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A Case Study on U=U Messaging and HIV Prevention in Alabama and Mississippi

The Henne Group (THG) has a long history of impactful research to benefit people living with HIV. In early 2021, THG, in collaboration with ViiV HealthcarePrevention Access Campaign (PAC), and Q-Catalytics, conducted a campaign in Alabama and Mississippi to educate both HIV-positive and HIV-negative men on “Undetectable equals Untransmittable” or U=U Messaging.  Simply stated, U=U informs people living with HIV that, if they take their HIV medication as prescribed and maintain an undetectable viral load, they cannot transmit the virus. Seven southern states account for nearly 50% of all new HIV cases in the United States. THG conducted this study in two of these states – Alabama and Mississippi.


In each state, THG conducted a pretest survey to measure U=U awareness, before launching a social media campaign in both states and peer-to-peer education in Mississippi but not in Alabama. A longitudinal survey was conducted with the same group of respondents after the campaign was over.

The study measured the increase in awareness of U=U messaging. Q-Catalytics CEO and Director of Analytics Rebecca Quarles, Ph.D., said: “Longitudinal studies are powerful because they allow us to observe change at the individual level permitting us to examine the characteristics of people who learned about U=U during the campaign.” While various media advertisements were placed in both states, peer-to-peer engagement was only deployed in Mississippi where three trained, full-time U=U ambassadors disseminated U=U information through online meetings and in-person events.   


Overall, the findings showed a statistically significant increase in awareness of U=U (+22 percentage points). In Mississippi, where peer-to-peer engagement took place, awareness increased by 28 percentage points. In Alabama, where only social media advertising was utilized, awareness increased by 19 percentage points. This is evidence that both social media advertising and peer-to-peer engagement contributed to increased awareness in these two states. 


These results show that properly designed and executed social media advertisements and peer-to-peer engagement campaigns can significantly raise awareness of U=U messaging, even in areas where awareness of U=U is low and diffusion of information about it is dampened by low incomes, low educational levels, and high levels of stigma surrounding HIV. 


To view the full white paper and read the results of the THG study, please click the link below:  



White paper U=U Alabama and Mississippi
White paper MSM Deep south B2G.pdf
Adobe Acrobat document [787.8 KB]


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