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AIDS Behav. Author manuscript; available in PMC 2022 December 01.
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Published in final edited form as:

AIDS Behav. 2021 December ; 25(12): 4225–4234. doi:10.1007/s10461-021-03287-9.

Social Media & PrEP: A Systematic Review of Social Media

Campaigns to Increase PrEP Awareness & Uptake Among Young
Black and Latinx MSM and Women
Sakina Z. Kudrati1, Kamden Hayashi2, Tamara Taggart1,*,3
1Department of Prevention and Community Health, George Washington University, Washington,
DC, USA
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2Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT,
USA

Abstract
Pre-exposure prophylaxis (PrEP) has been shown to be highly effective at reducing the risk
of HIV. Despite efforts to employ various social marketing strategies to promote PrEP among
young people at greater risk for HIV, PrEP awareness and uptake remain low. We conducted a
comprehensive review of current literature that presents or evaluates the use of social media and/or
specific communication campaigns to increase PrEP awareness among young Black and Latinx
men who have sex with men (MSM) and women. Eight articles met the inclusion criteria for
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the final analysis. The most used platforms included Facebook, Instagram, and custom mobile
applications. Social media is a dynamic and promising tool that may be used to increase PrEP
awareness, uptake, and adherence among young Black and Latinx MSM and women.

Abstract
Se ha demostrado que el profilaxis preexposición (PrEP) es muy eficazo para reducir el riesgo
de contraer el VIH/SIDA. A pesar de los esfuerzos empleando diversas estrategias sociales
de marketing para promover el PrEP entre los jóvenes que tienen mayor riesgo de contraer
el VIH/SIDA, el conocimiento y la aceptación del PrEP siguen siendo bajas. Realizamos una
revisión exhaustiva de la literatura actual que presenta o evalúa el uso de las redes sociales e
campañas de comunicación específicamente para aumentar el conocimiento sobre el PrEP entre
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Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. [Link]
terms-v1
*
Corresponding Author: Tamara Taggart, PhD, MPH, Department of Prevention and Community Health, George Washington
University, Milken Institute School of Public Health, 950 New Hampshire Ave, NW, Suite 300, Washington, DC 20052,
ttaggart@[Link], 202-994-0276 (t).
Authors’ contributions: SK conducted data search, extraction, and analysis, wrote sections of the paper, and reviewed and approved
the final draft of the manuscript. KH supported data analysis, edited the manuscript, and reviewed and approved the final draft of the
manuscript. TT conceived and designed the study, conducted data collection and analysis, wrote sections of the paper, and reviewed
and approved the final draft of the manuscript.
Publisher's Disclaimer: This Author Accepted Manuscript is a PDF file of an unedited peer-reviewed manuscript that has been
accepted for publication but has not been copyedited or corrected. The official version of record that is published in the journal is kept
up to date and so may therefore differ from this version.
Conflicts of interest/Competing interests: None
 Kudrati et al. Page 2

los jóvenes hombres que tienen relaciones sexuales con hombres (HSH) y las mujeres de raza
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negra y latinx. Ocho artículos satisfacieron los criterios de inclusión para el análisis final. Las
plataformas más utilizadas incluyeron Facebook, Instagram y aplicaciones móviles personalizadas.
Las redes sociales demuestran ser un instrumento dinámico y prometedor que se puede utilizar
para aumentar el conocimiento, la aceptación y la adherencia del PrEP entre los HSH y las
mujeres jóvenes de raza negra y latinx.

