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Ensuring high attendance levels was the primary concern of peer educators and was also a necessary first step in terms of achieving the other measures of success that they identified. The peer-led, socially focused event trialled, ‘Sexy Trivia’, performed well in this regard, with peer educators reporting attendance as notably higher than previous sexual health promotions. However sheer numbers were not the only factor of interest to peer educators, with a key priority being attracting those who were not already engaged with sexual health. In contrast to previous events where turnout had been both small and limited to those already playing a vocal role in sexual health promotion, the Sexy Trivia trial drew a larger and more diverse audience. When comparing the effectiveness of Sexy Trivia with previous sexual health promotion events it is important to remember that this trial involved payment of an incentive for attendance. While this may at first seem an unfair comparison, the presence of an incentive was a vital component of the approach. Incentives have been shown in previous studies to increase the effectiveness of sexual health promotion in terms of the cost necessary to reach each person (Currie et al., 2010). However perhaps equally important is the type of person attending. While previous work has questioned whether the role of science communication is to further develop the interest of those already engaged in science or to pique the interest of those who are not engaged (Medvecky and Leach, 2013), in a sexual health promotion context it is clear that efforts must be made to avoid preaching solely to the converted. If the goal of a peer educator is to attract an audience that is not already engaged in sexual health issues, then it is clear that something beyond sexual health information will need to be provided in order to capture this demographic. With survey and interview results suggesting that alcohol would be an effective means of attracting a higher-risk audience, an incentive that could be used for alcohol (amongst other options) was likely a vital component of the trial’s success. Among the trial participants approximately half were classified as higher-risk, indicating great success in attracting the audience most likely to benefit from messages about sexually transmissible infections.

Two factors were used to evaluate attitudes towards sexual health testing; personal attitudes and subjective norms. While there was no significant difference between Sexual Health Talk and Sexy Trivia participants in terms of personal attitudes towards testing for chlamydia each time they have a new sexual partner, subjective norms were significantly different. Subjective norms aim to measure how the participants perceive the attitudes of people who are important to them in terms of whether they would approve of testing. Sexy Trivia participants scored significantly higher on this measure and it is possible that the structural differences between a talk and an interactive, group based activity such as trivia could account for these differences. Rather than the one-way transmission of information that makes up the majority of a talk or lecture, experiences such as Sexy Trivia allow for interaction not just between the presenter and the participant, but between participants as well. As trivia is inherently designed to provoke discussion about the answer within each group, posing questions about sexual health issues to pre-existing social groups seems to be a useful means of gauging the attitude of one’s friends on what is often a rarely discussed topic. Previous studies have shown that university students often overestimate the frequency of sexual activity amongst their peers (Scholly et al., 2005) and that while close friends are often supportive of sexual health testing, most young people avoid telling others about testing, due to the perception of stigma and judgement (Theunissen et al., 2015). This approach aligns with science communication research on the phenomenon of cultural cognition, where group values influence risk perceptions and other beliefs (Dimaggio, 1997). The success of Sexy Trivia at changing attitudes is consistent with this framework, as a core tenant is that “People feel that it is safe to consider evidence with an open mind when they know that a knowledgeable member of their cultural community accepts it” (Kahan, 2010). As this effect was found primarily amongst males participating in Sexy Trivia, this could be a useful strategy for engaging an audience that is often hesitant to approach sexual health issues. By providing an external prompt to begin the discussion, activities like these can help to align the expectations of participants with the reality of others’ perspectives.

In terms of facilitating behavioural change, there were two measures on the survey that were relevant to evaluating success; perceived behavioural control and behavioural intentions. While perceived behavioural control is one factor of the likelihood of seeking a test, behavioural intentions are designed to be the overall determinant of whether testing

will occur. In the trial, participants who attended the Sexual Health Talk showed significantly higher results in terms of perceived behavioural control, however behavioural intentions showed no significant difference. As perceived behavioural control relates to the level of autonomy participants feel they have over whether they complete the target action (Fishbein and Ajzen, 1975), the higher scores for the Sexual Health Talk make sense, given that the talk was much more comprehensive in terms of explaining what a sexual health test involves and how to go about getting one. However while this is certainly an advantage, this must also be placed within the context of who would be attending the event. Sexy Trivia was more effective at attracting a larger audience, and this audience included a high proportion of higher-risk students. Given that there was no significant difference between the two events in terms of behavioural intentions (i.e. the likelihood of getting tested) and a significant increase in subjective norms (i.e. perception of other’s approval of testing), it is clear that an event that reaches more people will be more effective at changing attitudes at a community level.