Integrating Social Marketing and Diffusion of Innovations for HIV Prevention Among Young Black Gay Population In New Orleans

Background: According to the CDC's latest HIV surveillance report, New Orleans is one of the areas that have been hit hardest by HIV/AIDS. The HIV infection rate has risen dramatically among the young Black gay population in New Orleans.

Program background: Responding to the skyrocketing HIV infection rate among the young Black gay population in New Orleans, the Louisiana Office of Public Health STD/HIV Program (SHP) is currently developing an intervention strategy. In line with the goals of the HIV FOCUS innovative initiative, SHP’s strategy aims to achieve the following four goals to prevent further infection of HIV in that vulnerable population : 1) reduce the number of undiagnosed individuals and link them to care, 2) decrease the number of late diagnoses of HIV infection, 3) make routine HIV screening a standard of care within healthcare settings, and 4) normalize the HIV testing process.

Evaluation Methods and Results: The four primary activities that lead to achieving the proposed goals and objectives are:  1) communication network analysis and mapping, 2) identifying informal opinion leaders among the target population, 3) HIV testing at Walgreens, and 4) a narrowly targeted social marketing campaign.  The uniqueness of this project is to integrate social marketing and an informal opinion leader strategy to accelerate the diffusion and adoption of evidence-based information and practice about HIV prevention and testing among young Black gay population in New Orleans, Louisiana.  The informal opinion leaders strategy advances the traditional popular opinion leader (POL) strategy.   This informal opinion leader-based  intervention consists of four consecutive activities: 1) identify informal opinion leaders among the target population, 2) provide training to improve their knowledge about methods that promote HIV prevention, such as safe sex and HIV testing once a year (or more), 3) support the opinion leaders activities to educate their followers and peers with information about HIV prevention, accessibility to health care (e.g., HIV testing centers), importance of routine HIV testing, and  4) finally, normalize the HIV testing process in the New Orleans area.

Conclusions: This project highlights three key points. First, this project emphasizes the importance of cultural factors in shaping and influencing the target population's behaviors, such as a strong Catholic culture, the stigma of homosexuality, poverty, and low educational levels among the Black community in New Orleans. Second, the design of the intervention includes communication network analysis. Network analysis is capable of visualizing the flow of influence among the target population.  Third, the importance of improving the sustainability of the health intervention is recognized, a particular strength of the informal opinion leader strategy. 

Implications for research and/or practice: This project includes not only formal influence based on people's rational decision making, but also informal influence, which is generated by informal opinion leaders who actually live and communicate with the target population more frequently and with more credibility due to their greater accessibility and trustworthiness.