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THE POWER OF REPRESENTATION FOR HIV PREVENTION

Home > Blog > THE POWER OF REPRESENTATION FOR HIV PREVENTION

February 7, 2023  |  By Brunet-García
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Proving the impact of first-person storytelling for PrEP uptake in Black and Hispanic  Communities

Despite major advancements in HIV prevention and treatment, communities of color make up a disproportionately high number of new cases. Especially Black, Hispanic, and Native American communities.

A major contributor to this unequal impact is the imbalance of PrEP use across demographics. PrEP is a medication that can prevent HIV infections. Despite no-cost prescription programs, the uptake of this preventative medication among communities of color lagged behind the national average.

The “I’m Ready” campaign, created for the US Department of Health & Human Services, used first person storytelling to increase representation by featuring the stories of real PrEP users.

Encouraging Black and Brown communities to take charge of their sexual health through access to no-cost PrEP through the Ready, Set, PrEP program for those without prescription drug insurance.

We know that first-person storytelling works to support positive HIV outcomes. We wanted to go beyond the campaign metrics and learn about HOW it worked. Specifically how these stories informed an individual’s decision to start, or stay on, PrEP.

We conducted qualitative research, specifically in-depth interviews, with members of our key audience who had engaged with the campaign.

Among other findings, thematic analysis revealed that much of our audience:

  • Had existing knowledge of PrEP.
  • Perceived that PrEP was not for them because they did not see themselves reflected in PrEP messaging. Early on in PrEP marketing, stigma around sex and less varied representations of gender identity and race/ethnicity kept many from considering this protective measure.

 

An image with white text on a purple background. The text reads: “To be honest, I thought [PrEP] was for my counterparts. If I can be totally honest, my white counterparts.” - Study Participant
 

These themes demonstrated that first-person storytelling, specifically the kind used in the “I’m Ready” campaign, affected audience perceptions in four key ways:

  1. Meaningful representation increased relevance of the message
  2. This same representation made audiences more receptive
  3. Addressing emotions mitigated health literacy challenges
  4. Stigma about taking PrEP can be eased through relatability to the featured stories

 

An image with white text on a light blue background. The text reads: “For me, the message was seeing myself. Seeing another Black man. Seeing another Black queer man.”  - Study Participant

Our research revealed that first-person storytelling can impact each stage of an individual’s PrEP journey. The decision to take PrEP is complex, incremental, nonlinear, and takes time.

Historical and contemporary injustices make this decision especially complex for LGBTQ+ communities of color. For Black, Hispanic, and Native American audiences, having stories that resonate in-market invites these communities to first see themselves as a potential PrEP user, then reflects the possibilities along the stages of a complicated behavior-change process. Complementing existing PrEP education campaigns, encouraging more PrEP users, and protecting more people against HIV.
 

A graphic image that reads: The impact of first-person storytelling on behavior change related to PrEP uptake Precontemplation    →     Contemplation Created awareness of PrEP and increased relevance of PrEP Contemplation      →    Preparation Motivated self reflection about HIV prevention Preparation      →    Action Provided digital resources for learning more and cues-to-action for HIV prevention-related behaviors Action      →    Maintenance Encouraged self-reflection that supported staying on PrEP

 

An image with white text on a red background. The text reads: “It resonates more when somebody really talks about their authentic truth, and why they decided to get on PrEP, and why they decided to continue to stay on PrEP.” - Study Participant

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