Public health officials and medical researchers face a persistent challenge regarding sexual and reproductive health. While products such as human papillomavirus (HPV) vaccines and sexually transmitted infection (STI) self-test kits are widely available and effective, consumer adoption rates often lag behind public health targets. For example, data indicates that a vast majority of cervical cancer cases are preventable through vaccination, yet stigma continues to hinder the purchase and use of these preventive measures.
This resistance is not merely a matter of lack of education or access. It often stems from deep-seated psychological and social factors that make purchasing these items embarrassing or anxiety-inducing. Marketing researchers have long understood that stigma acts as a barrier to consumption. However, less attention has been paid to how political beliefs interact with this stigma to shape consumer behavior.
A new study published in Psychology & Marketing investigates this intersection. The research explores how political ideology influences the way consumers perceive and react to stigmatized health products. It further examines whether specific advertising strategies, such as using artificial intelligence agents or government sponsorship, can modify these reactions.
Identifying the knowledge gap
Yunlu Zhao, a researcher from the Department of Management at the University of Bologna, along with colleagues from the University of Leeds, led this investigation. The team identified that while previous research has looked at how ideology affects responses to controversial goods or widely accepted products like recycling, there was a lack of understanding regarding products that are beneficial but stigmatized.
The researchers sought to understand the specific psychological processes that might cause conservatives and liberals to view these products differently. They drew upon Moral Foundations Theory, a framework that suggests political ideologies are rooted in different moral priorities. Liberals tend to prioritize “individualizing” foundations, which focus on fairness and care. Conservatives often place equal or greater weight on “binding” foundations, such as authority, loyalty, and purity.
The team hypothesized that these moral differences would alter how individuals perceive the social acceptability of sexual health products. They designed a multi-step investigation to test this theory and to see if advertising cues could bridge the gap between these ideological groups.
Analyzing real-world health data
The first phase of the research involved a large-scale analysis of secondary data to establish whether a link between ideology and product adoption exists in the real world. The researchers examined data on HPV vaccination uptake among adolescents across the United States from 2011 to 2022. They combined this health data with state-level political metrics, specifically the partisan composition of state legislatures.
The researchers controlled for various factors that could influence vaccination rates, such as income, education, and urbanization. They then ran a statistical model to see if the political leaning of a state predicted its vaccination coverage.
The analysis showed a clear pattern. States with a higher degree of conservative ideology exhibited lower rates of HPV vaccine uptake. This correlation persisted even when accounting for demographic and socioeconomic variables. This finding provided the necessary empirical foundation to justify a deeper investigation into the individual psychological drivers behind this trend.
Uncovering the psychological chain of events
To understand the “why” behind the real-world data, the researchers conducted a survey-based study involving 201 U.S. adults. Participants were shown a variety of stigmatized products, including condoms, STI test kits, and menstrual cups. They were asked to rate their attitude toward the products, their intention to purchase them, and how socially acceptable they perceived the products to be.
Participants also completed a questionnaire that assessed their moral foundations and their political ideology. The researchers analyzed the data to trace the sequence of psychological events linking ideology to consumer response.
The study revealed that conservative participants responded more negatively to the products than liberal participants. The analysis linked this negative response to a specific chain of events. Conservative ideology was associated with a lower emphasis on the “individualizing” moral foundations of care and fairness regarding these topics. This reduced emphasis was linked to a perception that the products were less socially acceptable. This perception of lower social acceptability, in turn, was linked to a decreased intention to purchase the items.
Testing artificial intelligence in advertising
Having established the baseline difference between liberals and conservatives, the researchers moved to experimental methods to test potential interventions. They focused first on the use of artificial intelligence (AI) in advertising. The team questioned whether replacing a human spokesperson with an AI agent would alter consumer responses, given that AI might be perceived differently by each ideological group.
In this experiment, 425 young male participants were shown advertisements for either an HPV vaccine or male contraceptives. The participants were randomly assigned to view an ad featuring a human doctor, an ad featuring a humanoid AI robot, or a control ad with no agent.
