Swiping right on PrEP: a qualitative study of MSM preferences for PrEP public health messaging on dating apps

Figures & data

Figure 1. Enrollment summary. Summarizes the recruitment and enrollment process for individual interviews, including participant attrition. Recruitment of Spanish-speaking participants is highlighted in the yellow section of the figure.

Table 1. Interview topics and sample questions.

Content area	Questions and probes
Warm-up questions
	Tell me about the advertisements you see on dating apps? Are any for health services?
Dating app use
	Tell me when you are likely to use dating apps to meet new sexual partners. What setting do you typically use them in? Tell me about your use of dating apps while also using drugs or consuming alcohol. How often are you under the influence of drugs or alcohol when using dating apps? How does your use of the apps change when you are using these substances? What do you communicate about your sexual health on the apps? For example, do you post about your use of PrEP or most recent HIV test?
PrEP advertisements on apps
	How would you feel about a PrEP program being advertised to men through gay dating apps? What impact might it have on the uptake of PrEP? Why or why not? What do you want to see in a promotion for a PrEP program on a dating app?   ○ What types of text and/or pictures would you like to see? What do you think is important to include in messaging offering PrEP on dating apps?
Attitudes toward PrEP
	Where do you like to get information about sexual health? What do you think about using PrEP for HIV prevention? Why do you feel this way? Is PrEP something you would consider using? Why or why not? Have you ever tried to access PrEP? How did that go? For those who didn’t start, what happened? How did you hear about it?

Table 2. Participant demographics (N = 19).

Age in years
	Mean (SD)	28 (± 6.8)
Race
	White	7 (37%)
	Other	6 (32%)
	Multiple races/mixed race	5 (26%)
	American Indian/Alaskan native	1 (5%)
Ethnicity
	Hispanic or Latinx	12 (63%)
	Not Hispanic or Latinx	7 (37%)
Language of interview
	English	15 (79%)
	Spanish	4 (21%)
Insurance status
	Insured	18 (95%)
	Uninsured	1 (5%)
Highest level of education completed
	Bachelor's degree	9 (47%)
	Associate's degree	3 (16%)
	Some college	5 (26%)
	High school	2 (11%)
PrEP use
	Current	5 (26%)
	Previous	9 (47%)
	Never	5 (26%)
PrEP prescription source for previous and current users (N = 14)
	Traditional clinic	7 (50%)
	Mobile unit	7 (50%)

Table 3. Themes, definitions, and representative quotes.

Theme	Definition	Representative quotes
(1) Relevant and relatable advertisements	The preference for advertisements that are tailored to specific viewers based on key demographic variables such as age, race, gender, and geographic location, to increase relatability	“The ads that I see, I’m just not drawn to them because they just look so general. There's nothing that catches my eye.” (Participant 1, age 23, White, not Latinx)
		“I think maybe peer messaging is really important especially for the age group high school, college, adolescents. They prefer to learn things from people in their age group.” (Participant 4, age 24, White, not Latinx)
(2) Expansion of target audiences to promote access	A desire to expand PrEP advertisements beyond MSM audiences given that HIV can affect anyone, also includes interest in reaching MSM who do not identify as part of the LGBTQIA+ community	“People think [PrEP] is only for gay men, so I think it would be good to like put women, trans, trans women, trans men, everyone like in one photo.” (Participant 16, age 27, White, Latinx)
		“I feel like because people who are Black and Brown are very distrusting of a lot of health services. Just to be able to have more accurate information instead of going by what your friend says would be a little bit more helpful.” (Participant 10, age 33, mixed race, Latinx)
(3) Concise and captivating advertisements	A preference for PrEP advertisements that are visually appealing but not at the expense of clarity and conciseness, also includes interest in advertisements containing practical and actionable information	“I want to see single-word answers to my questions. I want to see four bullet points: free, safe, accessible, start tomorrow.” (Participant 5, age 30, White, not Latinx)
		“Short video ads that are done well will grab somebody’s attention more than any billboard or any picture could ever because there’s a sound and there’s a changing image on the screen, and you will suck somebody’s attention right towards it. And in a video format, you can include much more information than a picture ever could.” (Participant 2, age 25, White, not Latinx)
(4) PrEP advertisements and services as options, not obligations	An aversion to PrEP advertisements that equate its use with a social obligation, also includes dislike of “pop-up” or forced-engagement style advertisements	“I always felt like I was kind of pushed to get [PrEP] or something … Every ad that I’ve seen, or a lot of them, they talk about just being on PrEP as kind of like being a social obligation to society. I don’t see it as a social obligation or a social necessity … I think that it’s personal.” (Participant 3, age 28, other race, Latinx)
		“If you don’t want to see [PrEP advertisements], you’re not going to use the app anymore. It’s not going to work.” (Mobile unit user focus group)

