Uncertainty in Online U.S. News Coverage of Truvada

Information Seeking and MSM's Beliefs about PrEP and Condoms

This study examined how frequently men who have sex with men (MSM) used a selection of sources, including news media, social media, health organizations, and dating/hookup apps, for HIV information. Additionally, the study explored the extent to which MSM's efficacy beliefs about pre-exposure prophylaxis (PrEP) and perceptions of condom importance could be predicted by the sources they used. A sample of MSM (N= 969) were surveyed online. Results showed that respondents obtained information about HIV most often from HIV organizations, LGBT organizations, and dating/hookup apps, particularly the apps Growlr, Scruff, and Grindr. Use of the app Scruff was the strongest source-based predictor of beliefs about both PrEP and condoms. Implications for health promotion are discussed.

Communication Strategies for Discussing PrEP with Men Who Have Sex with Men

HIV continues to be a pressing problem, particularly for men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a highly effective means of preventing HIV infection, but adoption of it by MSM has been sluggish. Though there are many reasons for PrEP's limited adoption, healthcare providers' lack of skill in communicating with MSM likely plays a role. This study employed in-depth interviews with MSM who have adopted PrEP to explore how effective patient-provider communication surrounding PrEP takes place. Findings revealed that healthcare providers utilized five strategies to communicate with their MSM patients about PrEP. These strategies included (1) disclosure of identity and personal information; (2) knowledge of information that may be relevant to MSM patients; (3) positivity; (4) relationship inquiries; and (5) remaining calm. Employing the strategies uncovered in this study may be useful in improving communication between healthcare providers and their MSM patients and may help to increase MSM's adoption of PrEP.

News coverage of drug development: implications for the conveyance of health information

BACKGROUND

Technical information regarding health-related advances is sometimes esoteric for the general public. News media, therefore, plays a key role in public health promotion via health information conveyance. In this study, we use China as a sample country and analyze the claims and frames in news coverage of health-related advances, with special focus on news coverage of the development and performance of newly developed or tested drugs.

METHODS

A keyword search was performed to retrieve news articles from four representative news agencies in China. In total, 3029 news reports were retrieved, of which 128 were selected for further analysis.

RESULTS

Four aspects of news coverage of drug development were identified: (1) the characteristics of new drugs covered, (2) the sources of information, (3) the accuracy of health information in newspapers, and (4) textual features of news coverage.

CONCLUSIONS

Our findings reveal that guidelines should be established to facilitate more systematic news reporting on health-related advances. Additionally, literacy among the general public and professionalism in health information conveyance should be promoted to negate the "illusion of knowing" about health-related advances.

Biomedicalization, Stigma, and "Re-Gaying" HIV/AIDS in the Israeli Media

HIV and AIDS are not merely biomedical conditions-they are socially constructed phenomena. Media coverage plays a prominent role in the public's understanding of HIV/AIDS. "Biomediatization" denotes the coproduction of HIV/AIDS by biomedicine and mass media. Nevertheless, despite the importance of the media in the social construction of HIV/AIDS, research on HIV/AIDS coverage in the Israeli media is negligible. This study examined the social construction of HIV/AIDS in Israel. The sample includes all items (88 texts and videos) published in three of the top news websites in a 1-year period that mentioned HIV or AIDS. Thematic analysis was employed. Three themes were identified. "The biomedicalization of HIV/AIDS" depicted HIV/AIDS as a one-faceted, biological phenomenon that concerns the body of the individual and is a public health issue. The second theme, "HIV/AIDS and stigma," consisted of subthemes: "acknowledging stigma" and "constructing stigma." In the former, the stigma ascribed to HIV/AIDS was acknowledged and discussed. The latter revealed various mechanisms employed by the media to construct and perpetuate HIV/AIDS stigma. The third theme we identified, "re-gaying HIV/AIDS," concerned the various venues through which HIV/AIDS is associated with gay men. The findings show that HIV/AIDS was depicted as a biomedical condition that concerns the individual. The implications of our study include a need to change the rhetoric of HIV/AIDS in the Israeli media such that it will address the complex issues of power and inequality that HIV/AIDS entails.

Intention to Behavior: Using the Integrative Model of Behavioral Prediction to Understand Actual Control of PrEP Uptake Among Gay Men

PrEP is an effective daily prevention medicine used to reduce risks of HIV infections. Previous research has pointed out the intention-behavior gap on PrEP uptake among gay men. The current study built on research examining how the integrative model of behavioral prediction (IMBP) factors influences PrEP uptake among gay men to explore how actual control variables, namely skills and environmental constraints, moderated the intention-behavior relationship. We used results from formative interviews to construct a survey and collected data from 420 gay men. Results showed several factors that were associated with PrEP uptake among gay men. Specifically, the lack of access to an LGBTQ-friendly healthcare provider(s) and lack of English fluency had significant main effects on PrEP uptake behavior, while lack of access to a healthcare provider and lack of healthcare system knowledge were significant moderators of the intention-behavior relationship. This study advances our understanding of the IMBP and offers practical implications for PrEP promotion. Limitations and suggestions for future studies are discussed.

