2025 Theses Doctoral

Empathy in Frames: Assessing the Impact of Ethnic Concordance in Animated Cartoons on HIV/AIDS Stigma among South African Young Adults

Berthe, Paul C.J.

This dissertation investigates whether culturally tailored animated interventions can reduce HIV- and AIDS-related stigma among young adults in South Africa.

Despite ongoing public health campaigns, HIV stigma remains a persistent barrier to prevention and treatment, particularly in populations historically marginalized by race and socio-economic status. Given the increasing reach of digital media, this project explores whether short-form animated videos can serve as cost-effective, scalable tools for stigma reduction—especially when tailored to reflect the cultural identity of target audiences. The dissertation comprises four studies.

First, a rapid review of randomized controlled trials (RCTs)targeting HIV-related stigma identifies key gaps in the literature. Second, a pre-specified research protocol outlines an experimental approach to testing culturally resonant messaging through animation. Third, a pilot study compares two animated videos—one featuring a Black South African protagonist and one with a White protagonist—to explore early signals of effectiveness and inform the full-scale RCT. Fourth, the main trial evaluates the impact of ethnic concordance between message protagonist and viewer on HIV stigma, knowledge, and engagement outcomes using a randomized controlled design with 729 participants.

Findings from the pilot and full study suggest that cultural tailoring through protagonist ethnicity mayenhance knowledge acquisition and perceptions of ethnic representation in health messages, though effects on HIV stigma were less robust. The studies also suggest that these types of HIV-literacy cartoons could have high levels of user engagement, and that deploying short animated interventions via digital platforms could be feasible and merit further research. Together, the results provide new evidence for the role of culturally specific media in public health communication and suggest promising directions for future research and intervention design.