AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #112 - The consequence of HIV prevention messages and use of sexually explicit imagery on US men who have sex with men
Authors: Presenting Author: Dr J Michael Wilkerson - University of Minnesota
Additional Authors: Dr. Alex Iantaffi, Mr. Jeremy Grey, Dr. BR Simon Rosser,
Aim: The recent surge in HIV incidence among US men who have sex with men (MSM) has been cited as evidence of failed HIV-prevention messaging, raising questions about how interventionists should proceed when developing prevention media. As part of a qualitative study about MSM’s experience with sexually explicit media (SEM), we exposed participants to HIV-prevention ads that varied in their explicitness to identify factors influencing ad acceptability.
Method / Issue: We recruited 60 US MSM ages 18 and over who viewed SEM at least weekly into one of nine online synchronous and asynchronous focus groups. During the synchronous focus groups, we exposed participants to five still ads with varying degrees of explicitness and one video ad. Ads were modified to remove information that would identify a company or agency, leaving only the image and key prevention message. The least explicit still ad showed images of condoms and motorcycle helmets, drawing a comparison between the two protective behaviors. The most explicit still ad showed two men having anal sex while wearing a condom. The video ad included scenes from a well-known gay SEM studio and an equally well-known drag queen promoting condom use. Transcripts were entered into NVivo8. Two members of the research team completed a content analysis to identify major themes and then used axial coding to link findings to the existing literature.
Results / Comments: The majority of participants identified as white (74.7%), gay (82.3%), HIV-negative (69.6%), and between ages 18-44 (84.8%). In all focus groups, a tension emerged between participants who preferred sexually explicit images and those who did not. Participants not in favor of explicit images associated the images with thoughts of sex, but not necessarily condom use. These participants suggested that the safer sex messages were lost, even when the explicit images demonstrated condom use. Participants uncomfortable with the explicit images espoused a social narrative consistent with public health’s image of a sexually responsible man who has sex with men, e.g., eschewing sexual promiscuity and anal sex without condoms. Some of the participants seem to have incorporated the narrative into their sexual script while others seem to espouse the narrative to avoid potential stigmatization. Most participants supported the use of explicit images in sexually charged environments frequented only by MSM. In environments catering to MSM but accessible to heterosexual persons, sexually suggestive images were preferred over more explicit images. Participants were adamant that images suggesting male-to-male sexual intimacy were inappropriate in environments where MSM were not the majority.
Discussion: Potential stigmatization and the environment in which messages are delivered appear to influence the acceptability of HIV-prevention. When conducting marketing research to develop HIV-prevention media, interventionists should explore the extent to which imagery reinforces or inhibits MSM’s receptivity of prevention messaging and how best to match the degree of explicit imagery with environment.
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