Harnessing Social Media, Influencers, and Community Engagement to Confront HIV-Related Stigma in Peru: Longitudinal Descriptive Study of the DiME Campaign

Abstract Background HIV remains a public health challenge worldwide, and HIV-related stigma constitutes a major barrier to prevention, testing, and treatment efforts. Mitigating HIV-related stigma is crucial to improving outcomes for people living with HIV and reaching global HIV targets. Social media platforms and influencers are increasingly used for public health communication and may provide an opportunity to shape social norms and reduce HIV-related stigma among adolescents and young adults. Objective This study aimed to describe the experience of implementing a Spanish-language community-engaged social marketing campaign to address HIV-related stigma among adolescents and young adults in Peru and collaborating with influencers (social media personalities with large and engaged followings) to disseminate campaign content. Methods Based on formative community-engaged research with adolescents and young adults living with HIV, HIV advocates, and clinic providers, we developed social media content (Instagram [Meta Platforms, Inc.] and TikTok [ByteDance] platforms) that sought to address common myths and stereotypes regarding HIV, encouraged empathy for people living with HIV, and aimed to normalize conversations around testing, prevention, and treatment. Additionally, we hired 7 top Peruvian influencers (4 lifestyle influencers, 1 physician, 1 reality television star, and 1 newscaster) to create and post content from their accounts aligned with these themes. Seventy-eight Peruvian (unpaid) microinfluencers, defined as influencers with modest followings, were invited to disseminate content. All content was reviewed and approved by a community advisory board prior to posting. Results The campaign occurred over 5 months in 2024. We created and posted 48 videos to the campaign Instagram account and 49 videos to the campaign TikTok account, yielding 1,475,918 views, 1462 comments, and 63,488 likes. The campaign generated 2206 Instagram followers and 11,800 TikTok followers, 46% of whom were in Peru. The 5 top posts created by the content creation agency and study team received 742,314 views, 1108 comments, and 50,071 likes, while the 5 top influencer posts had a total of 2,484,934 views, 1079 comments, and 129,258 likes. Forty-seven percent (684/1462) of comments on agency and study team content were positive, compared with 65% (947/1462) of comments on influencer content. Thirty unpaid microinfluencers reposted content, as did 7 additional microinfluencers not involved in the campaign. We received 512 direct messages inquiring about HIV services, requesting HIV-related information, or sharing personal experiences related to HIV. Conclusions Social media is a useful tool for disseminating antistigma messaging. Collaboration with influencers to disseminate content was successfully implemented and expanded campaign reach.