title: Reducing the stigma of herpes simplex virus infection: lessons from an online video contest.
abstract: BACKGROUND
  Herpes simplex virus (HSV) is one of the most common sexually transmisible infections worldwide. HSV-associated stigma negatively impacts emotional and sexual health, suggesting a need for novel approaches to reducing stigma. The aims of this study were to describe the range of destigmatising strategies used by the public in brief online videos, and to describe videos that were successful or unsuccessful in creating a destigmatising message.
  
  
  METHODS
  A thematic content analysis was performed on 103 publicly produced YouTube videos designed to destigmatise HSV infection for an Australian online contest.
  
  
  RESULTS
  Five destigmatising strategies were identified: providing information, normalising through familiarity, promoting disclosure, negating a negative perception and expressing moral indignation. Most videos employed multiple strategies. Regarding the degree of destigmatisation achieved, videos were coded as unsuccessful, successful, mixed or neutral. Unsuccessful and successful videos often employed the same strategies, but differed in their ability to balance positive and negative messages about HSV and to manage affective content. Some videos were successful despite not providing information about HSV. Mixed videos were appreciated differently in different contexts, and the use of humour was especially problematic. Neutral videos tended to exclusively provide information while avoiding affective content.
  
  
  CONCLUSIONS
  Efforts to reduce HSV-associated stigma may be unsuccessful and may even perpetuate stigma. Special attention must be paid to balance and to affective content, specifically humour, when attempting to convey a destigmatising message. Doing so may help reduce the role stigma plays as a barrier to appropriate care for patients with HSV infection.
authors.affiliation: Department of Pediatrics, Children's Hospital of New York at New York Presbyterian Hospital, New York, NY, USA. les9041@nyp.org
authors.forename: Lee S
authors.initials: LS
authors.lastname: Shearer
authors.forename: Lisa
authors.initials: L
authors.lastname: Simmons
authors.forename: Adrian
authors.initials: A
authors.lastname: Mindel
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Stanberry
authors.forename: Susan L
authors.initials: SL
authors.lastname: Rosenthal
mesh_terms: D000293:Adolescent; D000328:Adult; D001363:Awards and Prizes; D005260:Female; D006266:Health Education; D006293:Health Promotion / Q000379:methods; D006558:Herpes Genitalis / Q000517:prevention & control* / Q000523:psychology* / Q000635:transmission; D006560:Herpes Labialis / Q000517:prevention & control* / Q000523:psychology* / Q000635:transmission; D006801:Humans; D020407:Internet; D008297:Male; D009014:Morals; D012650:Self Disclosure; D057545:Social Stigma; D014741:Video Recording; D014925:Wit and Humor as Topic; D055815:Young Adult