Change targets, messaging, and content delivery for a community-engaged social media campaign addressing HIV-related stigma in Peru: a qualitative study

Mitigating stigma related to human immunodeficiency virus (HIV) is critical to improving HIV outcomes and achieving global HIV targets. We conducted formative community-engaged research to identify key characteristics of a social media campaign to address HIV-related stigma among youth in Lima, Peru. Focus groups and in-depth interviews with young people living with HIV (men who have sex with men, transgender women, sex workers, persons with perinatally-acquired HIV, cisgender women, and Venezuelan migrants), HIV advocates, and healthcare providers were conducted from November 2022 to July 2023. Audio recordings were transcribed verbatim and analyzed for emergent themes using framework analysis. Two change targets were identified for campaign messaging: (1) changing how HIV and people living with HIV (PLWH) are perceived and (2) changing attitudes and actions towards PLWH. Messages aligning with the first change target included education to raise awareness that HIV does not discriminate; HIV is a chronic, treatable condition; and "undetectable equals untransmittable" (U = U). Messages aligning with the second target included normalizing open conversations about HIV, encouraging support versus pity for PLWH, fostering unity among HIV-affected communities, and promoting inclusion of PLWH. Participants provided recommendations to achieve these messaging objectives, including how, to whom, and by whom messages are delivered.