Gain-Framed Health Messaging, Medical Trust, and Pre-Exposure Prophylaxis (PrEP) Self-Efficacy: An Experimental Study
Anthony J Gifford1, Rusi Jaspal2, Bethany A Jones1
1NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 4FQ, UK.
Healthcare (Basel, Switzerland)
|August 28, 2025
Summary
Gain-framed health narratives effectively reduced medical mistrust and improved pre-exposure prophylaxis (PrEP) self-efficacy in men who have sex with men (MSM). Identity resilience also played a key role in enhancing trust and confidence for PrEP uptake.
Area of Science:
- Psychology
- Public Health
- Behavioral Science
Background:
- Pre-exposure prophylaxis (PrEP) is effective for HIV prevention, but uptake is low among men who have sex with men (MSM) in the UK.
- Psychological barriers like medical mistrust and low self-efficacy hinder PrEP engagement.
- Effective interventions require psychologically informed strategies beyond biomedical availability.
Purpose of the Study:
- To test if narrative persuasion and message framing can reduce psychological barriers to PrEP uptake.
- To investigate the influence of gain-framed versus loss-framed narratives on medical mistrust and PrEP self-efficacy.
- To examine the role of identity resilience in mediating these psychological factors.
Main Methods:
- An online experiment with 246 men who have sex with men (MSM).
- Participants completed baseline identity resilience measures.
- Random assignment to gain-framed or loss-framed narrative conditions, followed by post-manipulation measures of medical mistrust and PrEP self-efficacy.
Main Results:
- Gain-framed narratives led to lower medical mistrust compared to loss-framed narratives.
- Medical mistrust was associated with lower PrEP self-efficacy.
- Higher identity resilience correlated with lower medical mistrust and higher PrEP self-efficacy.
Conclusions:
- Gain-framed health narratives causally reduce mistrust and indirectly enhance PrEP self-efficacy.
- Identity resilience is a crucial psychological factor for trust and behavioral confidence in PrEP use.
- Combining gain-framed narratives with identity resilience strategies can improve equitable PrEP uptake among MSM.
Keywords:
gain-framed messagingidentity resiliencemedical mistrustpre-exposure prophylaxis (PrEP)self-efficacyMore Related Videos
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