YouTube PrEP Videos Are Beneficial for At-Risk Populations

Aleksandar Kecojevic, DrPH, MPH

YouTube videos can be considered a reliable way to share information regarding pre-exposure prophylaxis (PrEP) for HIV, according to a new evaluation of content on the video-sharing website.

Led by Aleksandar Kecojevic, DrPH, MPH, an assistant professor of public health at William Paterson University, the study investigators used 2 search terms to explore the contents available on YouTube: “pre-exposure prophylaxis,” the name of the medication, and “Truvada,” a common Gilead Sciences’ PrEP product consisting of combination 200-mg emtricitabine and 300-mg tenofovir disoproxil fumarate. Search results were filtered to include videos that were viewed at least 100 times or more, with duplicate videos and those without audio excluded.

"Given the popularity of YouTube, it has the potential to be a widespread patient resource," Kecojevic told MD Magazine. "The public health concern is that many of the videos are created by consumers and are based on personal experiences, or even worse on anecdotal evidence rather than on facts. Therefore, a long-term goal for physicians and public health educators would be to play a part in creating resources on this medium."

The final tally consisted of 217 unique videos compiled by 1 or both keywords. The investigators utilized 7 categories to organize the videos and determine their value: Defining PrEP, explaining how PrEP works, describing who can use PrEP, mentioning PrEP as a safe treatment, describing PrEP adverse effects (AEs), describing how to obtain PrEP, and mentioning PrEP costs.

More than 80% of the videos defined and promoted the use of PrEP, and more than 60% described the population that can utilize PrEP. However, by comparison, less than one-third of the videos addressed the cost or AEs of PrEP.

In total, 35.9% (n = 78) of the videos considered how to obtain the treatment, and 27.6% (n = 60) discussed the costs of PrEP. Notably, while media outlets consisted less than 20% of the sample used, these videos were more than 2 times as likely to discuss the cost of PrEP as determined by chi-square analyses (P <.001).

The majority of the videos in the sample were directed toward a target audience of gay and bisexual men (n = 83; 38.2%), while racial minority gay and bisexual men were the audiences of 14.3% (n = 31) of the videos. Only 5 videos mentioned the transgender population specifically, but a number included that population as beneficiaries of the therapy. A scientific audience was targeted in 17 (7.8%) videos.

"Resources like YouTube videos can be helpful to many populations on varied topic areas, including HIV/AIDS," Kecojevic said. "However, the extent to which they inform decisions is unknown as is the extent to which consumer based advice results in inaction or negative behaviors. We need more research to examine this aspect of YouTube videos - whether getting the information on YouTube changes health behavior."

The authors noted that the findings of the study “highlight that the personal experiences one might have in taking [PrEP] are covered in YouTube videos. Studies have found that such anecdotal information presented in video format may have an expansive impact on individuals’ health care decisions, extending its benefits from being a diagnostic aid or an educational tool for health care conditions to [be] a source for information sharing among patients coping with various health issues. Hence, it is important for the medical professionals to integrate consumers’ narratives into their messages.”

Collectively, the videos collected were viewed a total of 2,369,003 times—however, a single video from the Centers for Disease Control and Prevention (CDC) accounted for approximately 1.2 million of those views, with the second-most viewed video, from the online media source VICE, tallying slightly more than 193,000 views.

As for sources of the videos, institutions accounted for 30.4% (n = 66) of the videos and consumers accounted for 29.0% (n = 63), followed by Community Based Organizations (CBOs) with 22.1% (n = 48) and media with 18.4% (n = 40). No significant differences in length were observed, but the Kruskal-Wallis test revealed differences in both views (P = .003) and comments (P <.001).

The authors concluded that “public health professionals should be aware of the extent to which PrEP-related content appears on social media and, more importantly, be attuned to the content, which can be inaccurate or misleading. Future research is needed to identify aspects of YouTube videos that attract viewer attention and best practices for using this medium for increasing public awareness and understanding of PrEP.”

The study, “Pre-Exposure Prophylaxis YouTube Videos: Content Evaluation,” was published in JMIR Public Health and Surveillance.

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