Table

No. item	Guide questions/description	Reported on page # and/or supplemental information
Domain 1: research team and reflexivity
Personal characteristics
1. Interviewer/facilitator	Which author/s conducted the interview or focus group?	GC, MDL
2. Credentials	What were the researcher's credentials? e.g., PhD, MD	1
3. Occupation	What was their occupation at the time of the study?	Research assistant
4. Gender	Was the researcher male or female?	Female
5. Experience and training	What experience or training did the researcher have?	Training in qualitative methods
Relationship with participants
6. Relationship established	Was a relationship established prior to study commencement?	Investigators had no prior relationship to the participants.
7. Participant knowledge of the interviewer	What did the participants know about the researcher? e.g., personal goals, reasons for doing the research	Participants were provided a brief summary of the study purpose and given the opportunity to ask questions about the study.
8. Interviewer characteristics	What characteristics were reported about the interviewer/facilitator? e.g., Bias, assumptions, reasons and interests in the research topic	Interested in public health
Domain 2: study design
Theoretical framework
9. Methodological orientation and theory	What methodological orientation was stated to underpin the study? e.g., grounded theory, discourse analysis, ethnography, phenomenology, content analysis	6, 7
Participant selection
10. Sampling	How were participants selected? e.g., purposive, convenience, consecutive, snowball	5
11. Method of approach	How were participants approached? e.g., face-to-face, telephone, mail, email	5
12. Sample size	How many participants were in the study?	Figure 1
13. Non-participation	How many people refused to participate or dropped out? Reasons?	Figure 1
Setting
14. Setting of data collection	Where was the data collected? e.g., home, clinic, workplace	Interviews were conducted over the phone while the participant was in a private setting (usually their home). The mobile unit staff focus group was conducted through an audio-only Zoom call while staff were in clinic and participants were in a private setting. The mobile unit user focus group was conducted in person in a private conference room.
15. Presence of non-participants	Was anyone else present besides the participants and researchers?	No
16. Description of sample	What are the important characteristics of the sample? e.g., demographic data, date	Table 2
Data collection
17. Interview guide	Were questions, prompts, guides provided by the authors? Was it pilot tested?	Table 1
18. Repeat interviews	Were repeat interviews carried out? If yes, how many?	No
19. Audio/visual recording	Did the research use audio or visual recording to collect the data?	7
20. Field notes	Were field notes made during and/or after the interview or focus group?	No
21. Duration	What was the duration of the interviews or focus group?	6
22. Data saturation	Was data saturation discussed?	8
23. Transcripts returned	Were transcripts returned to participants for comment and/or correction?	No
Domain 3: analysis and findings
Data analysis
24. Number of data coders	How many data coders coded the data?	7
25. Description of the coding tree	Did authors provide a description of the coding tree?	7
26. Derivation of themes	Were themes identified in advance or derived from the data?	7
27. Software	What software, if applicable, was used to manage the data?	7
28. Participant checking	Did participants provide feedback on the findings?	No
Reporting
29. Quotations presented	Were participant quotations presented to illustrate the themes/findings? Was each quotation identified? e.g., participant number	Yes, Table 3
30. Data and findings consistent	Was there consistency between the data presented and the findings?	Yes
31. Clarity of major themes	Were major themes clearly presented in the findings?	8–12, Table 3
32. Clarity of minor themes	Is there a description of diverse cases or discussion of minor themes?	8–12, minor themes are incorporated throughout

Developed from Tong et al. (2007).

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

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Data availability

The data sets generated and analyzed during this study are not publicly available to protect the confidentiality of our study participants. However, datasets are available from the corresponding author on reasonable request and contingent upon institutional review board approval for data sharing.