Providing Online-Based Sexual Health Outreach to Gay, Bisexual, and Queer Men in Ontario, Canada: Qualitative Interviews with Multisectoral Frontline Service Providers and Managers
Publication: AIDS Patient Care and STDs
Volume 32, Issue Number 7
Abstract
The Internet is a common tool for gay, bisexual, and other men who have sex with men (MSM) to find sexual partners and sexual health information. Given persistently high human immunodeficiency virus (HIV) infection rates among MSM, it is important to examine the role of online outreach for MSM as part of HIV prevention and care. We provide an overview of the unique perspectives of online sexual health outreach, delivered through AIDS Service Organizations (ASOs) through sociosexual Internet sites and mobile applications. Data were drawn from the qualitative arm of the community-based Cruising Counts study conducted across Ontario from December 2013 to January 2014. ASO online outreach providers and managers (n = 22) were recruited to complete a 1-h in-person/telephone interview to explore in-depth their experiences with, and perspectives on, delivering online outreach services for MSM in Ontario. Thematic analyses were conducted inductively using NVivo 10. Service providers suggested a high demand for online outreach services for MSM. Strengths and advantages of online outreach over face-to-face outreach included anonymity, instant access to services, peer model, and accessing hard-to-reach populations of MSM. Barriers included consistent quality of service, collaborations between companies that own online technologies and outreach service agencies, budgetary and staff capacity issues, and uncertainty of best practices and evaluation parameters for online outreach. Findings from these interviews can inform service providers, policy makers, and researchers on how online sexual health outreach can play a greater role in HIV prevention by better acknowledging and addressing the opportunities and barriers experienced by service providers working with MSM communities online.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Beymer MR, Weiss RE, Bolan RK, et al. Sex on demand: Geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles county. Sex Transm Infect 2014;90:567–572.
2.
Bien CH, Best JM, Muessig KE, Wei C, Han L, Tucker JD. Gay apps for seeking sex partners in China: Implications for MSM sexual health. AIDS Behav 2015;19:941–946.
3.
Blackwell C, Birnholtz J, Abbott C. Seeing and being seen: Co-situation and impression formation using Grindr, a location-aware gay dating app. New Media Soc 2015;17:1117–1136.
4.
Brennan DJ, Lachowsky NJ, Georgievski G, et al. Online outreach services among men who use the Internet to seek sex with other men (MISM) in Ontario, Canada: An online survey. J Med Internet Res 2015;17:e277.
5.
Grov C, Rendina HJ, Jimenez R, Parsons JT. Using online settings to identify gay and bisexual men willing to take or with experience taking PrEP: Implications for researchers and providers. AIDS Educ Prev 2016;28:378–392.
6.
Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an Internet social networking site. PloS One 2012;7:e33119.
7.
Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men's use of the Internet: Research from the 1990s through 2013. J Sex Res 2014;51:390–409.
8.
Mustanski B, Greene GJ, Ryan D, Whitton SW. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: The Queer Sex Ed intervention. J Sex Res 2015;52:220–230.
9.
Ciesielski CA. Sexually transmitted diseases in men who have sex with men: An epidemiologic review. Curr Infect Dis Rep 2003;5:145–152.
10.
Wong W, Chaw JK, Kent CK, Klausner JD. Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002–2003. Sex Transm Dis 2005;32:458–463.
11.
Rhodes SD, Vissman AT, Stowers J, et al. A CBPR partnership increases HIV testing among men who have sex with men (MSM): Outcome findings from a pilot test of the CyBER/testing internet intervention. Health Educ Behav 2011;38:311–320.
12.
Beyrer C, Baral SD, Collins C, et al. The global response to HIV in men who have sex with men. Lancet 2016;388:198–206.
13.
Public Health Agency of Canada. Summary: Estimates of HIV prevalence and incidence in Canada, 2014. Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Canada, 2015.
14.
Public Health Agency of Canada. HIV/AIDS Epi updates: National HIV prevalence and incidence estimates for 2011. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Canada, 2014.
15.
McFarlane M, Kachur R, Klausner JD, Roland E, Cohen M. Internet-based health promotion and disease control in the 8 cities: Successes, barriers, and future plans. Sex Transm Dis 2005;32:S60–S64.
16.
Ostergren JE, Rosser BS, Horvath KJ. Reasons for non-use of condoms among men who have sex with men: A comparison of receptive and insertive role in sex and online and offline meeting venue. Cult Health Sex 2011;13:123–140.
17.
Tsui HY, Lau JT. Comparison of risk behaviors and socio-cultural profile of men who have sex with men survey respondents recruited via venues and the Internet. BMC Public Health 2010;10:232.
18.