Keywords
Social media; PrEP awareness; HIV prevention; Health communication

Introduction
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In the United States (U.S.), Black and Latinx individuals are disproportionately affected by
HIV. In 2018, Black Americans accounted for an estimated 42% of new HIV diagnoses,
while individuals of Latinx ethnicity accounted for 27% [1]. Age variations in surveillance
data indicates that young people are especially affected by HIV. Individuals between the
ages of 13–24 years accounted for 21% of all new diagnoses in 2018, with young Black
and Latinx men who have sex with men (MSM) reporting higher rates than their White
counterparts [2]. Similarly, Black and Latinx women account for 75% of all new HIV
diagnoses, with 41% of those occurring among girls and women between the ages of 13–34
years [3]. Pre-exposure prophylaxis (PrEP) is a proven effective biomedical HIV prevention
intervention that when taken consistently can decrease the risk of acquiring HIV from sex by
up to 99% [4]. Despite its promise, awareness and uptake of PrEP among young Black and
Latinx individuals remains low [5–7].
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To reduce HIV rates in the U.S., PrEP awareness and uptake must increase among those
who are most vulnerable to HIV, including young Black and Latinx MSM and women.
One strategy for increasing PrEP awareness is through the development and integration
of digital communication and/or health messages surrounding PrEP use, availability, and
access [8]. Social media, in particular, may help bridge gaps in message delivery and expand
coverage and dissemination of health information across various groups of people. This
method proves especially useful in reaching younger audiences, given that 95% of teenagers
report having access to a smartphone [9]. Moreover, compared to White youth, Instagram
and Twitter usage is higher among Latinx and Black youth, which underscores the potential
for PrEP promotion through social media to reach these groups [10].

For the purposes of this systematic review, social media is defined as any platform
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allowing for bi-directional or multi-directional exchange of information, such as Facebook,

Instagram, Twitter, and YouTube. These platforms offer unique opportunities to connect and
engage different types of audiences and help spread information through specific features
and functions integrated in the platform. Social media not only facilitates resource and
information sharing about PrEP, but it also has the power to shift stigma and social norms
surrounding HIV and PrEP use [11–13]. While various interventions have been employed to
increase PrEP awareness, the aim of this systematic review is to assess the characteristics

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of social media-based interventions that focus on increasing PrEP awareness, uptake, and/or
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adherence among Black and Latinx individuals under the age of 29 years who may be at risk
for HIV.

Methods
Search Strategy
This review paper used a systematic approach to gather relevant research articles pertaining
to the use of social media platforms or communication campaigns to increase PrEP
awareness. The search was conducted in consultation with a librarian and subject expert
(TT) on April 2, 2020. The following databases were used to conduct the search: PubMed,
Scopus, and Web of Science. The searches were performed and modified for each respective
database using the following search syntax: (“Pre-Exposure Prophylaxis” [mesh] OR “pre­
exposure prophylaxis” [tiab] OR “preexposure prophylaxis” [tiab] OR “Emtricitabine,
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Tenofovir Disoproxil Fumarate Drug Combination” [Mesh] OR Truvada OR (Emtricitabine

AND Tenofovir) OR Descovy OR (PrEP AND (HIV OR “human immunodeficiency
virus”))) AND (mass media OR communication OR social network OR social networking
OR social marketing OR social media OR Twitter OR Facebook OR Instagram OR YouTube
OR Snapchat OR blog OR mobile apps OR mobile application OR Web 2.0).

Selection Criteria
The articles selected for this review were screened for relevance, duplication, and the
selection criteria. Quantitative, qualitative, and mixed-methods study designs were included.
The inclusion criteria were: (1) study conducted in the U.S.; (2) study primarily focused on
the use of social media to communicate information about PrEP (social media is defined
as any platform allowing for bi-directional or multi-directional exchange of information,
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such as Facebook, Twitter, Instagram, YouTube, etc.); (3) target population includes Black
and Latinx MSM and women under the age of 29 years; and (4) published after 2012
when the Federal Drug Administration approved daily oral PrEP for HIV prevention [14].
The exclusion criteria were (1) study conducted outside the U.S.; (2) exclusively used
social media to advertise or market a specific PrEP product for commercial purposes; (3)
used social media for study recruitment only; (4) used social media to collect data and/or
information on PrEP users; (5) research protocols, commentaries, and grey literature; and (6)
study in a language other than English.

