JMIR Publications

ABSTRACT

Background:

There is still an HIV epidemic in the U.S., which is a substantial issue for priority populations bearing a disproportionate burden of HIV infection. Daily oral pre-exposure prophylaxis (PrEP) has been shown to be safe and effective in reducing sexual HIV acquisition risk. However, studies document that PrEP awareness/usage is low. There is also a limited understanding of social media, such as Instagram, as a PrEP information source.

Objective:

Given the paucity of research on PrEP-related Instagram posts and popularity of the social media platform, the purpose of this research is to describe the source and message characteristics of PrEP-related posts on Instagram.

Methods:

Using Crowdtangle Search, a public insights tool owned/operated by Facebook, we retrieved publicly accessible and English-language-only Instagram posts for the 12-month period preceding April 22, 2020, using the terms: Truvada or “pre-exposure prophylaxis” or #truvada or #truvadaprep or #truvadawhore or #truvadaforprep. We employed a qualitative coding methodology to manually extract information from posts. Using a pre-tested codebook, we performed a content analysis on N=250 posts, examining source and message characteristics (i.e., organization type [e.g., government, news], individual type [e.g., doctor]), including specific information about PrEP (e.g., how it works, its cost) and indicated users. Frequencies and percentages were calculated for all categorical variables. A chi-square analysis was conducted to determine differences between source types on a variety of message characteristics.

Results:

Three-quarters of posts (n=193, 77.2%) were posted by organizations. Of the 250 posts reviewed, about two-thirds (n=174, 69.6%) included a photograph, more than half (n=142, 56.8%) included an infographic, and one in 10 (n=30, 12%) included a video. More than half defined PrEP (n=137, 54.8%), but fewer posts promoted PrEP use, explained how PrEP works, and included information on effectiveness or who can use PrEP. The most commonly hashtagged population among posts was men who have sex with men, but not necessarily bisexual men. Few posts contained race/ethnicity-related hashtags (n=11, 4.4%). Fewer posts contained transgender-associated tags (e.g., #transgirl; n=5, 2.0%). No posts contained tags related to heterosexuals or injection drug users. We found statistical differences between source types (i.e., individual versus organization). Specifically, posts from organizations more frequently contained information about who can use PrEP, whereas posts from individuals more frequently contained information describing side effects.

Conclusions:

This study is among the first to review Instagram for content related to PrEP, and it answers the National AIDS Strategy’s call to more clearly articulate the science surrounding HIV risk/prevention through a better understanding of the current public information environment. This study offers a snapshot of how PrEP is being discussed (and by whom) on one of the most popular social media platforms and provides a foundation for developing and implementing PrEP promotion interventions on Instagram.