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

NCT06724445 | Completed

• 1 other identifier: AAAU5702
• Study Type: interventional
• Target: 1,496
• Locations: 1 country
• Sites: 1

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.

Conditions

HIV-related Stigma

Outcome Measures

Primary Outcomes (2)

• Attitudes towards HIV

  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.

  Up to 14 days

• Health Ethnicity Perceptions

  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.

  Up to 14 days

Secondary Outcomes (3)

• Behavioral intentions

  Up to 14 days

• HIV knowledge

  Up to 14 days

• Viewer Engagement with Cartoon

  14 days

Study Arms (2)

Thabo group

EXPERIMENTAL

Participants will view a cartoon video featuring a Black seropositive protagonist

Behavioral: Thabo cartoon

Steve group

ACTIVE COMPARATOR

Participants will view a cartoon video featuring a White seropositive protagonist

Behavioral: Steve cartoon

Interventions

Thabo cartoon BEHAVIORAL

The animated cartoon features Thabo, a Black South African man living with HIV. Through his narrative, viewers follow his daily experiences managing his condition and confronting societal stigma in a South African context. The story explores his interactions with family, friends, and community members, highlighting both challenges and moments of resilience. The animation concludes with Thabo delivering an anti-stigma message directly to viewers.

Thabo group

Steve cartoon BEHAVIORAL

The animated cartoon follows Steve, a White man living with HIV. His narrative parallels Thabo's, showing his daily experiences managing HIV and facing societal stigma. The story depicts his interactions with family, friends, and community members, presenting the same situations and challenges as in Thabo's story. The animation ends with Steve delivering the same anti-stigma message to viewers.

Steve group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

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

Sponsors & Collaborators

• Columbia University: lead

Study Sites (1)

Busara Center for Behavioral Economics

Multiple Locations, South Africa

Location

Study Officials

• Yanis Ben Amor, PhD

  Columbia University

  STUDY CHAIR

• Adam Sacarny, PhD

  Columbia University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Global Health and Microbiological Sciences; Executive Director, Center for Sustainable Development in the Climate School

Study Record Dates

• First Submitted: December 5, 2024
• First Posted: December 9, 2024
• Study Start: November 11, 2024
• Primary Completion: December 23, 2024
• Study Completion: December 23, 2024
• Last Updated: April 20, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

ZA (1)