Covidence, a systematic review data management program, was used for deduplication
and to conduct title, abstract, and full-text review (see PRISMA diagram, Figure 1). The
primary reviewer (SK) screened all titles and abstracts (n= 1,045) based on the inclusion
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and exclusion criteria. Next, the primary and secondary reviewers (SK, TT) independently
evaluated all retrieved full-text articles (Kappa statistic = 0.90). Discrepancies during full­
text review were discussed with a third reviewer (KH) until consensus was reached.

Data Extraction and Study Quality

Data were extracted from eight full-text articles using a set of 20 defined fields
related to study sample characteristics, social media platform used, characteristics of

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the communication channels (e.g., bi-directional or multi-directional; group facilitators or

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moderators), the method used to communicate PrEP messages (i.e., video, infographic, flyer,
website, etc.), the use of health behavior or social marketing theories, message content, the
benefits and disadvantages of using the social media platform, and study outcomes.

We conducted a quality assessment using a checklist tool for systematic reviews [15–17].
The checklists contain a series of questions about the research methods, study design, and
analysis used to evaluate the quality and validity of each study. After reviewing the checklist
items for each study design, it was determined that a minimum of 70% of the checklist items
must be met for the study to be included in the review.

Results
In total, eight published articles met the inclusion criteria (Figure 1) [18–25]. All studies
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were conducted in the U.S. and were published after FDA approval of PrEP in 2012.
Half of the studies met 100% of the inclusion criteria, whereas the other half (n=4) met
at least 80% of the criteria. Qualitative, quantitative, and mixed-methods study designs
were employed across the 8 studies. A range of social media platforms were used to
communicate information on PrEP and PrEP services. Facebook, Instagram, and mobile
applications were the most commonly used platforms to promote PrEP awareness, uptake,
and/or adherence. These platforms were designed to provide information about PrEP, to help
users consider their PrEP eligibility, or to link them to providers (the full list of social media
platforms is provided in Table 1). The following sections provide a comprehensive review
of each study’s sample characteristics, social media characteristics, intervention design, and
outcomes.
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Study Sample Characteristics

Specific study sample characteristics such as age, gender, race/ethnicity, sexual orientation,
and geography were set as part of the inclusion criteria for this review. Five out of the
eight studies explicitly indicated a target population consisting of individuals or participants
between the ages of 18–29 years [19, 22–25]. The remaining studies were unable to
collect this information due to the nature and parameters of their study design. One study
exclusively included Black women in their study, while five studies included Black and/or
Latinx gay, bisexual, and other MSM [18–20, 22, 24, 25]. One study included transgender
women in their study sample [19]. Four studies were conducted in large metropolitan
cities including, New York, Chicago, Atlanta, Seattle, and San Francisco [19, 22, 24, 25].
Additional details on each study’s sample characteristics can be found in Table 2.
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Social Media Characteristics & Intervention Design

All articles included information pertaining to the social media platform used, the processes
and functionalities developed to increase PrEP awareness or uptake, and the methods and
theoretical frameworks used to design the study or intervention. The following sections will
highlight these characteristics based on the social media platforms reported. Table 2 provides
a summary of each study and key findings related to how various social media platforms and
technologies were used to increase PrEP awareness, uptake, or adherence.

