As a 26-year-old former Grindr-user and a single-and-ready-to-mingle gay man, I am a frequent target of Internet HIV prevention messages/advertisements. Every once in awhile, I do feel obliged to click on the ads because of all these gorgeous half-naked men they use to lure me in. Then, BANG -- "YOU ARE AT RISK FOR HIV! And here is how you can make an appointment for HIV testing" or "Please take this survey about your sexual behaviors." Wait, what happened to the men? I am blushing because even my potential sex partners during my Grindr days would start conversations with a greeting of some sort (usually "sup," "hey," or "bored") before they jumped straight into the intimate sexual questions. All I can say is: Thank you so much for thinking about my penis and, of course, my anus too.
I work in HIV prevention and I know people who believe that this HIV prevention strategy would be effective. Remember when you were young, and your mother repeatedly warned you NOT to touch the fan with your hands? The first thing I did when my mother left me with my older sister was touch the fan, and even today, my sister still tells the tale of how I approached her with fingers covered in blood afterward. Also, I can't tell you how many "Internet ads are going to revolutionize HIV prevention" conversations and meetings I have had to sit through. It's 2014, and there should be no surprise that we can reach a large number of people over the Internet. Just getting the message out there is not enough, as evidenced by the high and increasing HIV rates among men who have sex with men (MSM) ages 18 to 24, the most tech-savvy of all age groups. It's time for the field to come up with innovative strategies to change HIV-related perceptions and behaviors.
Instead of focusing solely on HIV facts, Dr. Brian Mustanski from Northwestern University suggested adopting a comprehensive framework of health in HIV prevention and incorporating other factors in the life of lesbian, gay, bisexual and transgender (LGBT) youth. At the 2014 Innovative Use of Technology for HIV Prevention and Care Conference, Mustanski presented his work with the Impact Program to improve the health of LGBT individuals. Unlike traditional HIV interventions that emphasize HIV facts and knowledge, the "Keep It Up!" online project focuses on the social and situational safe-sex context, such as bars/night clubs, online hookups, relationships and community involvement. This focus is established because HIV transmission is never an individual phenomenon; it is a negotiation between two or more people regarding safe sex practices (e.g., talking about using condoms, disclosing HIV status, or getting tested for HIV together). Participating young MSM have expressed high acceptability toward this intervention, and most importantly shown a decrease in unprotected anal intercourse.
Finding romantic relationships and defining sexuality are rites of passage for adolescents, including LGBT youth. The second online project, the Queer Sex Ed project, seeks to address the gap of LGBT tailored knowledge on relationships and sexuality in the school-based sex ed curriculum, such as sexual identity (coming out), healthy relationships, and being part of the LGBT community. This gap often leads to risks of HIV and other sexually transmitted infections. For example, Mustanski's group found that HIV risks often increase in the context of serious relationships. When LGBT youth enter serious relationships, they often cease to practice safe sex without going through the proper negotiation steps to protect themselves (e.g., HIV testing and communication between partners). Therefore, it is important for future interventions to take these factors into consideration.
Similarly, at the HOPE Lab here at UCLA, we don't just target sexual risk behaviors -- our work emphasizes the use of social media in building online communities, and using them to promote HIV prevention behaviors (i.e., HIV testing). Using trained peer leaders to facilitate HIV/AIDS discussions, including both private conversations and public posts, we have implemented a Facebook groups-based HIV/AIDS intervention with at-risk African- and Latino-American MSM. African- and Latino-American MSM are disproportionately impacted by HIV because of reduced access to care, less access to HIV testing, and less knowledge about their status. The results were promising; participants in the study were more likely to request home-based HIV testing kits than the comparison group (Facebook group that focused on general health) at the end of the intervention.
So here is what I have to say to public health: Eyes up here, people. I am a hell of a lot more than just my penis and anus. In fact, I am multifaceted just like everyone else in this world; I am a self-proclaimed music aficionado, an occasional gymgoer, and a wanderer of the blogosphere. Therefore, instead of focusing only on sexual risks, public health needs to address meaningful events in the life of at-risk individuals and give them reasons to care about and to protect against HIV/AIDS.
Jason is a public health research associate at the University of California, Los Angeles under the guidance of Sean Young, Ph.D., at the Department of Family Medicine. Jason's research focuses on how the Internet can be used to promote the well-being of LGBTQ youth. In the past 10 years, he has lived in Los Angeles, Bangkok (Thailand), Pittsburgh, Taipei (Taiwan), South Bend and Iowa City. Jason is also an avid music aficionado and he enjoys all kinds of different music, from Bach's counterpoint to Glass's minimalism. For more information, please contact Jason at firstname.lastname@example.org.