JMIR Publications

ABSTRACT

Background:

Pre-Exposure Prophylaxis (PrEP) is proven to prevent HIV infection. However, PrEP uptake to date has been limited and inequitable. Analyzing the readability of existing PrEP-related information is important to understand the potential impact of available PrEP information on PrEP uptake, and to identify opportunities to improve PrEP related education and communication.

Objective:

We examined the readability of online PrEP information identified using search engines and circulated on Twitter. We investigated the readability of online PrEP documents, stratified by how the PrEP document was obtained online, information source, document format and communication method, topics (i.e., PrEP modalities), and intended audience.

Methods:

Online PrEP information in English was systematically identified using search engines and the Twitter API. We manually verified and categorized results, and described the method used to obtain information; information source; document format and communication method; PrEP modality; and intended audience. We converted documents to plain text for analysis and assessed readability of the collected documents using 4 readability indices. We conducted pairwise comparisons of readability based on how the PrEP document was obtained online, information source, document format, communication method, PrEP modality, and intended audience then adjusted for multiple comparisons.

Results:

A total of 463 documents were identified. Overall, the readability of online PrEP information was at a higher level (10.2 grade reading level) than what is recommended for health information provided to the general public (9th grade reading level, as suggested by the Department of Health and Human Services). Brochures (n=33, 7% of all identified resources) were the only type of PrEP materials that achieved the target of 9th grade reading level.

Conclusions:

Online PrEP information is often written at a complex level for potential and current PrEP users to understand. This may hinder PrEP uptake for some people who would benefit from it. Readability of PrEP related information found online should be improved to align more closely with health communication guidelines for reading level to improve access to this important health information, to facilitate informed decisions by those with need for PrEP, and to realize national prevention goals for PrEP uptake and reducing new HIV infections in the United States.