HIV Prevention Research Ethics Training Institute Fellow Publishes Study on HIV Testing and Facebook

Dr. Sean D. Young, a 2013 Fordham University Research Ethics Training Institute Fellow

While Facebook may be used primarily to reconnect with old friends and share vacation photos, a recent study suggests that it  may also be an important tool in HIV prevention.

A new study by Fordham University HIV Prevention Research Ethics Training Institute Fellow Dr. Sean D. Young of UCLA found that using social media and online communities not only leads to increased HIV testing and encourages significant behavior change among high risk groups, but also turns out to be one of the best HIV-prevention and testing approaches on the Internet.

Young, assistant professor of family medicine and director of innovation for the center for behavior and addiction medicine at the David Geffen School of Medicine at UCLA and the study’s lead investigator, said that his findings were not just applicable to HIV prevention efforts. He indicated that there are similar effects for general health and well-being because their approach combines behavioral psychology with social technologies, and these methods might be used to change health behaviors across a variety of diseases.

The authors found that people in the study were highly engaged and maintained active participation in the study. “Internet HIV prevention interventions and mobile health applications have had very high dropout rates and problems getting people engaged, and this effect is even more pronounced among high-risk groups such as minority populations and men who have sex with men,” Young said. “However, our approach appeared to overcome these issues and changed behavior.”

This study, published on September 3 in the Annals of Internal Medicine, comes a few months after another study by Young and his team, which found that social media could be useful in HIV and STD prevention efforts by increasing conversations about HIV prevention.

For this study, Young and his researchers recruited 112 men who have sex with men (MSM) either through banner ads placed on social networking sites such as Facebook, through a Facebook fan page with study information, through banner ads and posts on Craigslist, and from venues such as bars, schools, gyms and community organizations in Los Angeles.

A majority (60%) of the participants where African American, while 28 percent were Latino, 11 percent were white and 2 percent were Asian.

Each participant was randomly assigned to either an HIV group or a general health group on Facebook, the latter serving as the control, and then randomly assigned to two peer leaders within their groups. Participants were under no obligation to engage with peer leaders or other participants or to even remain members of their respective Facebook groups. They were also allowed to adjust their Facebook settings in order to control the amount of personal information they shared with other group members.

Throughout the study, participants were able to request and receive home-based HIV self-testing kits. At the beginning of the study and again at 12 weeks, participants completed a 92-item survey that included questions about Internet and social media usage, including their use to discuss health and sexual risk behaviors; general health behavior like exercise and nutrition; and sex and sexual health behaviors including HIV testing and treatment.  Among other things, the researchers looked for evidence of behavior change, such as reduction of sexual partners, and requests for home-based HIV test kits with follow-ups to obtain test results.

The research yielded several interesting findings.

Firstly, 95% of the intervention participants voluntarily communicated on Facebook, along with 73% of those in the control groups. Of those in the intervention group, 44% requested testing kits, compared to 20% of those in the control group. In addition, the intervention group members chatted and sent personal messages far more frequently than  the control group members.

The study also found that African American and Latino MSM, who are at higher risk for becoming infected with HIV compared with the rest of the population, find social networks to be an acceptable platform for HIV prevention. Additionally, the findings indicate that African Americans and Latinos also find home-based tests to be an acceptable HIV testing method.

Unlike the high dropout rates in other Internet-based HIV-prevention interventions, Young’s study had a follow-up retention rate of 93%.

Limitations to the study include the fact that researchers only used two Facebook communities per condition, meaning these methods should be tested with more people before implementing them. It is also important to note that no best practices regarding the use of social networking for HIV communication have been established.

According to Young, the next step will be to assess how this method might generalize to other populations, diseases, and prevention efforts.

“We have created a potential paradigm for health behavior change using new social technologies,” he said. “We are beginning to explore this approach in other areas.”

For further information see:

Young, S. D., & Jaganath, D. (2013). Online Social Networking for HIV Education and Prevention: A Mixed-Methods Analysis. Sexually transmitted diseases40(2), 162-167.

Young, S. D., Cumberland, W. G., Lee, S.-J., Szekeres, G., & Coates, T. (2013). Social Networking Technologies as an Emerging Tool for HIV Prevention: A Cluster Randomized Trial. Annals of Internal Medicine. 159(5), 318-324.

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