In recent years, the battle against HIV has seen remarkable advances, notably through the use of pre-exposure prophylaxis (PrEP), a preventive medication capable of reducing HIV infection risk by over 99 percent when taken consistently. Despite the tremendous promise PrEP holds, particularly for adolescents and young adults—a demographic disproportionately affected by new HIV cases—its adoption within this group remains frustratingly low. Physician-scientists from Beth Israel Deaconess Medical Center (BIDMC) and Boston Children’s Hospital have uncovered novel insights into how targeted communication strategies using behavioral economics principles and social media platforms can bridge this critical gap in HIV prevention education.
The study, recently published in Patient Education and Counseling, sheds light on the preferences of young people aged 13 to 24 regarding educational content about PrEP delivered via social media. This age group, responsible for approximately 20% of new HIV infections in the U.S. in 2022, presents unique challenges and opportunities for public health outreach. The researchers hypothesized that conventional messaging—often fear-based or negative in tone—might be less effective among youth accustomed to rapidly digesting engaging, upbeat content on platforms such as TikTok, Instagram, and YouTube.
Utilizing the concepts rooted in behavioral economics, the investigators designed and tested two distinct styles of short, social-media-like videos. One employed a gain-framed approach, emphasizing the positive outcomes and benefits of taking PrEP, while the other employed a loss-framed strategy, warning about the risks associated with not utilizing the medication. Both versions targeted the adolescent and young adult psyche, focusing on authenticity and relatability to enhance viewer engagement.
Focus groups including thirty young participants, aged between 15 and 25 and recruited from diverse regions including Boston, Michigan, and Los Angeles, were exposed to both styles of videos. Remarkably, more than half of these participants (53%) expressed a clear preference for the gain-framed messaging, citing its positive tone and emphasis on PrEP’s high effectiveness as factors that made the information more appealing and memorable. The participants also highlighted the importance of clear, aesthetically engaging visuals that mirrored the short-form content consumption style they frequently encounter on social media.
Importantly, the participants reported that videos accompanied by an authentic voice—especially those perceived as trustworthy when shown in clinical settings such as doctors’ offices—would more likely prompt them to seek further information or consult healthcare professionals. This response underscores a vital intersection where digital outreach can dovetail with traditional healthcare encounters, creating a multipronged strategy to improve PrEP uptake among youth.
Dr. Douglas Krakower, associate professor in the Division of Infectious Diseases at BIDMC and senior author of the study, points to a critical bottleneck impeding PrEP adoption: knowledge gaps. Although PrEP has been approved for adolescent use since 2018 due to its proven efficacy, awareness and understanding of the medication’s benefits remain limited. Krakower emphasizes the necessity of tailored educational campaigns that resonate with the developmental stages and media consumption habits of adolescents and young adults to mitigate these knowledge deficits effectively.
One striking implication of this research is the pivotal role that social media platforms may play in modern health education. Unlike traditional public health messaging, which often relies on dense, formal materials or fear-driven narratives, social media content demands succinct, engaging, and approachable communication. The researchers propose that official healthcare entities and public health departments should leverage these platforms more aggressively, creating content that not only informs but also connects on a personal level with young people.
The study also highlights the potential for collaboration with social media influencers—individuals who command significant trust and attention from youth audiences. When influencers are engaged thoughtfully, they can assist in delivering accurate, medically sound information framed in a tone and style that feels genuine and non-threatening. This approach could counteract misinformation and build greater confidence among youth to explore HIV prevention options like PrEP.
While the findings are promising, the authors acknowledge limitations in the study’s demographic composition. The participants were predominantly white and cisgender, groups not representative of the highest-risk populations in the U.S., such as Black and Latino youth and transgender individuals who disproportionately bear the burden of new HIV infections. Therefore, future research must include more diverse participants to ensure that messaging strategies are effective across all subgroups most vulnerable to HIV.
The integration of behavioral economics into health communication exemplifies a sophisticated effort to understand and influence decision-making processes in adolescents and young adults. By dissecting how message framing—whether highlighting gains or losses—shapes perceptions and behavioral intentions, the study provides an empirical basis for crafting interventions that leverage psychological insights for public health benefit.
Ultimately, this research invites a paradigm shift in HIV prevention education. It challenges healthcare providers and public health professionals to meet youth precisely where they spend much of their time—online—and to engage with them in ways that reflect their values, communication preferences, and cultural context. Social media-driven campaigns promoting positive, gain-focused messages about PrEP, supported by medical authority and peer involvement, hold the promise of transforming adolescent and young adult engagement with HIV prevention.
The urgency of this work cannot be overstated. With thousands of new HIV cases annually among U.S. teenagers and young adults, optimizing the dissemination of life-saving information is crucial. The convergence of behavioral economics, digital media savvy, and clinical expertise represents a dynamic and innovative front in the ongoing endeavor to reduce HIV transmissions and empower young people to safeguard their health proactively.
This study’s insights extend beyond HIV prevention, offering a valuable blueprint for how public health communication might evolve in the digital era. By prioritizing authenticity, positivity, and developmental appropriateness—and by harnessing the power of social media influencers—the field can harness new modalities to reach vulnerable populations, increase health literacy, and improve health outcomes more broadly.
In conclusion, to halt the HIV epidemic among young people, health educators must embrace a nuanced understanding of how youth consume information today. Social media is not merely a distraction but an essential channel through which vital health messages can—and must—be delivered. This innovative approach, grounded in behavioral science, may well be the key to turning the tide in the fight against HIV.
Subject of Research: Behavioral economics application to HIV pre-exposure prophylaxis education for adolescents and young adults
Article Title: “To reach the new generation… TikTok:” Applying behavioral economics to adolescent and young adult HIV pre-exposure prophylaxis education
News Publication Date: 25-Jul-2025
Web References: https://www.sciencedirect.com/science/article/abs/pii/S0738399125006445; http://dx.doi.org/10.1016/j.pec.2025.109277
Keywords: HIV prevention, Behavioral economics
