Reducing HIV vaccine and prevention hesitancy among sexual and gender minority adolescents - Project Summary
Adolescents and young adults are disproportionately affected by HIV in the USA, accounting for 21% of new
infections, with sexual and gender minority (SGM) youth carrying the greatest burden of disease. Recently,
phase I trials of potential HIV vaccines have opened possibilities for more prevention options available to youth
(in addition to oral and injectable PrEP). However, implementation of biomedical HIV prevention (e.g., PrEP)
among youth is hindered by numerous barriers that will likely affect HIV vaccine uptake, including
misinformation/lack of information, medical mistrust, and stigma. Youth-focused messaging on biomedical HIV
prevention is nearly nonexistent, leaving SGM teens with incomplete knowledge and fostering
misunderstanding and negative perceptions about biomedical HIV prevention methods. In addition, lessons
learned from the rollout of the HPV and COVID-19 vaccines indicate that unclear public health messaging, dis-
or misinformation from media/online sources, and vaccine stigma contributed to lack of trust, delayed uptake,
or outright refusal of vaccines. As HIV vaccines are in development, and PrEP remains underutilized among
SGM adolescents, now is the best time to understand and address biomedical HIV prevention concerns and
misinformation among youth. Therefore, this study proposes to preemptively debunk (i.e., “prebunk”)
misinformation about HIV vaccines, improve attitudes regarding multiple methods of biomedical HIV
prevention, and improve awareness, intentions, and uptake among SGM youth. In Aim 1, using an online
survey, we will gain comprehensive understanding of biomedical-HIV-prevention-related knowledge, social
norms and attitudes, and behavioral intent among a diverse nationwide sample of 700 SGM youth age 13-21.
In Aim 2, we will develop 8 brief youth-centered video vignettes aimed at prebunking vaccine misinformation
and presenting one or more complementary biomedical prevention methods (vaccine, PrEP, condoms). These
video messages will be delivered through narrative storytelling formats that are relevant, compelling, and
persuasive for youth. We will obtain feedback about the video vignettes from SGM youth and adult
stakeholders at multiple timepoints during video production and integrate this feedback into the final cuts. In
Aim 3, we will test the effectiveness of our messages in a randomized controlled trial with 500 SGM youth,
which will compare the video messages against an information-only control (e.g., publicly available information
from CDC on HIV vaccines and other forms of biomedical prevention). Three-month post-test outcomes
include vaccine acceptability and intentions, vaccine beliefs, and proxies for vaccine uptake (e.g., prevention
information seeking, HIV/STI testing, PrEP initiation.) Within this aim, we will also explore barriers and
facilitators to online- and in-person implementation via interviews with staff in community/clinical settings and
experts in entertainment education and streaming media.