JMIR Publications

ABSTRACT

Background:

HIV remains a persistent health problem in the US, especially among women. Women who are at-risk of HIV face numerous barriers to HIV services and information, underscoring the critical need for strategies to increase awareness of evidence-based HIV prevention methods, such as HIV pre-exposure prophylaxis (PrEP), among women.

Objective:

To identify the historical trends in the use of Twitter hashtags specific to women and HIV PrEP and explore content about women and PrEP shared through Twitter.

Methods:

Qualitative descriptive study using a purposive sample of tweets containing hashtags related to women and HIV PrEP from 2009-2022. Tweets were collected via Twitter’s application programing interface (API) and coded using content analysis to generate results.

Results:

A total of 1,256 tweets from 396 unique users were relevant to our study focus of content about PrEP specifically for women (43.2% eligible tweets). We found that this sample of tweets was posted mostly by organizations, and significantly decreased after 2018. Most tweets specifically targeted people of color, including imagery and links to informational websites. Less than half of tweets contained any Health Belief Model concepts, and only a few contained cues to action. Lastly, while our sample included only tweets relevant to women, we found that the tweets directed to LGBTQ audiences received the highest levels of audience engagement.

Conclusions:

These findings point to several areas for improvement to future social media campaigns directed to women about PrEP. First, future posts would benefit from including more theoretical constructs such as self-efficacy and cues to action. Second, organizations posting on Twitter should continue to broaden their audience and followers to reach more people. Lastly, tweets should leverage the momentum and strategies employed by the LGBTQ community to reach broader audiences and destigmatize PrEP use across all communities.