HIV pre-exposure prophylaxis and the 'problems' of reduced condom use and sexually transmitted infections in Australia: a critical analysis from an evidence-making intervention perspective

HIV pre-exposure prophylaxis (PrEP) has been embraced in Australia, making PrEP available with public funding to people at risk of HIV. Here, we consider the associated 'problems' of reduced condom use and sexually transmissible infections (STIs), as seen by HIV professionals. Twenty-one interviews were conducted during May-August 2017. All agreed that PrEP was a valuable addition to HIV prevention, but their views about reduced condom use and STIs were variable. Using poststructural policy analysis, three main stances were identified: (1) Concerned/alarmed. PrEP was seen as causing reduced condom use, STIs and antibiotic resistance, posing threats to the general population; (2) Neutral/normalising. Stakeholders emphasised that condom use was declining and STIs increasing independently of PrEP, and that PrEP was simply a new tool to be accommodated; (3) Optimistic/critical. PrEP was seen as diminishing fear of HIV and engaging users in more frequent testing and treatment that could lead to declining STI rates. What linked all three stances was the selective performance of evidence, deploying a mixture of personal experience, clinical observations, behavioural data and epidemiology. Anticipating possible futures through evidence-making suggested practical, political and moral consequences for what PrEP could become. We encourage others to consider these consequences with care.

Stigma, the Media, and Pre-exposure Prophylaxis for HIV Prevention: Observations for Enhancing Knowledge Translation and Resisting Stigma in the Canadian Context

Pre-Exposure Prophylaxis (PrEP) is an effective, though sometimes stigmatized, strategy for HIV prevention. With the goal of examining how PrEP stigma can be addressed, this study examined the media's handling of stigma related to PrEP by searching the Canadian Newsstream and Daily Xtra news databases for key terms related to PrEP. Overall, 101 media articles were thematically coded in triplicate; 36.3% of which included mentions of PrEP stigma. LGBT media sources were more likely than mainstream sources to have included content coded as relating to PrEP stigma (p = 0.02). In these articles, uncertainty regarding PrEP, and neo-liberal attitudes towards sexual responsibility were major factors associated with media discussion of PrEP stigma. We discuss the role that heuristics play in shaping lay readers perceptions and interpretation of PrEP media coverage and discuss methods for overcoming stigma using evidence-based communication strategies.

Stigma Communication Surrounding PrEP: The Experiences of A Sample of Men Who Have Sex With Men

HIV is a serious problem in the USA, particularly for men who have sex with men (MSM). A new means of HIV prevention, called pre-exposure prophylaxis (PrEP), has been shown to be highly effective. However, in spite of earning FDA approval, adoption of PrEP by MSM has been limited. The purpose of this study was to examine the experiences of a sample of 38 MSM who have adopted PrEP, focusing on communication with healthcare providers and social networks. In-depth interviews were used to collect data. Findings revealed that stigmatization by healthcare providers as well as stigmatization by other MSM was a relatively common experience for participants. Additionally, participants described that a high level of health literacy, health advocacy, and communication skill were necessary to adopt PrEP. Given these findings, strategies are suggested for improving MSM's healthcare and increasing rates of PrEP adoption.

'It's just an excuse to slut around': gay and bisexual mens' constructions of HIV pre-exposure prophylaxis (PrEP) as a social problem

Since the 2012 FDA approval of HIV Pre-exposure Prophylaxis (PrEP) as a method to prevent HIV, its uptake among gay and bisexual men has been met with conflict. Drawing on discussions of PrEP from focus groups with gay and bisexual men in New York City (N = 5 groups, n = 32 participants), we sought to make meaning of the moral debate surrounding the implementation of biomedical HIV prevention medications. Grounded in the constructionist perspective on social problems, this case study focuses on the competing claims making activities gay and bisexual men engage in when framing PrEP and PrEP users. As HIV prevention is a communicative endeavour, analysing the micro level social problems work on PrEP provides key insight into the subcultural norms and values that shape sexual health practices and beliefs within gay and bisexual communities.

"It's Like Birth Control for HIV": Communication and Stigma for Gay Men on PrEP

This study focuses on how gay men communicate about pre-exposure prophylaxis (PrEP), focusing on how they learned about PrEP, how they discussed adoption with health care providers, and to what extent they have encountered stigma on social networks. In this qualitative study, 39 gay PrEP users were interviewed about PrEP. A majority of the participants learned about PrEP via friends and potential sex partners, and a majority of the participants experienced stigma from their health care provider and from other gay men online, mainly referring to promiscuity and risks of STIs. The authors recommend that health care providers should be trained in minimizing the expression of stigmatizing attitudes and should increase their knowledge of PrEP.

PrEP on Twitter: Information, Barriers, and Stigma

On May 14, 2014 the Centers for Disease Control and Prevention (CDC) endorsed the drug Truvada as an HIV preventative, called pre-exposure prophylaxis (PrEP). PrEP has been shown to dramatically reduce the risk of HIV infection, but its rate of adoption has been slow, and discourse surrounding it has been marked by stigma and uncertainty. The purpose of this study was to investigate how PrEP was discussed on Twitter. Our analysis focused on barriers to PrEP adoption and stigmatization of PrEP users. We analyzed a random sample of 1,093 top tweets about PrEP posted to Twitter a year before and a year after the CDC's endorsement. Our results showed that tweets likely reinforced uncertainty about barriers to PrEP adoption and that users employed Twitter's functionality to counter stigmatizing narratives about PrEP. We suggest that our findings illuminate both the limitations and strengths of Twitter as a mechanism for health promotion.