Communicative appeals and messaging frames in visual media for HIV pre-exposure prophylaxis promotion to cisgender and transgender women

Abstract

Women in the USA represent 15% of new HIV diagnoses but only 5% of pre-exposure prophylaxis (PrEP) users. We sought to characterise communicative appeals and messaging frames used in US visual media to cultivate PrEP demand among cisgender and transgender women using content analysis methodology. We catalogued and coded media items (images and videos) from US PrEP marketing campaigns featuring women. Production and content characteristics were abstracted, and communicative appeals from media items were qualitatively coded in duplicate. We then descriptively summarised production and content characteristics and identified discrete subgroups of media items, clustering around specific messaging frames, through qualitative thematic analysis. Racial/ethnic minorities and sexual/gender minority women were heavily featured, and numerous media items leveraged cognitive and social communicative appeals to promote PrEP. We identified three unique messaging frames emerging from coded media items, portraying PrEP as: (1) necessary prevention (protection frame), (2) a desirable yet accessible commodity (aspiration frame), and (3) a conduit to sexual autonomy (empowerment frame). To effectively communicate PrEP information and promote PrEP to women, PrEP marketing should leverage alternative appeals (subjective norms, self-efficacy), address anticipated barriers to uptake (stigma, cost, medication interactions), and deconstruct misconceptions of PrEP use(rs).

Keywords:

• Content analysis
• health communication
• HIV prevention
• mixed methods research
• PrEP

Data availability statement

Deidentified data and supporting material presented in this manuscript are available to download at: https://github.com/jrosen72/PrEPCAMM

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by the Johns Hopkins University Center for AIDS Research, a US National Institutes of Health-funded program (P30AI094189). JGR was supported by a predoctoral training grant from the US National Institute of Mental Health (F31MH126796). JNP was supported by a grant from the US National Institute of General Medical Sciences (P20GM125507). The content is solely the responsibility of the authors and does not necessarily represent the official views of the US National Institutes of Health.