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A. Mobile Apps—Three studies described the use of mobile applications to help improve
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PrEP awareness, uptake, and adherence [23–25]. Sharpe et al. (2018) conducted a qualitative
evaluation of existing Android apps found on the Google Play and Apple App stores to
assess the presence of different app features that could contribute to an increase in PrEP
uptake and adherence among individuals at risk for HIV [23]. The study found a total
of 11 apps, of which seven provided comprehensive information on PrEP, including what
PrEP is, when it should be taken, and who would benefit from using it [23]. The apps
also featured resources that provided location-based information on clinics and providers
offering PrEP services [23]. Other common tools and functions that were featured included
PrEP self-assessments, service locators, and adherence reminder systems [23]. Sullivan et al.
(2017) evaluated the usability of a comprehensive HIV prevention app for Black and Latinx
MSM comprised of tailored HIV-prevention related recommendations, quizzes to self-assess
PrEP eligibility, and links to other prevention services [24]. The app was designed using
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the Social Cognitive Theory and employed specific theoretical constructs such as goal
setting, self-efficacy, outcome expectations, and self-regulation [24]. The PrEP eligibility
assessment located in the app used an existing 7-item questionnaire developed by the CDC.
The researchers identified that 8 out of 86 (9%) PrEP eligible MSM in the study who were
not using PrEP began using it [24]. Of the eight who initiated PrEP, six reported that the app
influenced their decision to initiate [24]. Many of the reported reasons for PrEP initiation
involved the app’s ability to provide information on PrEP, recommend it based on behavioral
assessments, and allowed individuals to find a PrEP provider [24]. Based on analytic data,
40% viewed PrEP information in the app and a quarter used the PrEP eligibility screener
[24].

The final mobile application-based intervention was PrEPTECH, a telehealth initiation

program for PrEP [25]. The aim of the study was to link 25 young MSM of color to
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PrEP care by providing a free 3-month supply of PrEP via telehealth services. Participants
were referred to the study’s mobile-friendly website via the online dating app Grindr [25].
Features on the website were similar to the previous two studies, in that it included a service
locator, customizable daily PrEP reminders, and automated appointment reminders [25].
Although researchers determined that users were likely to be PrEP aware prior to using
the service, the intervention did serve to address barriers to access experienced by young
MSM of color by providing medication in an easy and confidential way [25]. Eleven out of
the 16 participants who continued PrEP as a result of enrolling in the study transitioned to
sustainable PrEP providers.

B. Facebook & Instagram—One study reported using Facebook to help propagate

information about PrEP, and two studies utilized both Facebook and Instagram [18, 19,
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22]. In the study that used Facebook only, researchers posted an article titled, “There is a
new pill to revolutionize Black women’s sexual health,” to a Facebook page of a website
that primarily focused on Black women’s health and lifestyle [18]. The article discussed
key information, such as the disparities that exist in new HIV diagnoses among women
in the U.S. and the potential benefits of PrEP for Black women. While the study’s aim
was to explore Black women’s perspectives on this issue by assessing feedback via the
comments section, it did so by presenting factual information regarding PrEP [18]. During

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their qualitative analysis, Hill et al. (2018) identified that favorable comments towards the
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article discussed raising more awareness about PrEP and supported the idea that PrEP
was an important HIV prevention option for Black women [18]. The article’s reach and
engagement on Facebook, as reported by the authors, included 678 likes, 451 shares, and
131 comments [18].

In the study that evaluated #PrEP4Love (P4L), a sex-positive HIV prevention campaign
based in Chicago, Dehlin et al. (2019) analyzed the web-based reach of the social marketing
campaign through views on two social media platforms, Facebook and Instagram [19].
The campaign’s social media ads directed visitors to the P4L website, which included a
PrEPLine staffed by University of Chicago employees who provided information about
PrEP (what it is and who it is for) and connected callers to PrEP services [19]. The
web-based ad campaign generated a total of 40,913,560 unique views across smart ads,
Facebook ads, and Instagram ads [19]. One of the three most clicked on smart ads was
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titled, “HIV Prevention Medication.” Data collected from PrEPLine enabled researchers
to track those who were referred for PrEP care through the P4L campaign. Eighty-three
individuals, many of whom identified as African American or Black, young, gay or same
gender loving men, called PrEPLine’s number [19]. Of these participants, 18% initiated
PrEP [19]. Approximately 53% of these individuals reported hearing about PrEP through
the P4L campaign [19]. Out of the 83 PrEPLine callers, 34% reported hearing about PrEP
through the P4L campaign [19].

