Sexual Health

Effects of an Audiovisual Intervention to Improve Competence to Consent to Research Participation Among Young Gay and Bisexual Men Who Use Stimulants.

TL;DR

Audiovisual consent interventions improved overall competence to consent, understanding, and appreciation scores compared to standard written consent among young gay and bisexual men who use stimulants, suggesting such interventions may be valuable tools for HIV and substance use behavioral trials.

Key Findings

Participants randomized to the audiovisual intervention had higher overall competence to consent compared to those receiving standard written consent.

  • Study enrolled 115 young gay and bisexual men aged 16-24 years between June 2024 and January 2025
  • 53 participants (46%) were randomized to standard consent and 62 (54%) to the audiovisual intervention
  • Overall competence to consent difference was statistically significant (p = .02)
  • The audiovisual intervention consisted of standard written consent plus an animated video

Participants in the audiovisual intervention group demonstrated higher understanding scores than those in the standard consent group.

  • Difference in understanding scores was statistically significant (p = .04)
  • Understanding was one of three competence domains evaluated alongside appreciation and reasoning
  • Standard consent consisted of a written informed consent form only

Participants in the audiovisual intervention group demonstrated higher appreciation scores than those in the standard consent group.

  • Difference in appreciation scores was statistically significant (p = .04)
  • Appreciation is a distinct domain of competence to consent separate from understanding and reasoning
  • The trial context involved a hypothetical study aimed at promoting sexual health and reducing stimulant use

There were no statistically significant differences in reasoning scores or willingness to participate between the two consent conditions.

  • Reasoning was one of three competence domains evaluated
  • Willingness to participate in the hypothetical trial was a secondary outcome
  • Both reasoning and willingness to participate did not differ between the audiovisual and standard consent groups

Participants in the audiovisual intervention group reported greater satisfaction with the consent process.

  • Satisfaction with the consent process was a secondary outcome measure
  • Acceptability of video-enhanced consent was high across both groups
  • Greater satisfaction was observed specifically among those who received the animated video in addition to written consent

The study population consisted of young gay and bisexual men who were at risk for HIV transmission or acquisition and reported recent stimulant use.

  • Participants were aged 16-24 years with a mean age of 21.8 years (standard deviation = 1.7)
  • Approximately half (53%) identified as White; the remaining participants were racial/ethnic minorities
  • Eligibility required being at risk for HIV transmission or acquisition and reporting recent stimulant use
  • Enrollment occurred between June 2024 and January 2025

Standard consent practices in HIV research were characterized as often not facilitating truly competent informed consent.

  • This characterization motivated the development and testing of the audiovisual intervention
  • The study specifically targeted behavioral trials focused on HIV and substance use
  • The intervention was designed to be brief, consisting of an animated video added to standard written consent

What This Means

This research examined whether adding an animated video to the standard written consent process could help young gay and bisexual men (ages 16-24) who use stimulants better understand and engage with research participation decisions. In a randomized trial of 115 participants, those who received the video alongside the written consent form scored significantly higher on overall ability to consent, as well as on two specific components: understanding the study information and appreciating how it applied to their own situation. There was no difference between groups in their reasoning abilities or in how willing they were to join the hypothetical trial. Participants who watched the video also reported being more satisfied with the consent process, and acceptability of the video-enhanced approach was high among all participants. The study focused on a population—young sexual minority men who use stimulants—that is disproportionately affected by HIV and is frequently recruited into behavioral research studies, yet may face barriers to fully understanding complex consent materials. This research suggests that brief animated videos added to standard written consent forms could be a practical tool for improving how well research participants understand and personally connect with the information they are given before joining a study. This has implications for making research participation more ethical and equitable, particularly in studies involving young people and marginalized communities where ensuring truly informed consent is especially important.

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Citation

P. Valente, Celia Fisher, K. Biello, M. Mimiaga, G. O'Connor, Nicoletta Pellegrino, et al.. (2026). Effects of an Audiovisual Intervention to Improve Competence to Consent to Research Participation Among Young Gay and Bisexual Men Who Use Stimulants.. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2026.02.020