Young SD, Szekeres G, Coates T. The relationship between online social networking and sexual risk behaviors among men who have sex with men (MSM). PloS One 2013;8:e62271.
19.
Yang Z, Zhang S, Dong Z, Jin M, Han J. Prevalence of unprotected anal intercourse in men who have sex with men recruited online versus offline: A meta-analysis. BMC Public Health 2014;14:508.
20.
Ashton M, Sopwith W, Clark P, McKelvey D, Lighton L, Mandal D. An outbreak no longer: Factors contributing to the return of syphilis in Greater Manchester. Sex Transm Infect 2003;79:291–293.
21.
Centers for Disease Control and Prevention. Internet use and early syphilis infection among men who have sex with men—San Francisco, California, 1999–2003. MMWR Morb Mortal Wkly Rep 2003;52:1229.
22.
Ehlman DC, Jackson M, Saenz G, et al. Evaluation of an innovative Internet-based partner notification program for early syphilis case management, Washington, DC, January 2007–June 2008. Sex Transm Dis 2010;37:478–485.
23.
Rhodes SD, McCoy TP, Tanner AE, et al. Using social media to increase HIV testing among gay and bisexual men, other men who have sex with men, and transgender persons: Outcomes from a randomized community trial. Clin Infect Dis 2016;62:1450–1453.
24.
Adam PC, Murphy DA, de Wit JB. When do online sexual fantasies become reality? The contribution of erotic chatting via the Internet to sexual risk-taking in gay and other men who have sex with men. Health Educ Res 2011;26:506–515.
25.
Liau A, Millett G, Marks G. Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sex Transm Dis 2006;33:576–584.
26.
Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep 2015;12:173–190.
27.
Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: A systematic review. J Med Internet Res 2014;16:e134.
28.
Global Forum on MSM & HIV. Rights in action: Access to HIV services among men who have sex with men. 2015. Available at: http://msmgf.org/wp-content/uploads/2015/12/KP-Brief-MSM-FINAL.pdf (Last accessed May 12, 2018). Global Forum on MSM & HIV, Oakland, California.
29.
Adams D, Klindera K, Walsh CS, Wolf RC. Innovative programmatic approaches to HIV prevention and care services for gay men, other men who have sex with men (MSM) and transgender persons using information and communication technology (ICT). Dig Cult Educ 2014;6:152–163.
30.
Bourne C, Knight V, Guy R, Wand H, Lu H, McNulty A. Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men. Sex Transm Infect 2011;87:229–231.
31.
Reback CJ, Grant DL, Fletcher JB, et al. Text messaging reduces HIV risk behaviors among methamphetamine-using men who have sex with men. AIDS Behav 2012;16:1993–2002.
32.
Saberi P, Siedle-Khan R, Sheon N, Lightfoot M. The use of mobile health applications among youth and young adults living with HIV: Focus group findings. AIDS Patient Care STDS 2016;30:254–260.
33.
Rana AI, van den Berg JJ, Lamy E, Beckwith CG. Using a mobile health intervention to support HIV treatment adherence and retention among patients at risk for disengaging with care. AIDS Patient Care STDS 2016;30:178–184.
34.
Fields SD, Wharton MJ, Marrero AI, Little A, Pannell K, Morgan JH. Internet chat rooms: Connecting with a new generation of young men of color at risk for HIV infection who have sex with other men. J Assoc Nurses AIDS Care 2006;17:53–60.
35.
Sullivan PS, Carballo-Diéguez A, Coates T, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet 2012;380:388–399.
36.
Ybarra ML, Bull SS. Current trends in Internet-and cell phone-based HIV prevention and intervention programs. Curr HIV/AIDS Rep 2007;4:201–207.
37.
Holloway IW, Rice E, Gibbs J, Winetrobe H, Dunlap S, Rhoades H. Acceptability of smartphone application-based HIV prevention among young men who have sex with men. AIDS Behav 2014;18:285–296.
38.
Fantus S, Souleymanov R, Lachowsky NJ, Brennan DJ. The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: Perspectives of online outreach workers. BMC Med Ethics 2017;18:1–12.
39.
Hallett J, Brown G, Maycock B, Langdon P. Changing communities, changing spaces: The challenges of health promotion outreach in cyberspace. Promot Educ 2007;14:150–154.
40.
Klausner JD, Levine DK, Kent CK. Internet-based site-specific interventions for syphilis prevention among gay and bisexual men. AIDS Care 2004;16:964–970.
Information & Authors
Information
Published In
Copyright
Copyright 2018, Mary Ann Liebert, Inc.
History
Published in print: July 2018
Published online: 1 July 2018
Published ahead of print: 13 June 2018
Topics
Authors
Author Disclosure Statement
No competing financial interests exist.
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Get Access
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.