Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support

Sarah K Calabrese; Kristen Underhill; Valerie A Earnshaw; Nathan B Hansen; Trace S Kershaw; Manya Magnus; Douglas S Krakower; Kenneth H Mayer; Joseph R Betancourt; John F Dovidio

doi:10.1007/s10461-016-1318-9

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support

AIDS Behav. 2016 Jul;20(7):1499-513. doi: 10.1007/s10461-016-1318-9.

Authors

Sarah K Calabrese^{1

2}, Kristen Underhill^{3

4}, Valerie A Earnshaw^{3

5}, Nathan B Hansen^{3

6}, Trace S Kershaw^{7

3}, Manya Magnus⁸, Douglas S Krakower^{9

10}, Kenneth H Mayer^{9

10}, Joseph R Betancourt¹¹, John F Dovidio^{3

12}

Affiliations

¹ Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 135 College Street, Suite 358, New Haven, CT, 06510, USA. sarah.calabrese@yale.edu.
² Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA. sarah.calabrese@yale.edu.
³ Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA.
⁴ Yale Law School, Yale University, New Haven, CT, USA.
⁵ Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
⁶ Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA.
⁷ Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 135 College Street, Suite 358, New Haven, CT, 06510, USA.
⁸ Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
⁹ Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
¹⁰ The Fenway Institute, Fenway Health, Boston, MA, USA.
¹¹ Disparities Solutions Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Psychology, Yale University, New Haven, CT, USA.

Abstract

Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting ("beneficiary") and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.

Keywords: Black/African American; Framing; HIV; Men who have sex with men (MSM); Pre-exposure prophylaxis (PrEP); Prejudice; Public opinion.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Black People / psychology*
Black People / statistics & numerical data
HIV Infections / prevention & control*
Health Knowledge, Attitudes, Practice
Homosexuality, Male / psychology*
Humans
Male
Perception
Pre-Exposure Prophylaxis*
Prejudice*
Public Opinion*
Racism*
Sexual Behavior / psychology
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding