Exploring PrEP health promotion amongst London’s Black African community

Background: ‘Pre-Exposure Prophylaxis’ (PrEP) offers multiple advantages to users, with its individually-controlled uptake in singular daily pill form offering a surreptitious alternative to traditional HIV prevention measures, alongside
being highly effective in blocking virus transmission. However, its promotion has largely neglected the Black African community as an at-risk group, generating resistance to PrEP uptake which is attributable to poor messaging
in prior campaigns which negatively stigmatises them with HIV, causing subsequent dissociation from perceiving themselves as eligible PrEP candidates.

Two studies were performed to explore awareness (1) and promotion (2) of PrEP in this community.

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Study 1

Methods: The present study aimed to address this gap by asking how to raise awareness of PrEP within London’s BA community appropriately and effectively. To this end, a focus group was conducted featuring two members of the BA community, both working in the domain of sexual health. Seven questions focused on various aspects of raising PrEP awareness guided the discussion. Four main themes were identified: taboos and stigma; medical mistrust; local engagement; and the diversity of the BA community.

 

Results: The effects of stigma on healthcare workers’ ability to discuss PrEP were considered for the first time in a UK-based sample, as were the consequences of widespread medical mistrust. Key considerations pertaining to community engagement were contemplated, and participants discussed the importance of catering to numerous segments of the BA population. These results provide a first step towards increasing PrEP awareness within the BA community and ultimately remedying some of the HIV-related health inequalities experienced by this population.

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Study 2

Methods: The current study explored a literature-guided approach to designing an informational PrEP message series which manipulated content based on assigned psychosocial variables under the ‘Health Belief Model’.
Participants (N = 30) were from London’s Black African community, rating messages on 5 measures of effectiveness in ‘Qualtrics’, with the aim being to locate the best and worst performing for each.

 

Results and conclusions: Results implied bestperforming message content centred around PrEP uptake being empowering for users by giving them control in their sexual partnerships, particularly overcoming pressures of condom use and HIV transmission fears to unborn children. Poorly-performing messages touched upon affixed concepts like PrEP use being vital in areas of high geographical HIV risk, conspiracyrelated mistrust and side-effects from medicinal PrEP. Implications include offering major direction in tailoring future messaging, to resolve PrEP inequity amongst this underserved population.