{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:59:29Z","timestamp":1790791169178,"version":"4.1.0"},"reference-count":56,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Social media is a useful tool for disseminating antistigma messaging. Collaboration with influencers to disseminate content was successfully implemented and expanded campaign reach.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93260","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:42:50Z","timestamp":1790790170000},"page":"e93260-e93260","source":"Crossref","is-referenced-by-count":0,"title":["Harnessing Social Media, Influencers, and Community Engagement to Confront HIV-Related Stigma in Peru: Longitudinal Descriptive Study of the DiME Campaign"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6489-5936","authenticated-orcid":false,"given":"Alyson","family":"Nunez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3373-8899","authenticated-orcid":false,"given":"Milagros","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2794-5527","authenticated-orcid":false,"given":"Marguerite","family":"Curtis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9405-0750","authenticated-orcid":false,"given":"Jhoselyn","family":"Acosta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8123-5853","authenticated-orcid":false,"given":"Josue","family":"Valera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5481-2277","authenticated-orcid":false,"given":"David","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8185-7680","authenticated-orcid":false,"given":"Yihan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6122-0967","authenticated-orcid":false,"given":"Ella","family":"Chun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9478-3506","authenticated-orcid":false,"given":"Kristin A","family":"Kosyluk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8732-6959","authenticated-orcid":false,"given":"Jerome T","family":"Galea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4890-5728","authenticated-orcid":false,"given":"Molly F","family":"Franke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0656-0036","authenticated-orcid":false,"given":"Renato A","family":"Errea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"R1","unstructured":"UNAIDS, \u201cAidsinfo: global data on HIV epidemiology and response. URL: https:\/\/aidsinfo.unaids.org\/ [Accessed 02-08-2026]"},{"key":"R2","unstructured":"Global Network of People Living with HIV (GNP+), \u201cPeople Living with HIV Stigma Index 2.0. Global report 2023. Hear Us Out: Community Measuring HIV-Related Stigma and Discrimination; 2023."},{"issue":"6","key":"R3","doi-asserted-by":"publisher","first-page":"863","DOI":"10.2105\/AJPH.2017.303744","article-title":"Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes","volume":"107","author":"Turan","journal-title":"Am J Public Health"},{"key":"R4","unstructured":"Stigma and HIV. US Centers for Disease Control and prevention. URL: https:\/\/www.cdc.gov\/hiv\/health-equity\/index.html [Accessed 03-08-2026]"},{"key":"R5","unstructured":"HIV and stigma and discrimination. UNAIDS; URL: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/07-hiv-human-rights-factsheet-stigma-discrmination_en.pdf [Accessed 07-09-2026]"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-026-05191-6","article-title":"A qualitative descriptive study of the drivers, perpetuators, and impacts of stigma among youth living with HIV in Lima, Peru","author":"Curtis","journal-title":"AIDS Behav"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s10461-024-04489-7","article-title":"Drivers and facilitators of HIV-related stigma in healthcare settings in Ireland","volume":"29","author":"Vaughan","journal-title":"AIDS Behav"},{"issue":"7","key":"R8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011453","article-title":"Examining the associations between HIV-related stigma and health outcomes in people living with HIV\/AIDS: a series of meta-analyses","volume":"6","author":"Rueda","journal-title":"BMJ Open"},{"issue":"3S2","key":"R9","doi-asserted-by":"publisher","first-page":"3S2","DOI":"10.7448\/IAS.16.3.18640","article-title":"Impact of HIV\u2010related stigma on treatment adherence: systematic review and meta\u2010synthesis","volume":"16","author":"Katz","journal-title":"J Int AIDS Soc"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1089\/apc.2023.0178","article-title":"A systematic review of the impact of HIV-related stigma and serostatus disclosure on retention in care and antiretroviral therapy adherence among women with HIV in the United States\/Canada","volume":"38","author":"Nawfal","journal-title":"AIDS Patient Care STDS"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1356430","article-title":"HIV-related stigma and associated factors: a systematic review and meta-analysis","volume":"12","author":"Dessie","journal-title":"Front Public Health"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.52152\/RCR.V11.5","article-title":"Norms-shifting on social media: a review of strategies to shift health-related norms among adolescents and young adults on social media","volume":"11","author":"Lutkenhaus R.","journal-title":"Rev Commun Res"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/70379","article-title":"Exploring online health information-seeking behavior among young adults: scoping review","volume":"27","author":"Stifjell","journal-title":"J Med Internet Res"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.33737","article-title":"Social media role and its impact on public health: a narrative review","volume":"15","author":"Kanchan","journal-title":"Cureus"},{"key":"R15","unstructured":"Social media users in Peru. NapoleonCat. URL: https:\/\/napoleoncat.com\/stats\/social-media-users-in-peru\/2023\/ [Accessed 26-10-2025]"},{"key":"R16","unstructured":"Social