Engaging communities to develop and evaluate communication strategies for HIV prevention among women in the Southern US

Project Summary This proposal addresses NIMH’s Notice of Special Interest, “Advancing Health Communication Research on HIV Prevention, Treatment and Cure” (NOT-MH-21-105). This proposal will advance the basic science of HIV prevention communication by engaging communities disproportionately impacted by HIV in the creation and testing of theory-based prevention messaging. Worldwide, women account for almost half of new HIV infections (44%). In the United States (US), women account for 19% of new HIV infections, and the US South has the highest rate of new HIV infections (52%). Herein, we propose to develop and test a multi-component communications intervention to promote evidence-based HIV prevention tools in populations and geographic areas with high HIV incidence. Rigorous health communication research is needed to: 1) develop messages that address distinct barriers to seeking out HIV prevention (i.e., low risk of perception, lack of awareness or knowledge, stigma), and 2) map communication channels and social networks to effectively increase reach and engagement. Our diverse team of HIV clinicians, behavioral scientists and health communication experts includes faculty from Texas Southern University, the 2nd largest Historically Black College and University (HBCU) in the US. We have strong partnerships and an extensive track record of outreach and engagement with young adults and women in communities disproportionately impacted by HIV. This five-year study will take place in Houston, Texas, an epicenter of the HIV epidemic in the US South. We will use community based participatory research methods and Community Engagement Studios to engage young women in co-creating and testing communication content across multiple components (i.e., words, graphics, videos). Using a community engagement framework, we will pursue the following aims: 1) Assess barriers and facilitators to the use of comprehensive HIV prevention strategies, 2) Co-create theory-based message features (i.e., strategic word choice/ framing), graphics, and short videos (30-120 seconds) for promotion of HIV prevention tools. Theory-based features include enhanced active choice, protective agency assignment, autonomy restoration, anticipated affect. 3) Evaluate the effect of different theory-based message features, graphics and videos on HIV prevention intention. We will evaluate effects in three separate evaluations of young women. This proposal takes a rigorous approach to understanding the basic behavioral science of HIV prevention communication. If successful, this model of message design may translate to other populations and forms of HIV prevention in development (e.g., once-a-year implants, injectables, broadly neutralizing antibody infusions).