Adolescents and young adults say they want to learn about HIV prevention the same way they learn about new tunes, life hacks, and the latest slang—on social media, according to a new study led by physician-scientists at Beth Israel Deaconess Medical Center (BIDMC) and Boston Children’s Hospital.

Participants in the study published in Patient and Education Counseling responded best to short informational videos that were positive and pro-active, rather than negative or fear-based, the investigators found.

The scientists used behavioral economics principles to test how message framing affects how young people respond to information about HIV pre-exposure prophylaxis (PrEP), a daily pill or long-acting injection that can reduce the risk of contracting HIV by up to 99%. More than 6,400 U.S. teens and young adults age 13–24 contracted HIV in 2022, accounting for about 1 in 5 of all new infections.

“PrEP is a highly effective intervention for the prevention of HIV and has been approved for adolescents and young adults since 2018, but, unfortunately, use among those aged 13–24 continues to be the lowest, despite the need,” said senior author Douglas Krakower, MD, an associate professor in the Division of Infectious Diseases at BIDMC.

“One barrier to use in this age group is their limited knowledge of PrEP. To end the HIV epidemic, we need educational strategies specifically tailored to their developmental stage.”

To explore how best to bridge that knowledge gap, Krakower and colleagues—including corresponding author Carly E. Guss, MD, MPH, an attending physician in the Division of Adolescent/Young Adult Medicine at Boston Children’s Hospital—created two short social-media-style videos: one with gain-framed messaging, which focused on the benefits of taking PrEP, and one with loss-framed messaging, which emphasized the risks of not using it.

Thirty young people, ages 15–25, recruited from centers in Boston, Michigan and Los Angeles, watched both videos and shared their thoughts in video meeting-based focus groups. Most had limited experience with PrEP; only a third had ever been tested for HIV, and more than a third felt they personally didn’t need it.

More than half (53%) preferred the gain-framed version of the videos. They said the positive tone, emphasis on PrEP’s high efficacy, and clear, memorable visuals made the message more appealing.

Participants favored videos that felt authentic and relatable and said they would trust the content more if shown in a doctor’s office. Many said the videos would prompt them to seek more information online or from a health care provider.

The findings suggest that public health campaigns aiming to reach youth should combine social media distribution with in-clinic viewing, use positive framing, and involve young people in content development. The study’s authors say the findings can guide public health professionals looking to reach young audiences with HIV prevention messages.

Their recommendations: use social media platforms like TikTok and Instagram, favor positive messages over fear-based ones, keep the tone authentic, and involve young people in the content development process.

“We found that teens and young adults want to use social media to educate themselves about sexual health, but most videos on TikTok are created by users themselves, not educational entities or health care providers,” said Krakower, also a research scientist at The Fenway Institute and an associate professor in medicine and population medicine at Harvard Medical School.

“To ensure that accurate health care information is reaching adolescents and young adults, departments of public health and health care centers should expand educational outreach to include TikTok campaigns posted on official accounts and also shown in waiting rooms, or working with social media influencers to create videos that are authentic, trustworthy, and relevant to this population.”

As the participants were predominately white and cis gendered, the researchers note that future studies should include more diverse populations, particularly groups most at risk for HIV. Still, the message is clear: to reach young people with life-saving HIV prevention tools, meet them where they are—online.