media usage in Peru - statistics & facts. Statista. URL: https:\/\/www.statista.com\/topics\/7219\/social-media-usage-in-peru\/#topicOverview [Accessed 26-10-2025]"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/46345","article-title":"A model of social media effects in public health communication campaigns: systematic review","volume":"25","author":"Kite","journal-title":"J Med Internet Res"},{"issue":"4","key":"R18","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1111\/phn.13554","article-title":"I found it on Instagram: exploring the impact of social media on public health communication","volume":"42","author":"Carton-Erlandsson","journal-title":"Public Health Nurs"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1177\/2055207618821521","article-title":"Tailoring in the digital era: stimulating dialogues on health topics in collaboration with social media influencers","volume":"5","author":"Lutkenhaus","journal-title":"Digit Health"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2022.101306","article-title":"Parasocial relationships, social media, & well-being","volume":"45","author":"Hoffner","journal-title":"Curr Opin Psychol"},{"issue":"7","key":"R21","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1080\/10410236.2024.2397268","article-title":"Health-related communication of social media influencers: a scoping review","volume":"40","author":"Ka\u0148kov\u00e1","journal-title":"Health Commun"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1177\/15248399241258442","article-title":"The emerging landscape of social media influencers in public health collaborations: a scoping review","volume":"26","author":"Michel","journal-title":"Health Promot Pract"},{"issue":"9","key":"R23","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1038\/s41591-021-01487-3","article-title":"Effects of a large-scale social media advertising campaign on holiday travel and COVID-19 infections: a cluster randomized controlled trial","volume":"27","author":"Breza","journal-title":"Nat Med"},{"issue":"3","key":"R24","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/OLQ.0000000000000100","article-title":"An assessment of the GYT: Get Yourself Tested campaign: an integrated approach to sexually transmitted disease prevention communication","volume":"41","author":"Friedman","journal-title":"Sex Transm Dis"},{"issue":"11","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4387","article-title":"Social media and HIV: a systematic review of uses of social media in HIV communication","volume":"17","author":"Taggart","journal-title":"J Med Internet Res"},{"issue":"13","key":"R26","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1097\/QAD.0000000000003628","article-title":"Systematic review and quantitative and qualitative comparative analysis of interventions to address HIV-related stigma and discrimination","volume":"37","author":"Ferguson","journal-title":"AIDS"},{"issue":"12","key":"R27","doi-asserted-by":"publisher","first-page":"3337","DOI":"10.1007\/s10461-020-02906-1","article-title":"\u201cIt\u2019s Like Plan B but for HIV!\u201d Design and evaluation of a media campaign to drive demand for PEP","volume":"24","author":"Fagan","journal-title":"AIDS Behav"},{"issue":"7","key":"R28","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1177\/00178969231197623","article-title":"A multi-site intervention using influencers to communicate about syringe service programmes","volume":"82","author":"Bonnevie","journal-title":"Health Educ J"},{"issue":"8","key":"R29","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11081346","article-title":"Assessing Brigada Digital de Salud audience reach and engagement: a digital community health worker model to address COVID-19 misinformation in Spanish on social media","volume":"11","author":"Andrade","journal-title":"Vaccines (Basel)"},{"key":"R30","unstructured":"Peru. UNAIDS. URL: https:\/\/www.unaids.org\/en\/regionscountries\/countries\/peru [Accessed 23-10-2024]"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/739624","article-title":"Genital tract infections, bacterial vaginosis, HIV, and reproductive health issues among Lima-based clandestine female sex workers","volume":"2012","author":"Perla","journal-title":"Infect Dis Obstet Gynecol"},{"key":"R32","unstructured":"Epidemiological situation of HIV-AIDS in Peru [Report in spanish]. Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades; 2025. URL: https:\/\/epipublic.dge.gob.pe\/uploads\/vih-sida\/vih-sida_202512_31_161049.pdf [Accessed 23-09-2026]"},{"issue":"10","key":"R33","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1080\/09540121.2025.2542312","article-title":"Change targets, messaging, and content delivery for a community-engaged social media campaign addressing HIV-related stigma in Peru: a qualitative study","volume":"37","author":"Nunez","journal-title":"AIDS Care"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1271-3","article-title":"The health stigma and discrimination framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas","volume":"17","author":"Stangl","journal-title":"BMC Med"},{"key":"R35","doi-asserted-by":"crossref","unstructured":"Curtis M Nunez A Wong M et al. Drivers, facilitators, and impacts of stigma among youth living with HIV in lima, peru. medRxiv. Preprint posted online on Jul 17, 2025. [doi: 10.1101\/2025.07.10.25331213] [Medline: 40672489]","DOI":"10.1101\/2025.07.10.25331213"},{"issue":"Suppl 3","key":"R36","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.70168","article-title":"Social media messaging to reduce HIV-related stigma among young adults in Peru: a randomized controlled study","volume":"29 Suppl 3","author":"Balina","journal-title":"J Int AIDS Soc"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.2196\/74235","article-title":"Reporting digital health