Another intervention that leveraged the use of Facebook and Instagram to increase PrEP
awareness and uptake was “Empowering with PrEP”, or “E-PrEP” [22]. The peer-led social
media-based intervention used a community-based participatory research approach to design
a 6-week campaign to provide young Black and Latinx gay, bisexual, and other MSM,
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education and resources on PrEP [22]. Two theoretical models, the Diffusion of Innovations
and Information-Motivation-Behavioral skills model, were used to inform the development
of the intervention [22]. Peer leaders were trained and assigned to post specific PrEP related
content (text posts, pictures, infographics, and video clips) each week through a private
Facebook group or a private Instagram feed to facilitate conversations around PrEP with
recruited participants. Weekly topics included PrEP awareness, how to talk about sex and
PrEP, talking to partners and friends, overcoming barriers to PrEP, accessing PrEP, and
affording PrEP [22]. Patel et al. (2018) tested the feasibility of the intervention by using
a similarly designed control intervention (E-Health), which focused on a broad range of
health topics excluding HIV or PrEP [22]. Results and analyses of this intervention are still
ongoing [22].
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C. Twitter—McLaughlin et al. (2018) evaluated the use of Twitter to determine what

and how users were communicating about PrEP through their own informal networks
[21]. Researchers monitored “tweets” and “re-tweets” posted by individuals, non-profits,
academic organizations, news media, and commercial interests [21]. The results of the
content analysis determined that the most commonly tweeted category related to PrEP was
“recipients,” which pertained to who has received or should receive the drug. Researchers
also found that the majority of tweet creators (60.2%) were individuals who posted links
to referenced articles about Truvada from news or commercial websites [21]. The results

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indicated that the most common PrEP-related tweets covered information and issues related
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to Truvada, including the recipients of the drug, its efficacy, support available for people
using it, adherence and side effect issues, and cost and insurance coverage [21]. Tweets were
also more likely to be propagated if they contained an affective tone [21]. McLaughlin et al.
(2018) concluded that Twitter was a suitable channel for spreading health information and
knowledge about PrEP [21].

D. YouTube—One study explored the use of YouTube to share reliable information on

PrEP with different audiences through videos [20]. The authors conducted an analysis of
the sources, characteristics, and content of the most widely viewed PrEP videos [20]. A
total of 217 videos were included in their review, the majority of which originated in
the United States (78.8%) [20]. The content categories and the percentage of videos that
addressed each category were as follows: defines PrEP (82.9%), describes how PrEP works
(49.3%), describes who can use PrEP (60.8%), promotes PrEP as a safe option (23%),
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discusses side effects (32.3%), describes how to obtain PrEP (35.9%), discusses the cost of
PrEP (27.6%), and promotes use of PrEP (83.4%) [20]. Collectively, these videos generated
2,369,003 views. The single most widely viewed (1.2 million views) video was an animated
informational video published by the CDC [20]. Based on the results from the data analysis,
the number of views and comments on videos appealing to the general population of MSM
had a mean rank that was significantly higher than the videos appealing to the scientific
community (p =.04 and .01, respectively) [20]. This finding suggests that specific at-risk
groups are engaging with PrEP-related content online.

Discussion
Key Findings
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This systematic review highlights eight unique studies that demonstrate how social media
has been leveraged in recent years to communicate messages about PrEP with the intention
to increase knowledge, awareness, and uptake among Black and Latinx MSM and women.
The limited number of studies, as well as the mix of study designs and reported outcomes,
make it challenging to synthesize the evidence and to recommend a universal method to
further harness the use of social media for the purposes of delivering health information.
Nonetheless, this review underscores the range of social media platforms, tools, and
functions that may be used to engage young racial and sexual minority men and women
at elevated risk for HIV in PrEP.

The relatively small number of articles that met the inclusion criteria in this review indicates
that literature on this topic is limited. While these studies provided in-depth evidence on
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the various representations of PrEP online, they also acknowledged the need for additional
research and interventions. The general themes that were gathered from this systematic
review include: 1) social media and mobile technologies (applications) are a promising
approach for generating PrEP awareness among young racial and sexual minority men and
women who might otherwise be hard to reach, 2) social media platforms offer a number
of ways to communicate and share reliable PrEP information and services to specific

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audiences, and 3) PrEP awareness encompasses a range of sub-topics related to what PrEP
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is, who it is for, and provider and sexual partner communication about PrEP.

