Addressing stigma in sexual health: advertising as a tool for change

Stigma remains a pervasive barrier to public health initiatives, which is often exacerbated by advertisements that, while raising awareness of risks and consequences, can also inadvertently stigmatize individuals based on their sexual health status. Transformative advertising offers a strategy to overcome this barrier; however, research is needed to uncover the pathways and mechanisms through which this can occur. Leveraging the Elaboration Likelihood Model and social identity theory, this study develops a process model to identify how advertising can strengthen Anti-stigma Perceptions towards people with sexually transmitted infections. Employing an explanatory sequential mixed-methods approach (i.e. survey and interviews), it identifies three distinct mediating pathways in which Executional Elements, Message Strategy and Perceived Relatability influence Anti-stigma Perceptions through Advertising Effectiveness. Furthermore, Perceived Risk moderates responses: Executional Elements affect high-risk individuals, whereas Message Strategies influence low-risk individuals. Practical implications highlight considerations for designing public health advertising that drive effectiveness and reshape societal issues.