Improving Effectiveness of Audiovisual Public Service Announcements for the Promotion of STD/HIV Testing: What Works & What Doesn't with Young Women

Theoretical Background and research questions/hypothesis: Of the approximately 19 million new sexually transmitted diseases (STDs) or infections that occur each year in the U.S., almost half are among youth (ages 15-24), and most go undiagnosed. Young women bear the greatest STD burden and face the most serious, preventable health impacts. Diagnosis and treatment of STDs are critical, yet a lack of information, misconceptions and social stigma keep many young women from getting tested.  Media campaigns may play a role in raising awareness of STDs and promoting, normalizing and destigmatizing STD/HIV testing. To explore this issue and inform the development of a national STD testing campaign, CDC’s Division of STD Prevention sought to gauge young women’s reactions to a variety of video PSAs promoting STD/HIV testing.  

Methods: A total of nine STD/HIV-related public service announcements (PSA) were tested in 18 focus groups with sexually active young women. Groups were conducted in four U.S. cities, segmented by age (15-17/18-25 years), work/school status (older segments only), and race/ethnicity (African American/Caucasian/Hispanic/Latina). PSAs were selected to represent a range of lengths, tones, approaches and relationship scenarios (friends, sex partners, single); and based on the inclusion of key concepts identified in CDC’s formative research and drawn from the Health Belief Model and Theory of Reasoned Action. Participants were asked to discuss each of the PSAs and the approach taken, including likes and dislikes regarding the tone, message, format, and credibility/appropriateness of models/spokespersons. Discussions were transcribed and coded using NVivo 2 software (QSR International).

Results:  Overall, women responded positively to portrayals of: couples in supportive relationships, peer support, and women who were perceived as honest and relatable. Participants particularly appreciated portrayals of boys/men taking responsibility for and acknowledging their role in STD testing. The inclusion of diversity (gender, age, race/ethnicity) was important, both for making the PSA relatable across segments, and for avoiding the stigmatization of certain groups. While celebrities effectively caught participants’ attention, in some cases they also distracted from the message and/or put its credibility at risk. PSAs that presented relatable situations were more favorably received; however, specific factors (e.g., actress age and race/ethnicity, activities depicted) influenced relevance. Participants did not like announcements that: used language considered to be gross/graphic; were hard to understand (were too short, included fast speaking, used poetry); or used humor that did not take the issue seriously. While humor and entertainment were valued because they caught participants’ attention, it was also critical that the messages provide relevant information or present relatable situations to increase motivation for testing.

Conclusions: While humorous appeals and inclusion of celebrities may be able to attract attention, messages should be thought-provoking and provide clear, informative, relatable and memorable messages to successfully prompt further action. Diverse actors and relatable situations should be used to normalize and destigmatize STD testing.

Implications for research and/or practice: Findings suggest the need to consider the tone, length, and use of celebrities in PSAs for a topic such as STDs. Additional implications to be discussed.