What makes the use of social media and mobile technologies such a promising approach
for generating more PrEP awareness is its reach, accessibility, affordability, and usability.
In fact, one of the benefits of Facebook is its ability to reach a significant portion
of the U.S. population, including 67% of internet-using Black/African American adults
[18]. Additionally, video-sharing sites such as YouTube allow billions of users to create,
share, and watch videos confidentially and at their own convenience. For many users,
particularly younger audiences and sexual and racial minorities, YouTube serves as a
platform where individuals can access PrEP information, generate content, share sources
within their network, and disseminate information to wider audiences [20]. The same is
true for Twitter, which has more than 241 million active users and facilitates the sharing
of health information and advice in small and actionable steps [21]. Platforms such as
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Instagram have proven to be extremely influential in facilitating information sharing within

and between networks of friends and peers at a rate that was previously not possible [22].
Additionally, features such as individual “stories” and posts within the platform allow users
to intuitively share and view content from credible public health sources. In terms of cost,
free mobile apps that include features to address PrEP awareness, uptake, and adherence
can help to increase utilization of health information and resources by reducing social
and financial barriers to access [11, 13, 23]. Designing health communication or social
marketing campaigns to introduce new technologies, such as a PrEP mobile app, could be a
viable intervention to promote the continuum of HIV prevention and care.

While many online platforms are able to provide a space and channel for communication,
it is also important to consider how and where users are engaged in health-related content
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online. Some of the studies in this review explicitly included young Black and Latinx men
and/or women in their study samples, however the limited number of studies reveals an
opportunity to conduct more research that focuses on these specific groups. Hill et al. (2018)
demonstrated the ability to directly share information on PrEP to a group of Black women
on Facebook by posting an article to a webpage on the platform that was specifically created
for this audience [18]. Although the purpose of this study was to measure Black women’s
perceptions of PrEP by presenting an article on the benefits of its use, it indirectly made
information accessible to a key population [18]. Given that PrEP awareness and uptake is
lower among women compared to men, finding innovative ways to amplify PrEP messaging
that is targeted towards girls and women on social media is critical [26, 27]. Black and
Latinx adolescent girls and women were overall underrepresented compared to young Black
and Latinx gay, bisexual, and other MSM in the articles included in this review. This
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exclusion is particularly concerning given HIV incidence among Black women in the U.S.
This finding also highlights an opportunity for future research studies and interventions
to find ways to identify, reach, and engage young Black and Latinx women, including
transgender women, in online spaces that specifically promote PrEP in a safe and inclusive
manner [27].

Additionally, while popular social media platforms such as Facebook, Instagram, and
Twitter offer various modes of sharing and communicating information, it is also important

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to note their limitations in preventing the spread of misinformation and facilitating the illicit
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sale of prescription PrEP medications [21]. These limitations must be considered for future
communications-related interventions, since regulating oversight of the spread of accurate
information and ethical practices online is a large undertaking. Furthermore, the quality of
PrEP information being shared online or through PrEP-related communication interventions
was not reported in any of the articles included in this review. Quality control of information
online may help circumvent PrEP stigma and promote visibility of health information shared
by reputable and trusted public health sources.

Lastly, the studies included in this review illustrate that PrEP awareness-related messaging
and communication online should consider addressing misperceptions and concerns
surrounding PrEP use. The success of the Chicago-based communications campaign,
#PrEP4Love, was largely due to its focus on spreading sex-positive messages that promoted
the benefits of PrEP use online and in public spaces. This approach also helped to address
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stigma and shame commonly associated with HIV and MSM [19]. Sex-positive framing is
an especially important consideration for future communication campaigns or interventions
developed to promote PrEP use to young Black and Latinx MSM and women [19].

