‘There are people like me who will see that, and it will just wash over them’: Black sexual minority men’s perspectives on messaging in PrEP visual advertisements

Abstract

The high incidence of HIV among US Black sexual minority men is a public health crisis that pre-exposure prophylaxis (PrEP) for HIV can help address. Public health campaigns, which often include pictures of Black sexual minority men alongside PrEP-related messaging, have been developed to encourage PrEP awareness and uptake. However, the acceptability of the messaging within these campaigns among Black sexual minority men is unclear. We conducted four focus groups with 18 HIV-negative Black sexual minority men in Washington, DC to explore their perspectives regarding promotional messaging (textual elements) in PrEP visual advertisements, including their reactions to three large-scale public health campaigns. Primary themes included: (1) the need for additional information about PrEP, (2) preference for slogan simplicity, (3) the desire to normalise PrEP use, and (4) mixed views on the inclusion of condoms. Results indicated that the messaging in current PrEP visual advertisements may not sufficiently address Black sexual minority men’s questions about PrEP. Providing basic PrEP information and methods to access more information; using simple, unambiguous language; presenting PrEP use in a destigmatising, normalising fashion; and conveying the relevance of condoms if included in the advertisement could help increase the acceptability of future PrEP advertising among Black sexual minority men.

Keywords:

• HIV
• pre-exposure prophylaxis
• Black sexual minority men
• sexual and gender minorities
• social marketing

Acknowledgements

We are grateful for the time and support of study participants. We also thank the PlaySure, StaySure, PrEP4Love, and PrEPare for the Possibilities campaigns and the Illinois PrEP Working Group for supporting our use of their advertisements and associated images as visual stimuli in the study. All adapted advertisements and images are published with the permission of the campaigns. Copyright of PlaySure (2015) and StaySure (2016): New York City Department of Health and Mental Hygiene.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 One additional focus group was attempted but was ultimately excluded from the analytic sample because only one participant attended it.

Additional information

Funding

This study was funded by the DC Center for AIDS Research (DC CFAR) Pilot Awards Program (P30-AI117970). SKC was supported by the US National Institute of Mental Health via Award Number K01-MH103080.