implementations based on the iCHECK-DH guidelines and checklist: development of an interactive toolkit","volume":"27","author":"Liyanage","journal-title":"J Med Internet Res"},{"issue":"7-8","key":"R38","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1080\/21645515.2019.1581543","article-title":"A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination","volume":"15","author":"Ortiz","journal-title":"Hum Vaccin Immunother"},{"issue":"11","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7997","article-title":"Social media interventions to promote HIV testing, linkage, adherence, and retention: systematic review and meta-analysis","volume":"19","author":"Cao","journal-title":"J Med Internet Res"},{"issue":"12","key":"R40","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-066365","article-title":"Evaluating the impact of a linguistically and culturally tailored social media ad campaign on COVID-19 vaccine uptake among indigenous populations in Guatemala: a pre\/post design intervention study","volume":"12","author":"Abascal Miguel","journal-title":"BMJ Open"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241253758","article-title":"Black social media influencers engage higher percentages of Black gay and bisexual men in online outreach for HIV prevention research relative to paid ads","volume":"10","author":"Fahey","journal-title":"Digit Health"},{"issue":"3","key":"R42","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1093\/her\/cyab018","article-title":"Social media influencers can be used to deliver positive information about the flu vaccine: findings from a multi-year study","volume":"36","author":"Bonnevie","journal-title":"Health Educ Res"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/BF03391698","article-title":"Social media engagement and public health communication: implications for public health organizations being truly \u201csocial\u201d","volume":"35","author":"Heldman","journal-title":"Public Health Rev"},{"issue":"12","key":"R44","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1080\/10810730.2014.894596","article-title":"It\u2019s better to give than to receive: the role of social support, trust, and participation on health-related social networking sites","volume":"19","author":"Hether","journal-title":"J Health Commun"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10831-8","article-title":"Acceptability of an online peer support group as a strategy to improve antiretroviral therapy adherence among young people in Kampala district, Uganda: qualitative findings","volume":"25","author":"Kiirya","journal-title":"BMC Infect Dis"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2021.687677","article-title":"Khuluma: using participatory, peer-led and digital methods to deliver psychosocial support to young people living with HIV in South Africa","volume":"3","author":"Atujuna","journal-title":"Front Reprod Health"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.21037\/mhealth-20-68","article-title":"mHealth to reduce HIV-related stigma among youth in the United States: a scoping review","volume":"7","author":"Mulawa","journal-title":"Mhealth"},{"key":"R48","unstructured":"UNAIDS Terminology Guidelines. Joint United Nations Programme on HIV\/AIDS (UNAIDS); 2024. URL: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2024-terminology-guidelines_en.pdf [Accessed 23-09-2026]"},{"key":"R49","unstructured":"Lang K . How often should you post on Instagram in 2025? What data from 2 million posts tells us. Buffer. URL: https:\/\/buffer.com\/resources\/how-often-to-post-on-instagram\/ [Accessed 26-10-2025]"},{"key":"R50","unstructured":"Lang K . How often should you post on TikTok? Data from 11 million+ posts. Buffer. URL: https:\/\/buffer.com\/resources\/how-often-should-you-post-on-tiktok\/ [Accessed 26-10-2025]"},{"issue":"5","key":"R51","doi-asserted-by":"publisher","first-page":"5","DOI":"10.5817\/CP2022-5-5","article-title":"Reducing HIV public stigma through news information engagement on social media: a multi-method study of the role of state empathy","volume":"16","author":"He","journal-title":"Cyberpsychology (Brno)"},{"issue":"4","key":"R52","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.hjdsi.2014.10.005","article-title":"Using social media to engage adolescents and young adults with their health","volume":"2","author":"Wong","journal-title":"Health Care (Don Mills)"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.2196\/71510","article-title":"The ways of using social media for health promotion among adolescents: qualitative interview and focus group study","volume":"27","author":"Zimmermann","journal-title":"J Med Internet Res"},{"key":"R54","unstructured":"Hu N Mikolajczyk K . Average engagement rates for 12 industries [2026 update]. Hootsuite. Jan 2025. URL: https:\/\/blog.hootsuite.com\/average-engagement-rate\/ [Accessed 27-08-2025]"},{"issue":"2","key":"R55","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1080\/07399332.2016.1217863","article-title":"Women\u2019s experiences with HIV-related stigma from health care providers in Lima, Peru: \u201cI would rather die than go back for care\u201d","volume":"38","author":"Valencia-Garcia","journal-title":"Health Care Women Int"},{"issue":"12","key":"R56","doi-asserted-by":"publisher","first-page":"712","DOI":"10.3928\/01484834-20191120-06","article-title":"Faculty attitudes about caring for people living with HIV\/AIDS: a comparative study","volume":"58","author":"Leyva-Moral","journal-title":"J Nurs Educ"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:42:53Z","timestamp":1790790173000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e93260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":56,"URL":"https:\/\/doi.org\/10.2196\/93260","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"v28i6e93260"}}