Important next steps for using social media to increase PrEP awareness, uptake, and/or
adherence include identifying ways to reach and engage younger Black and Latinx MSM
and women online. Designing more robust communication campaigns that build trust,
promote sex-positive messaging, and represent the social and cultural interests of those
most vulnerable to HIV.

Limitations
This review has several limitations. The heterogeneity of the study designs, interventions,
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and outcomes in this review make it challenging to draw conclusions on effective methods
for leveraging social media to communicate information about PrEP. Additionally, this
review did not include analyses on the perceptions of PrEP among social media users
that could potentially influence the success of social media-based PrEP interventions. This
review also excluded studies that discussed the use of other digital communication methods
such as e-mail, text messaging, and websites. As previously described, the quality or source
of PrEP information being shared online was not a primary focus in this review, although
information quality control will be an important consideration for future studies.

Conclusion
Over the last two decades, social media has transformed the way many individuals share and
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consume health information. This review underlines the significant potential of social media
to help increase PrEP knowledge, awareness, and uptake among key groups of young people
that may be at risk for HIV. While a singular approach was not identified, the findings
demonstrate that various social media platforms can be leveraged to share and disseminate
information about PrEP in ways that are appropriate and engaging for specific audiences.
The findings from this review can be used to inform or develop additional research or
interventions that may help to address gaps in PrEP knowledge or awareness, specifically
among young Black and Latinx MSM and women living in the U.S.

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Acknowledgements:
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The authors wish to thank Kate Nyhan, MLS of the Yale University Harvey Cushing/John Hay Whitney Medical
Library and Laura Abate, MSLS of the George Washington University Himmelfarb Health Sciences Library for
their assistance with the design of the search criteria and screening process. This research was funded in part by
a pilot award from the District of Columbia Center for AIDS Research (DC CFAR), an NIH funded program
(P30AI117970), which is supported by the following NIH Co-Funding and Participating Institutes and Centers:
NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIMHD, NIDCR, NINR, FIC and OAR. The content
is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funding:
P30AI117970 (PI: Alan Greenberg)

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Figure 1.
PRISMA diagram describing screening and selection process.
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Table I.

Social media platforms used in selected studies (N=8).

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Social Media Platform Social Media Tool(s) Studies

PrEP self-assessments, service locators/maps,
Mobile Apps (n=3) Sharpe et al. (2018), Sullivan et al. (2017), Refugio et al. (2019)
adherence reminder systems
Facebook (n=3) Private group page, Facebook ads Hill et al. (2018), Dehlin et al. (2019), Patel et al. (2018)
Instagram (n=2) Instagram ads, Instagram posts Dehlin et al. (2018), Patel et al. (2018)
Twitter (n =1) Tweets McLaughlin et al. (2018)
YouTube (n=1) Videos Kecojevic et al. (2018)
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Table II.

