Empathy in Frames: Animated Cartoons To Reduce HIV Stigma Among South African Young Adults

Not Applicable

Completed

• Conditions: HIV-related Stigma

• Registration Number: NCT06724445
• Lead Sponsor: Columbia University

Brief Summary

This study looks at whether using cartoons that reflect the culture of South Africa can help change how young adults there think about HIV/AIDS. This study will test two types of cartoons in a two-arm (treatment, comparator) randomized controlled trial design-one with Black characters and one with White characters-to see how they affect people's attitudes and knowledge about HIV/AIDS. Randomly allocated participants will be Black seronegative South African adults between 18 and 35 years old. This group was chosen because they're a demographic disproportionately affected by HIV, they're at a high point in their lives for shaping and sharing beliefs, and they're also highly active online, which is where this study takes place.

The cartoons will show the daily struggles of the protagonist living with HIV/AIDS, and end with a call to action. The study aims to highlight how the characters' ethnicity influences how viewers feel about and remember the message. The investigators want to understand if seeing characters who look like them helps people understand and empathize more. The aim of this study is to learn how cultural representation can improve health communication and guide future efforts to reduce stigma in different communities. Ultimately, the investigators hope this study will contribute to better public health messages and create a more accepting environment for people with HIV/AIDS.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-11-11
• Study First Submitted: 2024-12-05
• Study First Submitted QC: 2024-12-05
• Study First Posted: 2024-12-09
• Primary Completion: 2024-12-23
• Study Completion: 2024-12-23
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-16
• Last Update Posted: 2025-04-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1496

Inclusion Criteria

• Must self-identify as Black South African
• Must be HIV seronegative
• Age range: 18-35 years
• Must currently reside in South Africa
• Must have basic English language comprehension
• Must have internet access to view video content

Exclusion Criteria

• Prior participation in HIV stigma reduction interventions
• HIV seropositive status
• Non-Black South African identity
• Outside target age range (18-35)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Attitudes towards HIV	Up to 14 days	HIV-related attitudes are measured using Beaulieu et al's SAT-PLWHA-S survey instrument, designed specifically to measure stigmatizing attitudes towards HIV/AIDS. The objective of this questionnaire is to measure participants' own HIV-related behaviors. This measurement uses a 5-point Likert-type scale (from 1 =strongly disagree to 5 = strongly agree) to understand how participants behave when confronted with HIV-related information. Respondents will be asked to answer items such as "Stories featuring diverse ethnic backgrounds make me feel more connected to the content" or "Ethnic diversity in health messages affects my trust in their accuracy".; A higher score indicates more positive attitudes and comfort levels regarding HIV and people living with HIV.
Health Ethnicity Perceptions	Up to 14 days	A composite index measuring participants' perceptions of the relevance, relatability, and trustworthiness of health messages based on the ethnicity of the message source. Items assess how protagonist ethnicity influenced viewers' ability to engage with the content, trust the information, and find the message relatable.; 3-item Likert scale index (1-5), with higher scores indicating more positive perceptions of ethnic concordance in health messaging.

Secondary Outcome Measures

Name	Time	Method
HIV knowledge	Up to 14 days	HIV knowledge is assessed using a shortened version of Carey and Colls' HIV Knowledge Questionnaire (HIV-KQ-18). Respondents will be required to rate their understanding of the infection, transmission, and treatment of HIV on a binary scale (1 = true, 2 = false). Typical questions range from "Can HIV be transmitted by sharing food with someone who is HIV positive?" to "A person with HIV can have an undetectable viral load with proper treatment".; A higher score indicates greater certainty of HIV knowledge.
Behavioral intentions	Up to 14 days	Behavioral Intentions will be measured using a shortened version of the Theory of Planned Behavior (TPB) Questionnaire used to assess attitudes toward the behavior, subjective norms, and perceived behavioral control. Focusing on attitudes, subjective norms, perceived behavioral control, and intention towards a specific behavior (e.g., engaging in HIV prevention practices) can yield a concise measure. This measure uses a 5 point Likert-type scale (from 1 = strongly disagree to 5 = strongly agree).; A higher score indicates greater readiness and confidence to engage in HIV stigma reduction activities.
Viewer Engagement with Cartoon	14 days	Quality of engagement will be measured using a shortened version of the User Engagement Scale (UES) adapted for health-related animated cartoons. This scale is designed to provide insights into how these interventions capture and hold the audience's attention, and potentially influence their health knowledge and behaviors. This measurement uses a 5-point Likert-type scale (from 1 = strongly disagree to 5 = strongly agree) to measure focused attention, perceived usability, aesthetic appeal, reward, and endurability.; A higher score indicates greater perceived effectiveness and engagement with cartoon-based HIV health messaging.

Trial Locations

Locations (1)

Busara Center for Behavioral Economics; 🇿🇦 Multiple Locations, South Africa