Pilot Testing of An HIV/STD Focused Motion Comic for Young People Ages 15-24

Background: Young people (ages 15-24 years) in the United States are disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STI), accounting for about 50% of all reported STIs each year. Deficits in HIV/STI knowledge, attitudes, beliefs and intentions (KABI) can increase risk of infection and reduce adoption of appropriate protective behaviors and contribute to this disease burden.  Narrative storytelling is a pragmatic and proven effective method of HIV/STI prevention communication that can instill knowledge, attitudes and beliefs, and create behavioral intentions consistent with HIV/STI prevention strategies. Technological advances, such as “motion comics”, provide new methods of storytelling that add voice actors, sound and music to comic books for an enhanced cinematic-like experience

Program background:  In an attempt to increase HIV/STI KABI, reduce HIV/STI risk behaviors and decrease HIV/STI rates among young people in the United States, we developed an HIV/STI-focused “motion comic” for young people ages 15-24 years.  Our objective was to combine the popularity of comics, the power of technology and health communication principles to create a novel and entertaining educational tool.  To enhance the acceptability of the motion comic to the audience we used the “Sabido Method” which generates content through theory and research with the target-audience.  To generate content we conducted two rounds of formative focus groups with 74 persons ages 15-24 years (mean age=19.5).   

Evaluation Methods and Results: To test the created content, a third round of fifteen focus groups (n=146) were conducted with the target population to screen the comic and qualitatively and quantitatively evaluate viewer satisfaction and effect on KABI.   Rated story elements included realism, humor, drama dialogue and the “cheese factor” of the content.  Pre/post viewing surveys measured the comic’s impact on HIV/STI knowledge, HIV stigma, condom attitudes, HIV testing attitudes, and behavioral intentions using paired sample t-tests. Most respondents liked the story elements (average of 75%) and would share it with friends (73%). Pre/post viewing surveys revealed a significant decrease in HIV stigma (t= 5.743, p=<.0001) and increase in behavioral intentions to engage in safe sex (t=-3.237, p=.002). 

Conclusions:  While the educational information in the motion comic significantly impacted KABI related to HIV/STI prevention, it was also entertaining enough to the target to keep them engaged in the story.  The success can be attributed to engaging in formative research with the target audience.

Implications for research and/or practice: Motion comics are a viable and effective health communication approach especially when created using the Sabdio methodology can be applied to several other public health issues.