for uptake (e.g., prevention information seeking, HIV testing). Within this aim, we will also explore barriers and facilitators to online- and in-person implementation via interviews with staff in community/clinical settings and experts in entertainment education and streaming media.