More blatant PrEP propaganda

Yes, this is real—a 13 year analysis of TWEETS

This will be a quick post. The following study by Shimrit Keddem et al (seven authors total) was published in May 2023 in J. Med. Internet Res.:

Characterizing Twitter Content About HIV Pre-exposure Prophylaxis (PrEP) for Women: Qualitative Content Analysis

This short piece is quite the whopper. We start with the following misleading quote:

HIV remains a persistent health problem in the United States, especially among women.

If you’re as old as I am or older, you might recall that this idea that “HIV” is on the verge of absolutely exploding among women has been being propped up for nearly the length of time that the story has been planted amid the public consciousness. Yet the prevalence of “HIV” positivity among women in the U.S. remains just about 20%, as it has for decades. Moving on. Here is their “objective”:

We aimed to identify historical trends in the use of Twitter hashtags specific to women and HIV PrEP and explore content about women and PrEP shared through Twitter.

So this is the state of “HIV” research, ladies and gentlemen. Developing drugs and treatment regimes in silico isn’t ridiculous enough; researchers are now presumably being given funding to peruse hashtags on X/Twitter. That’s how we know this is Very Serious. I’m not even sure what they intended to actually accomplish here with regard to public health. Let’s check out their methods and results.

This was a qualitative descriptive study using a purposive sample of tweets containing hashtags related to women and HIV PrEP from 2009 to 2022. Tweets were collected via Twitter's API. Each Twitter user profile, tweet, and related links were coded using content analysis, guided by the framework of the Health Belief Model (HBM) to generate results. We used a factor analysis to identify salient clusters of tweets.

So basically these researchers spent 13 years reading tweets. Then they did a factor analysis, which is a statistical method you might not have heard of, but basically it refers to the practice of condensing many variables into just a few; it is also sometimes called data reduction.

The results actually contain several items of interest. Let’s break it down.

A total of 1256 tweets from 396 unique users were relevant to our study focus of content about PrEP specifically for women (1256/2908, 43.2% of eligible tweets). We found that this sample of tweets was posted mostly by organizations. The 2 largest groups of individual users were activists and advocates (61/396, 15.4%) and personal users (54/396, 13.6%).

The numbers they give are presented in a very confusing way here. The 43.2% figure above refers to the percentage of the 2908 tweets that were aimed at women. However, the 15.4% and 13.6% figures below are referring to the percentage of the 396 users that were activists/advocates or personal users, so they have nothing to do with the 43.2%. Those percentages have nothing to do with one another. Regardless, it is interesting to me that of the users that were not organizations, more than half of them—61—were activists and advocates. I’m sure these activists posted very little if anything about the manifold toxicities involved in taking PrEP.

Among individual users, most were female (100/166, 60%) and American (256/396, 64.6%).

I’m including this only because it’s another example of statistics being presented in a very confusing manner. What is the 166 figure representing? I’m assuming it’s the number of the 396 users that are not organizations, but this information is not presented in a clear manner. We’re almost done now, and I find the following observation extremely intriguing. Boldface is added by me.

The earliest relevant tweet in our sample was posted in mid-2014 and the number of tweets significantly decreased after 2018.

What happened in 2018 that might have contributed to a significant decrease in pro-PrEP tweets? As readers of this substack surely know by now, 2018 was the year in which the first lawsuit was filed against Gilead Sciences for Truvada, which, along with Descovy, remains the most popular PrEP drug in the world. No wonder the number of tweets decreased.

Finally, we conclude with the same predictable targeting of communities of color for “retention in care” on a lifelong chemotherapy regime intended to be taken despite not having the condition targeted by the chemotherapy. Make it make sense. Also, if I were African American I would be getting very annoyed at being so blatantly targeted.

Most tweets specifically targeted people of color, including through the use of imagery and symbolism. In addition to inclusive imagery, our factor analysis indicated that more than a third of tweets were intended to share information and promote PrEP to people of color.

Well, that’s a depressing note to end on. What absolute nonsense. The propaganda really is coming from all sides and aimed at so many, and we have to ask—why? And when will it stop?