Summary of study and sample characteristics for the selected studies (N=8).
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Author, year Sample Study Purpose Study Design and Social Outcomes Findings specific to PrEP
Characteristics Media Platform specific to
PrEP
Hill et al. Black/African Understanding Qualitative study of PrEP Participants’ comments
(2018) [18] American women Black women’s Facebook comments posted awareness: were related to the
perspectives on PrEP in response to an article Favorable following themes: Support
titled, “There is a new pill to and for PrEP awareness,
revolutionize Black women’s unfavorable PrEP safety concerns,
sexual health” comments Institutional mistrust,
toward PrEP Alternatives to PrEP
Dehlin et al. Black/African Evaluate PrEP4Love Analysis of the web-based PrEP Millions of unique views
(2019) [19] American men and (P4L) - a sex-positive reach of PrEP4Love (P4L) awareness were generated across
women (including communication through views on social and uptake various social media
transgender campaign for PrEP media platforms (Facebook platforms. Most clicked on
women) between awareness launched and Instagram), smart ads, ads were for information on
the ages of 18–34, in Chicago, IL ads shared on web-based ‘HIV & AIDS Prevention’
with the majority platforms, and P4L website and ‘HIV Prevention
between 20–29 clicks Medication’
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Kecojevic et Adolescents and Describe the sources, Content analysis of 217 PrEP Video content categories
al. (2018) adult men and characteristics, and videos on YouTube - videos awareness identified: defines PrEP,
[20] women content of the most were coded for source, describes how PrEP works,
widely viewed PrEP view count, length, number who can use PrEP,
related YouTube of comments, content, and promotes PrEP as a safe
videos target audience option, side effects, how to
obtain PrEP, cost of PrEP,
and promotes PrEP use
McLaughlin Individual Twitter Explore how Content analysis of 1,435 PrEP The majority of PrEP­
et al. (2018) users, news media, information about Tweets on Twitter that knowledge related Tweets covered
[21] non-profit and PrEP is represented mention daily oral PrEP and and information related to
academic groups, in online public the characteristics of the awareness Truvada, such as recipients
and commercial forums, specifically sources of those Tweets of the drug, its efficacy,
entities Twitter support available for
individuals using it,
adherence and side-effects,
cost, and insurance
coverage
Patel et al. Black and Latinx Develop and pilot Conducted a cluster PrEP Analysis of intervention
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(2018) [22] gay, bisexual, test a theoretically randomized trial to compare knowledge, is underway. Authors
and other MSM grounded social E-PrEP, the 6-week online adoption, hypothesize that compared
between the ages of media-based peer­ PrEP education campaign, and uptake with E-Health, participants
18–29 led intervention to to the control condition, E­ randomly assigned to E­
increase PrEP uptake Health, among YBLGBM to PrEP will be more likely
in young Black and assess E-PrEP’s feasibility, to express interest in
Latinx gay, bisexual, accessibility, and preliminary initiating PrEP use and will
and other MSM efficacy for increasing self­ show changes in mediators
(YBLGBM) reported intention to use associated with PrEP
PrEP, PrEP uptake, and uptake (e.g., knowledge,
impact on PrEP knowledge attitudes, etc.)
and attitudes at 12-week
follow-up
Sharpe et al. Youth at risk for Evaluate mobile apps Conducted a qualitative PrEP uptake Less than 2% (11/621)
(2018) [23] HIV; MSM that are designed evaluation on mobile apps and of the identified apps in
with features to that met the inclusion criteria adherence the study were relevant
facilitate PrEP uptake for the presence of features to improving PrEP uptake
and adherence that contribute to PrEP and adherence. Those that
uptake and adherence were identified contained
features that provided
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comprehensive information
on PrEP and resources to
locate providers and clinics
offering PrEP services
Sullivan et al. Non-white (48.8%, Evaluate the usability Recruited 121 HIV-negative PrEP uptake Nine percent (8/86) of PrEP
(2017) [24] 59/121) MSM and acceptability MSM to use comprehensive eligible MSM in the study
median age of 28 of a theory-based HIV prevention app for started PrEP during the 4­
Android mobile 4 months and complete a month period, of which 6

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Author, year Sample Study Purpose Study Design and Social Outcomes Findings specific to PrEP
Characteristics Media Platform specific to
PrEP
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phone app for HIV post-use survey. The study out of the 8 reported that
prevention measured the use of the app the app influenced their
and its features, ordering decision to initiate PrEP
commodities, self-report of
establishing an HIV testing
plan, getting tested for HIV,
and starting PrEP or using
nPEP
Refugio et al Young MSM of Assess the feasibility Longitudinal study that PrEP uptake Median time to PrEP
(2019) [25] color between the of a telehealth-based enrolled 25 HIV-negative initiation among study
ages of 18–25 initiation program MSM between November participants was 46 days.
(PrEPTECH) for 2016 and May 2017 Of the 21 participants who
PrEP among young to receive cost-free PrEP completed the study, 16
MSM of color services via PrEPTECH, a wanted to continue using
telehealth-based program. PrEP. Eleven of those 16
Online surveys assessing transitioned to sustainable
features and experiences PrEP providers
were distributed at 3 months
and 6 months
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