Social Media Messaging to Reduce HIV-Related Stigma Among Young Adults in Peru: A Randomized Controlled Study

Abstract

Introduction

HIV-related stigma undermines prevention and treatment efforts, particularly among young adults. Social media offers a scalable platform for stigma-reduction efforts; however, empirical evidence of its effectiveness remains limited. Social media influencers may enhance the effectiveness of stigma reduction messages delivered via social media.

Methods

From November 2024 to January 2025, we conducted a randomized controlled study in Lima, Peru, among young adults aged 18–29 years to evaluate the impact of brief exposure to tailored social media content designed to reduce HIV-related stigma. Content featured widely recognized Peruvian influencers or young adult residents filmed in recognizable places in Lima. Participants were randomized to a simulated social media feed containing one of four HIV stigma-reduction videos, including one featuring a top Peruvian influencer, or a control video. Stigma was evaluated using the Bogardus social distance scale, scored using standard and intensity-based methods.

Results

Five hundred and sixty-seven persons participated (53% male, median age: 21 years). Median social distance pre-randomization score was 1 in controls (fifth–95th percentile: 1–7), 1 in Arm 1 (fifth–95th: 1–7), 1 in Arm 2 (fifth–95th: 1–6), 1 in Arm 3 (fifth–95th: 1–5) and 1 in Arm 4 (fifth–95th: 1–7). Comparisons of pre- and post-changes by study arm supported modest intervention effects. Controls showed a median change of 0 (fifth–95th: –1–2). Arm 1, featuring influencer-generated content, showed a median change of 0 (fifth–95th: –6–0), with a Wilcoxon rank-sum test indicating a statistically significant difference from controls (p = 0.001). Arm 2 showed a median change of 0 (fifth–95th: –1–0, p = 0.08). Arm 3 showed a median change of 0 (fifth–95th: –2–0, p = 0.01). Arm 4 showed a median change of 0 (fifth–95th: –3–0, p = 0.01).

Conclusions

Brief exposure to culturally tailored social media content led to modest reductions in HIV-related stigma among young adults in Peru immediately after viewing. Findings reinforce the potential role of social media and influencers in HIV stigma reduction efforts. Future research should examine whether social media interventions can reduce stigma among those with the most stigmatizing beliefs and identify dosing and delivery strategies that achieve durable reductions in stigma.