Date of Award

Spring 5-11-2018

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Health

First Advisor

Laura Salazar

Second Advisor

Richard Rothenberg

Third Advisor

Richard Crosby

Abstract

Background: HIV continues to disproportionately affect young Black men (YBM) and efforts are needed to increase HIV testing in this population. The primary purpose of this dissertation was to develop and evaluate a theory driven social media marketing (SMM) campaign (based upon social learning theory) to increase HIV testing among young Black men attending a public university in Atlanta, GA.

Methods: Three focus groups with YBM were conducted to develop a social media marketing campaign. The three month social media marketing campaign included targeted Facebook and Instagram advertisements as well as print advertising, campaign related events, a campaign website, and blog. Two hundred four students (n=106 for the baseline survey and n=98 for the post campaign survey) completed an online survey assessing sexual behaviors, attitudes toward HIV testing, stigma, testing barriers, exposure to HIV testing campaigns, social learning processes, and Integrated Behavior Model (IBM) constructs. Baseline data analyses involved a confirmatory factor analysis treating social learning as a latent variable and regressing IBM constructs on social learning. Evaluation of the campaign involved comparing pre and post differences in HIV testing frequency and mean scores for covariates as well as the association of the pre/post-grouping variable with HIV testing in a multivariable logistic regression model. A mediation analysis was conducted to assess a potential causal pathway through which the intervention affected HIV testing in bivariate models and in path analyses.

Results: The latent variable of social learning was indirectly associated with HIV testing intentions through experiential attitudes (β=0.135, p=0.014) and directly associated with experiential attitudes (β=-0.248, p=0.010). There was a significant difference in HIV testing frequency pre and post campaign (62.2% vs. 39.6%; p=0.001) in unadjusted analyses. Differential association (the people who share normative patterns of behavior with YBM) was the only mediator to have a direct association with HIV testing (AOR= 1.418, p= 0.035) in the adjusted model.

Conclusions: HIV testing was higher post campaign launch. Differential association for HIV testing may be the key to increase testing uptake among young Black men. Social learning may be extended to HIV testing behavior and may influence experiential attitudes toward HIV testing.


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