The researchers measured the participants’ attitudes and purchase intentions. They reasoned that liberals, who are typically more sensitive to issues of fairness and systemic bias, might view AI with skepticism. Conversely, conservatives might not share these specific concerns regarding algorithmic bias.
The impact of AI on the ideological divide
The results of the experiment showed that the use of AI cues narrowed the gap between liberal and conservative responses. However, the data revealed that this closing of the gap occurred because liberal participants responded less favorably to the AI advertisements compared to the human advertisements.
Conservative participants remained largely unaffected by the change in the advertisement’s spokesperson. Their attitudes did not significantly improve or decline when viewing the AI agent. The “bridge” across the ideological divide was formed not by elevating conservative acceptance, but by depressing liberal acceptance to a level closer to that of conservatives. This finding suggests that while AI might statistically reduce polarization in data, it does so by alienating the liberal segment rather than engaging the conservative one.
Examining the role of government sponsorship
The final study investigated the influence of institutional sponsorship. Government agencies often promote public health initiatives, but the researchers hypothesized that trust in government varies by ideology. They designed an experiment to see if disclosing government sponsorship versus corporate sponsorship would change consumer choices.
The study recruited 446 participants who were told they were entering a raffle to win a prize. They could choose between a box of condoms (the stigmatized product) and a tube of toothpaste (a control product). The raffle was presented as being sponsored by either a government agency (the Centers for Disease Control and Prevention), a corporation, or a collaboration between the two.
The researchers analyzed how the sponsorship source influenced the likelihood of choosing the condoms over the toothpaste, depending on the participant’s political ideology.
How sponsorship shifts liberal behavior
The analysis revealed that the source of the sponsorship had a significant impact on liberal participants. When the advertisement featured the government agency, liberals were more likely to choose the stigmatized product compared to when it was sponsored by a corporation.
In contrast, conservative participants showed no significant difference in their choices regardless of whether the sponsor was the government or a corporation. The presence of the government logo did not cause a backlash among conservatives, but it also failed to provide any persuasive boost.
This created a widening of the ideological gap. Because government sponsorship increased liberal adoption while leaving conservative adoption unchanged, the disparity between the two groups grew larger. The study suggests that while government involvement is effective for a specific segment of the population, it does not serve as a universal tool for increasing adoption across the political spectrum.
Implications for business and public health
These findings offer specific directions for marketers and policymakers working with sensitive health products. The research demonstrates that a “one-size-fits-all” approach is unlikely to be effective given the deep ideological differences in the market.
For businesses targeting liberal-leaning demographics or regions, the data suggests that emphasizing human connection and fairness is effective. The use of AI agents in these markets carries a risk of reducing engagement due to concerns about algorithmic fairness. Furthermore, partnerships with government agencies appear to be a strong asset in these markets, increasing the legitimacy and appeal of the products.
For markets with a higher concentration of conservative consumers, the strategy requires adjustment. The study indicates that appeals based on social acceptability are challenging because these consumers perceive the products as less acceptable to begin with. The data shows that neither AI agents nor government sponsorship effectively moves the needle for this group. Marketers might need to find alternative ways to frame these products that do not rely on the moral foundations of care and fairness, which appear to be less salient drivers for this group in this specific context.
Opening new avenues for inquiry
This research clarifies the current state of consumer behavior regarding stigmatized products but also raises new questions for the field. The current study focused exclusively on sexual and reproductive health products. It remains to be seen if these findings apply to other categories of stigmatized goods, such as weight-loss treatments or sustainable burial services.
Additionally, the finding regarding AI presents a new avenue for investigation. The researchers observed that liberals disliked the AI agents, likely due to fairness concerns. Future research could investigate whether different types of AI presentation or explicit assurances of algorithmic neutrality could mitigate this negative response.
Finally, the stability of conservative responses across different experimental conditions poses a challenge for researchers. Since neither AI nor government sponsorship significantly altered conservative behavior, future studies will need to identify what specific cues, if any, can successfully increase the social acceptability of these products for this demographic. Identifying the specific moral or practical levers that resonate with conservative consumers regarding public health remains an open and vital question.
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