Background:
Men who have sex with men (MSM) - especially those who actively seek multiple partners online - are at high risk of STIs, including hepatitis A (HAV) and hepatitis B (HBV) infection. Few studies have investigated high-risk MSM's preferences with regard to online educational materials.

Objective:
To understand MSM's preferences for online educational materials.

Method:
MSM who were uninfected and unvaccinated were recruited through banner ads on gay-related Web sites and invited to compare two educational sites. One was newly designed and another was highly rated in a previous comparison study. Intentions to vaccinate were recorded before and after viewing the campaigns, and men were asked a series of questions about their preferences.

Result:
Of 214 volunteers, 90 were eligible. Intentions to vaccinate improved significantly when pre- and post-test intentions were compared. Men believed the new campaign, compared to the other campaign, was more likely to encourage MSM to think about getting vaccinated, talk to their healthcare provider about vaccination, make an appointment, get a vaccine, or complete the series. The majority preferred one campaign over the other because it was ‘more informative' and recommended improvements included adding more referral information, improving graphics, adding statistics (e.g. rates of infection) and information about complications and side effects.

Conclusion:
There was great diversity among this online MSM sample, especially with regard to educational preferences. Preferences were primarily based on content, followed by the visual appeal of the graphics.

Implications:
The study methods and findings are useful for those who design educational materials, especially for MSM regarding hepatitis vaccinations. Knowing what will capture the attention of persons at risk will improve the effectiveness of educational materials. Striking a balance between too much text and not enough is critical, as is using bright, vibrant colors and graphics.