Beyond Numbers: Opportunities and Challenges Using Qualitative Methods in Social Media Studies of PrEP Discourse.

Abstract

Using pre-exposure prophylaxis (PrEP) discourse as a case study, we examine qualitative and multi-method approaches to analyzing health communication on social media platforms. These platforms have become crucial spaces for health promotion and community discourse, particularly on HIV prevention. Our review of 23 PrEP-focused studies that used social media data documents the different strengths of both methodologies. Qualitative analyses were strong at capturing how platform architecture shaped discourse quality: Reddit's forum structure enabled deeper narratives while X's (formerly Twitter) character constrained discussions. Algorithm-driven platforms' short-form video formats like TikTok emerged as unique media for health communication, enabling creative expression but limiting discourse depth. Multi-method studies dominated the literature (n = 15) yet struggled to meaningfully integrate quantitative metrics with qualitative insights. Frameworks are required that better combine computational approaches with qualitative analysis, while accounting for key challenges of social media data: the transient nature of data, context preservation, and post-authenticity validation.