Scroll, Search and Navigate: HIV Health Literacy and Prevention Among Students Attending a Historically Black College/University

Background
This study examined human immunodeficiency virus (HIV)–related health literacy and prevention among students at a Southeastern Historical Black College and University (HBCU) using the Integrative Health Literacy Model and the Consolidated Framework for Implementation Research.


Methods
Seven gender-specific focus groups (n = 20) were created between June and October 2023. The discussions explored health and HIV information-seeking behaviors, knowledge, prevention practices, and campus culture. Transcripts were analyzed using the domains of health literacy and the Consolidated Framework for Implementation Research.


Results
Participants primarily relied on social media and Google for health information, often passively encountering content rather than actively seeking it. Although most have basic knowledge of HIV, misconceptions persist regarding HIV transmission, prevention, and curability. Condom use and testing were endorsed but inconsistently practiced, and knowledge of preexposure prophylaxis (PrEP) was minimal. Female groups emphasized relational decision making and negotiation, whereas male groups raised more factual questions. Campus culture—including gossip, “dirty/clean” narratives, and sexual activity around events like homecoming—shaped both stigma and prevention behaviors. Barriers included comfort concerns regarding condom use, privacy concerns, judgmental staff, and uneven sexual health education before college.


Conclusions
The students highlighted the need for private, affordable, and culturally resonant preventive strategies. The Consolidated Framework for Implementation Research (CFIR) analysis identified opportunities for anonymous and bundled testing, peer-led education based on relationships and pleasure, and co-designed interventions that embed sexual health into campus life. Strengthening media literacy, promoting partner testing, and improving awareness of preexposure prophylaxis and rapid testing improve HIV prevention among HBCU students.