Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Pre-exposure prophylaxis (PrEP) is an effective but under-utilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have little evaluation data. Objective: We have evaluated Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health-equity and sex-positivity approaches to information dissemination. Methods: PrEP4Love launched in February, 2016 and remains an active campaign today. The analysis period for this paper was from the launch date in February, 2016- May 15th, 2016. Our analysis reviews the online reach through views on social media platforms (Facebook and Instagram), “smart ads,” or ads served to individuals across a variety of web platforms based on their demographics and browsing history, and PrEP4Love website clicks. Results: 40,913,560 unique views were generated across various social media platforms. Users clicked on PrEP4Love ads 0.06 percent of the time. 32,223,987 views were received from “smart ads;” The three most clicked on ads were “STD Signs & Symptoms –More Information on STD Symptoms,” “HIV & AIDS Prevention,” and “HIV Prevention Medication.” An additional 6,970,127 views were gained through Facebook and another 1,719,446 views through Instagram. There was an average of 182 clicks per day on the PrEP4Love website. Conclusions: This is the first study investigating public responses to a health equity and sex positive social marketing campaign for PrEP. Overall, the campaign reached millions of individuals. More studies of PrEP social marketing are needed to evaluate the relationship of targeted public health campaigns on stigma and to guide future PrEP promotion strategies.

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago’s PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar’s stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the micro-level (i.e., intrapersonal resources)—BLSMM scholars’ personal commitments to BLSMM communities, cultural knowledge and expertise, and shared life experiences; meso-level (i.e., scholar and affected community interactions)—historical membership, mutual interdependency and trust, and community and organizational gatekeeping; and macro-level (i.e., national policies and priorities regarding BLSMM)—national priorities regarding the health and social welfare of BLSMM, allocation of BLSMM research and program funding, societal sentiment, and national investment in the workforce development of BLSMM scholars and clinicians are detailed. In conclusion, we identify recommendations and strategies for advancing scientific, programmatic, and policy efforts, aimed at improving HSLO among communities of BLSMM.

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R² = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth’s awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S.

BACKGROUND Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have less evaluation data. OBJECTIVE The aim of this study was to evaluate Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health equity and sex-positivity approaches for information dissemination. METHODS P4L launched in February 2016 and remains an active campaign to date. The analysis period for this paper was from the launch date in February 2016 through May 15, 2016. Our analysis reviews the Web-based reach of the campaign through views on social media platforms (Facebook and Instagram), smart ads, or ads served to individuals across a variety of Web platforms based on their demographics and browsing history, and P4L website clicks. RESULTS In total, 40,913,560 unique views were generated across various social media platforms. A total of 24,548 users clicked on P4L ads and 32,223,987 views were received from smart ads. The 3 most clicked on ads were STD Signs & Symptoms—More Information on STD Symptoms, HIV & AIDS Prevention, and HIV Prevention Medication. An additional 6,970,127 views were gained through Facebook and another 1,719,446 views through Instagram. There was an average of 182 clicks per day on the P4L website. CONCLUSIONS This is the first study investigating public responses to a health equity and sex-positive social marketing campaign for PrEP. Overall, the campaign reached millions of individuals. More studies of PrEP social marketing are needed to evaluate the relationship of targeted public health campaigns on stigma and to guide future PrEP promotion strategies.