GYT Exposure Among Youth and Effects By Dose

Theoretical Background and research questions/hypothesis:  Youth account for half of the 20 million new sexually transmitted diseases (STDs) in the United States each year, and most do not know they are infected. The GYT: Get Yourself Tested campaign was launched in 2009 to promote STD testing among youth, linking them to testing services and encouraging communication with partners and health providers. To evaluate GYT’s impact, a national survey was conducted among youth, assessing GYT awareness, exposure, and associations with STD communication and testing behaviors by campaign dose.

Methods:  We sampled 4,017 youth (15-25 years) in a representative, probability-based, online survey that assessed: GYT awareness (with and without a visual prompt), campaign exposure through 0-7 channels/settings, and STD/HIV testing and communication behaviors. We used descriptive statistics for measures of campaign awareness and chi-square analyses to assess the statistical significance of differences between those aware and unaware of the campaign.  Further, we examined the relationship between the number of channels through which GYT had been viewed and the campaign’s target behaviors.

Results: Overall, 20% of respondents reported hearing about GYT without a visual prompt; 16.5% reported hearing/seeing GYT when visually prompted by a campaign logo. Those aware of GYT (unprompted) were more likely to report talking to a provider (39.1%) or partner (30.3%) and getting tested for STDs (48.4%) and HIV (46.2%), compared to those who were unaware of GYT (20.0%, 16.1%, 26.5%, and 24.4%, respectively; p<0.05). Those who recognized the GYT logo (prompted awareness) were also more likely than those who did not recognize the logo to report STD talking (with provider: 38.7% vs 20.1%; with partner: 32.8% vs. 15.5%) and testing (49.5% vs. 26.8%). Among those aware of the campaign, 39.7% of those who reported seeing/hearing GYT through 0 channels had ever been STD tested, compared to 47.6% among those reporting exposure through 1 channel, 50.5% among those exposed through 2-4 channels, and 70.7% among those reporting >5 channels. HIV testing also increased linearly with the number of reported exposures/channels, from 31.1% (0 channels) to 75.6% (>5 channels).

Conclusions: Data from a national sample suggest that GYT has reached about one-fifth of youth in the United States. Those exposed to the campaign were more likely to report STD testing/talking behaviors than those unexposed, and those who spontaneously reported awareness of the campaign were more likely to report STD testing/communication than those who recognized GYT only when visually prompted. Testing and communication behaviors increased with the number of channels/settings in which youth reported seeing GYT materials, indicating a possible dose-response relationship. Observed increases among those aware of GYT but reporting no channels/settings suggest potential indirect campaign effects.

Implications for research and/or practice: These findings highlight the importance of reaching audiences through multiple channels and settings to maximize impact of social marketing campaigns. The potential for indirect campaign effects through interpersonal communication and sharing is an important consideration that should be measured in future evaluations.