Enhancing Engagement with Online Health Messaging about Oral and Injectable PrEP Among Young-Adult MSM

项目总结/摘要 与男性发生性关系的年轻男性（YMSM）-尤其是黑人，西班牙裔和非西班牙裔白色 青年男性运动员感染艾滋病毒的风险更高。暴露前预防（PrEP）非常有效， 减少艾滋病毒感染的风险。因此，促进PrEP--例如，通过公共卫生 传播信息-是实现减少艾滋病毒/艾滋病长期目标的一项关键公共卫生战略， 艾滋病毒的传播。尽管PrEP的健康益处，尽管YMSM的PrEP意识水平很高，但只有 部分YMSM使用PrEP。2021年12月，美国食品和药物管理局批准了长效 注射PrEP是一种安全、高效的口服PrEP替代品。目前，YMSM对 注射PrEP，但表示对它很感兴趣，并希望了解更多有关它的信息。 信息传递是健康信息影响行为的必要的第一步，因此YMSM寻求 关于注射和口服PrEP的信息，必须了解他们提供了什么样的健康信息， 了解PrEP以及这些选择偏好背后的因素。的首要目标 建议的研究是应用健康传播理论的信息寻求，选择性媒体曝光， 和说服检查YMSM最有可能参与的各种类型的健康信息策略 当在线寻求有关PrEP的内容时（例如，关于PrEP的有效性的信息，一个范例的 证词）。目标1是确定增强YMSM参与PrEP的信息策略 消息，考虑这些消息参与模式是否受PrEP类型（注射 vs.口头）。目标2是测试人口统计学（例如，种族/民族）和心理（例如，（感知的耻辱） 预测这些消息传递策略的参与度。目标3是确定如何选择性地参与 不同的PrEP消息传递策略预测使用PrEP的意图。我们将通过以下方式实现这些目标： 对符合PrEP条件的YMSM（黑人、西班牙裔和非西班牙裔的比例相等）进行三项研究 白色），采用定性和定量方法。在研究1中，我们将召集焦点小组（N = 60）， 归纳性地收集有关YMSM首选（和避免）消息传递策略的见解。研究2（N = 600）和 研究3（N = 75）将是随机实验，其中YMSM浏览模拟互联网搜索结果页面 为了避免与自我报告的信息参与相关的偏见，研究2 3将不引人注目地跟踪浏览行为（例如，点击）。研究3还将包括收集视觉 通过移动的招聘方法收集行为数据。调查结果将为从业人员提供可操作的指导， PrEP消息最有可能吸引黑人，西班牙裔和非西班牙裔白色YMSM的注意力， 服务的最终目标，使他们向下艾滋病毒护理连续性。这款R21将为 R 01评估（a）在与其他在线内容竞争时， 社交媒体背景和（B）PrEP行为作为随时间推移的消息参与的结果。

Project Summary/Abstract Young-adult men who have sex with men (YMSM)—especially Black, Hispanic, and non-Hispanic White YMSM—are at heightened risk for HIV infection. Pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV risk when taken as directed. Therefore, promoting PrEP—for example, through public health communication messages—represents a key public health strategy toward the long-term objective of reducing the spread of HIV. Despite PrEP's health benefits and despite YMSM's high levels of PrEP awareness, only a fraction of YMSM use PrEP. In December 2021, the US Food and Drug Administration approved long-acting injectable PrEP as a safe, highly effective alternative to oral PrEP. At present, YMSM know little about injectable PrEP but express great interest in it and in seeking more information about it. Exposure to health messaging is a necessary first step for health messages to influence behavior, so as YMSM seek out information about injectable and oral PrEP, it is imperative to understand what kind of health information they seek out about PrEP and what factors underlie those selection preferences. The overarching goal of the proposed studies is to apply health communication theories of information seeking, selective media exposure, and persuasion to examine the various types of health messaging strategies YMSM are most likely to engage with when seeking content about PrEP online (e.g., information about PrEP's effectiveness, an exemplar's testimony). Aim 1 is to determine the messaging strategies that enhance YMSM's engagement with PrEP messages, considering whether these message engagement patterns are moderated by PrEP type (injectable vs. oral). Aim 2 is to test demographic (e.g., race/ethnicity) and psychographic (e.g., perceived stigma) predictors of engagement with these messaging strategies. Aim 3 is to identify how selective engagement with different PrEP messaging strategies predicts intentions to use PrEP. We will accomplish these aims by conducting three studies with PrEP-eligible YMSM (equal portions of Black, Hispanic, and non-Hispanic White), using qualitative and quantitative methods. In Study 1, we will convene focus groups (N = 60) to inductively gather insights about YMSM's preferred (and avoided) messaging strategies. Study 2 (N = 600) and Study 3 (N = 75) will be randomized experiments in which YMSM browse a mock Internet search results page for information about PrEP. To avoid biases associated with self-reported message engagement, Studies 2 and 3 will unobtrusively track browsing behaviors (e.g., clicks). Study 3 will also include the collection of visual behavior data via mobile recruitment methods. Findings will provide actionable guidance for practitioners about the PrEP messages most likely to engage Black, Hispanic, and non-Hispanic White YMSM's attention in service of the ultimate goal of moving them down the HIV care continuum. This R21 will set the stage for an R01 assessing (a) how messaging strategies engage attention when competing with other online content in a social media context and (b) PrEP behavior as an outcome of message engagement over time.