Information on HIV and Narration of U=U: a mixed method analysis on social media in Italy

Abstract Background Media play a pivotal role in disseminating accurate information, particularly regarding U=U (Undetectable = Untransmittable), to increase awareness and reduce stigma. This study analyses HIV Italian communication on Facebook and Instagram, with a focus on U=U evidence. Methods A mixed-method analysis examined posts on HIV, with linked articles, from Italian news sources from 01/2009 to 04/2023. News sources were categorised as “reliable” or “unreliable” using independent third-party classification. Topic analysis identified the main topics in the posts, while an inductive content analysis was conducted on linked articles regarding U=U. The language and the accuracy in explaining U=U was evaluated through a checklist. Results A total of 10,539 Facebook and 749 Instagram posts were analysed, with 716(7%) and 18(2%) from unreliable sources respectively. Reliable and unreliable content surged around World AIDS Day(WAD) on both platforms. On Facebook, the frequency of unreliable content increased over time, whereas on Instagram it was rare and recent. On Facebook, topics varied between reliable and unreliable sources. The 3 most frequent topics from reliable sources were WAD, voluntary HIV spread, and public figures with HIV; those from unreliable sources were Death and Migrant People; Luc Montagnier and COVID-19 Conspiracies; Public Figures with HIV. On Instagram, the first 3 topics were the Italian National Institute of Health and Prevention, WAD, and public figures with HIV. A total of 68 articles nominating U=U were found and analysed, revealing 4 main areas: U=U definition, Prevention, Impact on people living with HIV, and Stigma. The accuracy in explaining U=U was generally low, with 6 articles(8.8%) providing only a definition. Conclusions HIV communication in Italy is limited and centered around WAD, with persisting bias. The dissemination of the U=U evidence is lacking. Urgent action is needed to shift the narrative and emphasize this evidence Key messages • HIV communication in Italy is limited and concentrated around World AIDS day. • The U=U evidence is poorly disseminated, often providing only a definition and medical explanation.