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

项目摘要/摘要 与男性发生性关系的青壮年男性(YMSM)--特别是黑人、西班牙裔和非西班牙裔白人 YMSM-是艾滋病毒感染的高风险人群。暴露前预防(PrEP)在以下方面非常有效 按指示服用可降低艾滋病毒风险。因此，促进预防接种计划--例如，通过公共卫生 传播信息--代表了一项关键的公共卫生战略，旨在实现减少 艾滋病毒的传播。尽管PrEP对健康有好处，尽管YMSM对PrEP的认识水平很高，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 可注射PrEP作为口服PrEP的一种安全、高效的替代品。目前，基督教青年会知之甚少 可注射PrEP，但表示对其非常感兴趣，并希望了解更多有关它的信息。接触健康 消息传递是健康消息影响行为的必要的第一步，因此YMSM正在寻找 关于注射和口服PrEP的信息，必须了解它们是什么类型的健康信息 找出PrEP，以及这些选择偏好背后的因素。的首要目标是 建议的研究是应用健康传播理论的信息寻求，选择性媒体暴露， 以及调查YMSM最有可能采用的各种类型的健康信息策略的说服 当在线搜索关于PrEP的内容时(例如，关于PrEP的有效性的信息、样本的 证词)。目标1是确定加强YMSM与PrEP接触的消息传递策略 消息，考虑这些消息参与模式是否受PrEP类型(可注入)的影响 与口头比较)。目标2是测试人口统计学(例如，种族/民族)和心理(例如，感知到的耻辱) 这些消息传递策略的参与度预测指标。目标3是确定选择性参与如何 不同的PrEP消息传递策略预测了使用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(等比例黑人、西班牙裔和非西班牙裔)进行三项研究 怀特)，使用定性和定量的方法。在研究1中，我们将召集焦点小组(N=60)来 归纳收集有关YMSM首选(和避免)的消息传递策略的见解。研究2(N=600)和 研究3(N=75)将是YMSM浏览模拟互联网搜索结果页面的随机实验 有关PrEP的信息。为了避免与自我报告的信息参与度相关的偏见，研究2 而3将不引人注目地跟踪浏览行为(例如，点击)。研究3还将包括收集视觉数据 通过移动招聘方式获取行为数据。调查结果将为从业者提供关于以下方面的可行指导 最有可能引起黑人、西班牙裔和非西班牙裔白人YMSM注意的PrEP信息 服务的最终目标是将他们转移到艾滋病毒护理连续体中。这款R21将为一款 R01评估(A)在与其他在线内容竞争时，消息策略如何吸引注意力 社交媒体背景和(B)PrEP行为作为消息参与随时间推移的结果。

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.