Creating HIV Or Sexual Health Prevention Messages for Gay and Bisexual Men: Findings and Lessons Learned From the Act Against AIDS Campaign and Other HIV Communication Efforts

Theoretical Background and research questions/hypothesis: Given the current epidemiology of HIV/AIDS in the US, it is crucial to provide accessible content that motivates, informs, and empowers communities most at risk for HIV infection, including gay and bisexual men of all races, ages, and socioeconomic backgrounds.  The HIV prevention terrain is complex, and includes a number of different strategies with varying levels of efficacy.  Hence, it can be challenging to develop specific, actionable prevention messages for gay and bisexual men.

Methods: In this presentation, we will synthesize findings across all rounds of formative research with gay and bisexual men to suggest best practices for communicators seeking to produce effective and targeted messages. 

Results: While there are a range of HIV prevention options available, it cannot be assumed that most men who have sex with men (MSM) are aware of these options.  Our research suggests that many men are unfamiliar with pre- or post-exposure prophylaxis (PrEP and PEP), serosorting, or the fact that an HIV-positive individual can significantly lower his risk of transmitting HIV by getting and staying on antiretroviral treatment (ART).   Given uncertainty about unfamiliar risk-reduction strategies (or less equivocal risk-reduction strategies), it is recommended to develop messages that tie these strategies to better-known strategies like condom use.  Gay and bisexual men are highly receptive to condom messaging (despite some consultant concerns that gay men, particularly older gay men, might have grown weary of a condom message), and have been more receptive to messages about new prevention strategies if condom use was also acknowledged. Although there may be a need for a particular prevention message, the audience may not be receptive to the message.  For example, an attempted message directed at the importance of condom usage for sex outside committed relationships was met with strong negative reactions due to reinforcing negative stereotypes of gay men. While we have not found many differences in receptivity to HIV prevention messages by race, we have found important differences based on other segmentation variables, including behavior.  For example, we believe that individuals who have never had an HIV test respond to different messages than individuals who test infrequently.  We believe that messages addressing self-efficacy, including statements that tests can be free, fast and confidential are important for individuals who have never gotten an HIV test.  In contrast, for those who test infrequently, it may be more important to align their perceptions of their risk to their actual risk (e.g. “Your HIV test expires every time you have risky sex.”).

Conclusions: In summary, effective messaging for gay and bisexual men, like other audiences, requires an understanding of the diverse audience segments, and the differences in knowledge, beliefs, and behaviors of those segments. 

Implications for research and/or practice: Based on our findings, communicators should seek to create effective HIV or sexual health messages that are specific, actionable, reduce uncertainty, and promote strategies that are either known or acceptable to gay and bisexual men.