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Case Study
Raising U=U Awareness in the Deep South
This case study, conducted by The Henne Group (THG) and the Prevention Access Campaign (now "U=U plus" ), focuses on a public health intervention among Men Who Have Sex with Men (MSM) in Mississippi and Alabama
Background: The Challenge of HIV in the Deep South
HIV/AIDS remains a major public health threat in the United States , with the southern states disproportionately affected.
The Intervention:
Social Media and Peer-to-Peer Engagement
The goal of this three-month communication and advertising campaign in 2021 was to build awareness, believability, and acceptance of the U=U message among MSM in Mississippi and Alabama.
Social Media Advertising
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Where: Executed in both Alabama and Mississippi.
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​When: Three waves ran from April 9th through June 6th, 2021.
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Content: Three unique characters (Dee, Kaleb, Fernando) were featured in separate ads, each running for 18 or 19 days in sequence. The core message was: "[Character Name] is undetectable so she/he can't pass HIV to anyone".
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Channels: Social media platforms included Grindr, Jack'd, Scruff, Growlr, GBT Pages, and Facebook/Instagram.
Peer-to-Peer (P2P) Engagement
- Where: Exclusively in Mississippi.
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When: A 14-week period, from February 22 to May 28, 2021.
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Method: Three trained, full-time Prevention Access Campaign (PAC) ambassadors disseminated information, held online meetings, and built coalitions. The engagement was primarily virtual due to the COVID-19 pandemic.
Assessment and Key Findings
A longitudinal study was conducted among MSM in both states to evaluate the campaign's effectiveness, surveying 801 individuals in the pretest and 504 in the post-test.
Metric
Total Increase
+22%
This figure represents the overall increase in U=U awareness across the entire sample of MSM in both Mississippi and Alabama combined. The combined effect of the social media advertising and the peer-to-peer engagement (in Mississippi) resulted in an overall awareness increase of 22 percent from the pre-test to the post-test.
Mississippi Increase
+28%
Mississippi experienced the largest increase in U=U awareness, rising by 28 percent. This greater positive change is attributed to the fact that Mississippi received the full, multi-component intervention: both the social media advertising and the 14-week peer-to-peer engagement component. This suggests that the inclusion of P2P engagement significantly augmented the effectiveness of the communication campaign.
Alabama Increase
+19%
Alabama's U=U awareness increased by 19 percent. Since the campaign in Alabama consisted only of the social media advertising and did not include the peer-to-peer component , this figure demonstrates the independent effectiveness of the properly-designed social media advertising campaign alone. The difference between the two states confirms the hypothesis that the peer-to-peer component resulted in a larger positive change in awareness.
Key
Results
1- Peer-to-Peer Impact: As expected, Mississippi, which received the P2P component in addition to social media, saw a significantly greater increase in overall U=U awareness (+28%) compared to Alabama (+19%). This suggests that adding a P2P strategy can further increase awareness.
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2- Advertising Effectiveness: Only 26% of MSM recognized a character from the social media ads. However, those who did recognize a character showed higher levels of U=U understanding:
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Awareness: 73% vs. 50% for those who did not recognize a character.
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Believability: 78% vs. 68%.
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Acceptance: 59% vs. 38%.
3- The Role of Social Perception: The study found that 78% of those who believed other MSM would accept the U=U message also believed it themselves. This indicates that perceptions about peer acceptance are crucial to believability and personal acceptance.
4- Access to Healthcare: U=U awareness was higher among MSM who saw a healthcare provider. Critically, 58% (or 6 in 10) of MSM in the study were not seeing a healthcare professional. This finding highlights that access to care may play a major role in raising U=U awareness.
Conclusion and
Replication
The research demonstrates that well-designed and executed social media campaigns are effective at increasing U=U awareness. When these campaigns are augmented by a peer-to-peer engagement component, they lead to an even greater increase in awareness. Furthermore, encouraging HIV-negative MSM to seek a healthcare provider is suggested as a method to increase U=U awareness.
All of these components are potentially easily replicated in other locations
