Development and Evaluation of an HIV/STD-Focused Motion Comic for Young People Ages 15-24 Years in the US

Background: Prevention interventions to reduce HIV/STDs disproportionate impact among youth need to be relevant, engaging and acceptable to youth.  We developed and tested an innovative tool – a motion- and sound- enhanced comic (motion comic) – to improve prevention knowledge, stigma and intentions within this demographic.

Methods: We conducted three rounds of focus groups with youth ages 15 – 24 years.  Qualitative data collected during rounds 1 (n = 34) and 2 (n = 40) were used to gauge HIV/STD knowledge, attitudes and behaviors and to develop the storylines and characters of a motion comic addressing condoms, stigma, myths, and HIV/STD testing and disclosure of status.  The final 38-minute product was evaluated in round 3 (n = 144) using a pre-/post-test survey design; we used paired sample t-tests to assess changes between tests. 

Results: Among 216 participants, 62% were male, 29% self-identified as gay, and 55% were African American. Qualitative analysis revealed gaps in knowledge, barriers to protective behaviors (e.g., testing, condom use), and HIV/STD stigma.  Participants preferred comics in conventional settings with realistic art and a balance of humor, drama and suspense without overt health messages.  Participants held favorable opinions of the story plot (90%), drama (73%), and humor (71%); 75% indicated they would share the content with friends.  Exposure to the intervention was associated with statistically significant increases in HIV/STI knowledge; (t = 3.295, p = 0.001), in intentions to engage in HIV/ STI protective behaviors (t = 5.743, p < 0.001), and a decrease in HIV stigma; (t = 3.237, p = 0.002). 

Conclusions: The motion comic was acceptable and engaging to minority youth, and improved knowledge and intentions regarding HIV/STI prevention. This novel approach may be useful for reaching youth about other important health issues such as teen pregnancy and alcohol/drug use.