An interdisciplinary team of Penn State researchers have received a $442,750 grant from the National Institute of Mental Health to support a multi-faceted, three-part study that observes how gay and bisexual men search and find HIV prevention information — specifically information about pre-exposure prophylaxis (PrEP), a medicine that when taken as prescribed, is very effective at preventing HIV.
Over the next two years, the researchers will examine various types of health messaging of the type that young adult men who have sex with men (YMSM) are most likely to encounter when looking for content on PrEP. The researchers explained that they hope to identify strategies that will increase engagement with PrEP messaging. They also hope to learn how the messaging may affect intentions to use the medicine.
“HIV is not gone,” said Chris Skurka, an assistant professor of media studies in the Donald P. Bellisario College of Communications and lead author of the studies. “Infection rates obviously vary across the population, but the group that is most at risk is gay and bisexual men.”
According to the Centers for Disease Control and Prevention (CDC), of the 36,801 HIV diagnoses in the United States in 2019, almost 70% were gay and bisexual men. Estimated statistics for lifetime HIV risk are higher among some racial and ethnic groups within the gay and bisexual community. The estimated risk for gay and bisexual men who are white is about one in 11. For Hispanic men who are gay or bisexual, the risk is about one in five. For gay and bisexual Black men, it's about one in two.
“These are very scary statistics,” Skurka said.
PrEP was approved by the Federal Drug Administration in 2012 and recommended by the CDC in 2014 to patients who meet certain risk criteria. Despite being approved, recommended and highly effective, acceptance has been sluggish among the most at-risk groups.
“The context for why acceptance has been slow matters in getting YMSM to know about PrEP and getting them to seek more information about it,” Skurka said. “It's a complex decision that should be made with your doctor and with any romantic or sexual partners that you may have, but informing YMSM and getting them moving along the health care continuum is of utmost importance.”
Through focus groups, the study will gather insights on YMSM’s preferred and unpreferred ways to receive messaging about HIV prevention and PrEP. Following the focus groups, the researchers will run experiments that ask YMSM to demonstrate their internet browsing behaviors using a mock search engine. A third part of the study will also use eye tracking to monitor visual behavior using search engines on mobile devices.
Findings will provide guidance for practitioners about PrEP messaging that is most likely to engage Black, Hispanic, and non-Hispanic white YMSM.
“Our goal is to get more people in this population familiar with PrEP – both the oral version and the more novel injectable version — and ultimately reduce HIV incidence rates,” Skurka said.
The research team includes researchers from Penn State's Bellisario College of Communications, the College of the Liberal Arts and the College of Health and Human Development. Skurka said recruiting a diverse group of researchers was important to address the multiple facets of the study.
“Understanding a complex behavior, like PrEP use, and promoting PrEP use requires expertise,” Skurka said. “It’s psychology. It’s public health. It’s health communication. There's some overlap, but we are addressing this important topic from different angles.”
Coauthors on this study are Timothy Brick, associate professor of human development and family studies and scientist in SSRI's QuantDev; Jessica Myrick, the Bellisario Professor of Health Communication; Joshua Rosenberger, assistant professor of biobehavioral health and women's, gender, and sexuality studies and SSRI's Survey Research Center director; Rachel Smith, professor of communication arts and sciences; and Sam Tornello, assistant professor of human development and family studies. The researchers will work with the Philadelphia Department of Public Health to recruit eligible participants and conduct in-person components of the research.