Background:

Despite concerted efforts in engaging young people in HIV prevention services, uptake of HIV testing as well as HIV knowledge remains suboptimal among Nigerian Youth. HIV self-testing (HIVST) may hold promise as an innovative tool to assist in closing this testing gap. However, there is a paucity of data on how to frame health promotion messages to promote HIVST. To inform youth-focused interventions for promoting HIVST, we examined young people’s selection of gain- and loss-framed messages.

Methods:

We assessed creative ideas submitted by Nigerian youth (aged 14-24 years) in response to a World AIDS Day open contest, held on December 2018 and 2019, aimed at soliciting ideas on ways to promote HIVST among youth in Nigeria. A subset of the entries that specifically included narratives for framing HIVST messages were analyzed for this study. A thematic analysis of the contest entries was performed by a four-person multidisciplinary team to determine emergent themes related to gain-framed and loss-framed messages. We defined gain-framed as responses that described HIVST in terms of the benefits and loss-framed as responses that described the costs associated with failing to adopt HIVST.

Findings:

A total of 1,251 entries were received from the HIVST-themed open contest, of which, 50% (n=549) were females. Of these entries, 17% (n=211) creative ideas contained both gain- and loss-framed content. The gained-framed messages were centered around five themes: creating promotional messages that enhance youth confidence and autonomy, benefits of increased HIVST knowledge, messaging to overcome internal fears and concerns related to testing, and dismantling societal stigmatization of HIV. Whereas, the loss-framed messages were focused on three themes: highlighting challenges faced by individuals living with HIV, consequences of not testing for HIV and increased risk of acquiring new or transmitting HIV among young people.

Interpretation:

The findings extend our understanding on the role of message framing in promoting HIVST and can inform the development and structuring of health promotion messages for Nigerian youth. It also calls for further research to examine the extent to which these forms of messages impact uptake of HIVST and to better understand the processes that shape how people construe interpret messaging for HIVST.

Source of Funding:

This research study was funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant number: 1UG3HD096929-0

Dr. Iwelunmor gave Karan one of the biggest opportunities in college. As a mere freshmen eager to participate in research, Karan decided to take the chance and email her, explaining how he was very interested in her research and wanted to be a part of her team. She then decided to take a chance with him seeing his passion and allowed him to work with her team till my senior year. She was one of the first faculty at SLU to believe in him and his research capabilities. Karan will always be grateful for Dr. Iwelunmor as she gave him the chances to lead and create abstracts, present at different conferences, and strengthen his research and communication skills. It was through Dr. Iwelunmor's leadership and amazing team of researchers that Karan was able to take a lead role in this project and even present at the CUGH conference.