title: Explaining the Efficacy of Pre-exposure Prophylaxis (PrEP) for HIV Prevention: A Qualitative Study of Message Framing and Messaging Preferences Among US Men Who have Sex with Men.
abstract: We investigated message comprehension and message framing preferences for communicating about PrEP efficacy with US MSM. We conducted eight focus groups (n = 38) and n = 56 individual interviews with MSM in Providence, RI. Facilitators probed comprehension, credibility, and acceptability of efficacy messages, including percentages, non-numerical paraphrases, efficacy ranges versus point estimates, and success- versus failure-framed messages. Our findings indicated a range of comprehension and operational understandings of efficacy messages. Participants tended to prefer percentage-based and success-framed messages, although preferences varied for communicating about efficacy using a single percentage versus a range. Participants reported uncertainty about how to interpret numerical estimates, and many questioned whether trial results would predict personal effectiveness. These results suggest that providers and researchers implementing PrEP may face challenges in communicating with users about efficacy. Efforts to educate MSM about PrEP should incorporate percentage-based information, and message framing decisions may influence message credibility and overall PrEP acceptability.
authors.affiliation: Yale Center for Interdisciplinary Research on AIDS, Yale University, 135 College St, Suite 200, New Haven, CT, 06510, USA. kristen.underhill@yale.edu.|Yale Law School, Yale University, P.O. Box 208215, New Haven, CT, 06520, USA. kristen.underhill@yale.edu.
authors.forename: Kristen
authors.initials: K
authors.lastname: Underhill
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Morrow
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Colleran
authors.affiliation: Yale Center for Interdisciplinary Research on AIDS, Yale University, 135 College St, Suite 200, New Haven, CT, 06510, USA.|Yale School of Public Health, Yale University, New Haven, CT, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Calabrese
authors.affiliation: Program in Public Health, Brown University, Providence, RI, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Operario
authors.affiliation: Department of Psychology, Yale University, New Haven, CT, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Salovey
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D032882:Comprehension; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control*; D057220:Health Literacy; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D065129:Pre-Exposure Prophylaxis; D036301:Qualitative Research; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV prevention; Health communication; Men who have sex with men; Message framing; Pre-exposure prophylaxis