Story Telling, Innovative Technology, Comic Books and HIV/STI Prevention: Developing HIV/STI Focused Motion Comics for Young People Ages 15-24 Years

Background: Young people (ages 15-24 years) in the United States are significantly affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STI).  This disease burden may be due to deficits in HIV/STI knowledge, attitudes, beliefs and intentions (KABI) that may influence sexual risk and protective behaviors for HIV/STI transmission.  Interventions targeting young people should address gaps in knowledge and instill attitudes and beliefs consistent with HIV/STI prevention.

Program background: Story telling using comic books is a useful and pragmatic method of HIV/STI prevention communication to increase accurate knowledge, shape attitudes and beliefs, and create behavioral intentions for increased HIV/STI prevention behaviors.  Comic books are also easy to implement and are low-cost.  As comic books, comic-related media, and technology are popular among young people, innovations in computer animation provide new ways of presenting comics, such as the “motion comic.”  In order to: 1) address HIV/STI-related KABI among young people; 2) provide entertaining and engaging health education; 3) harness the power of technology; and 4) capitalize on the popularity of comics, we are developing an HIV/STI-focused “motion comic” for young people ages 15-24 years.  The goal of the project is to use audience engagement (Sabido Methodology) to create a 3-episode motion comic to deliver health communication messages to increase HIV/STI KABI with young people in support of reduced HIV/STI risk behaviors and decreased HIV/STI rates among young people in the US. 

Evaluation Methods and Results:We conducted two rounds of formative focus groups with 74 persons ages 15-24 years (X=19.5).  In round one (six focus groups) participants were asked about their HIV/STI knowledge, where they obtained health information, their attitudes regarding HIV/STI testing and condom use, comic story elements, and character creation.  Thematic analysis identified knowledge deficits about HIV/STI transmission and how to access health care, highlighted how stigma impaired participants’ capacity to be tested for HIV/STIs and to purchase contraceptives, condoms, and lubricants; indicated a desire to learn condom negotiation skills; and demonstrated that motion comics were an acceptable medium for communicating HIV/STI prevention messages.  Storylines and scripts were created to address the aforementioned themes.  In the second round of focus groups (six focus groups), participants provided feedback on character sketches and draft storylines.  Participant feedback indicated acceptance of the storylines and scripted scenes 

Conclusions: Based on information provided in the focus groups, 3 seven-minute motion comic episodes are being developed that address all five key themes identified in our focus groups research.  Currently, a third round of focus groups is underway to determine the efficacy of the motion comic prototype intervention to impact KABI for HIV/STI prevention. The final intervention will be disseminated through the internet and other social media accessed frequently by young people.

Implications for research and/or practice: This project demonstrates how to engage a target audience to develop innovative health communication interventions, and how to use novel communications methods to disseminate effective prevention messages.