Social Media and Behavioral Psychology to Promote HIV Testing

According to the recent study that was done at the University of California-Los Angeles Health Services in 2013, researchers found that social media could be useful in promoting safe sex behaviors including HIV testing through increasing conversations about HIV prevention. In this study the researchers selected 112 men who have sex with men to the study through banner ads and posts on social networking sites like Facebook (through Facebook fan page with study information), through posts on Craigslist, and from settings such as bars, gyms, schools and community organizations in Los Angeles. Participants then randomly assigned to one of the two Facebook discussion groups: an HIV intervention group and general health group (control group). Each participant was also assigned to two “peer leaders” within their group. The ones assigned for intervention group communicated with participants by sending messages, chats, and wall posts about HIV prevention and testing while the peer leaders for control group had conversations about general health issues such as exercising, healthy diet, and maintaining low-stress life style.

Authors of this study haven’t clearly introduced any behavioral theory or model for the intervention they implemented; however, most of the elements of Social Influence level Theory can be identified:

  1. Information: information about HIV virus, methods for prevention, and emphasizing on the importance of HIV testing delivered to the participants in the intervention group via messages, chats and wall posts by peer leaders.
  2. Social norms: participants of an intervention group were all men who had sex with men and were all members of the same community organizations like bars, schools, gyms or the fans of the same Facebook page and as a result they shared similar knowledge, attitudes, values, and behaviors toward HIV virus and prevention strategies.
  3. Social context: Individual’s attitudes toward HIV testing are partly influenced by setting like bars, schools and gyms. Also, conversations about HIV prevention and testing between members on Facebook could be influential in shaping the social context.
  4. Social networks: people who share the same values and beliefs regarding to HIV testing and prevention methods are fans of some similar pages on social networking sites like Facebook and Craigslist and share their beliefs and information with each other and may be influenced by their group members regarding to many health related behaviors like HIV testing.
  5. Selection: It is more likely that individuals in the intervention group select their friends on Facebook or other social networking sites according to social norms and based on shared characteristics.
  6. Socialization: participants who are members of the same social networking sites such as fans of the same page on Facebook develop attitudes and beliefs toward HIV testing and prevention methods that are compatible with their peers beliefs in this regard. Even those in the group who didn’t not believed in HIV testing before, might change their minds due to social pressure and under the influence of norms in the group.

REAIM

Reach:

  • In general, the nature of social media campaigns is their ability to disseminate messages to a large target population.  According to the data from World Bank, global internet use has increased exponentially with an estimated 1.8 billion internet users in 2009. Accordingly, members of social networking websites have been growing as well. For instance, in 2013 the number of Facebook active users was 680 million people. This provides a great opportunity to disseminate information to a large number of individuals.  However, one of the limitations of this study is that not all target population (MSM) are members of social networking sites such as Facebook, and they are mostly the ones with lower socioeconomic situation and in a greater risk of getting an infection.  Also, the researchers used only two Facebook communities for their intervention, whereas, this method should be tested with more people.

Efficacy:

Results of this study indicated that despite Internet HIV-prevention interventions and mobile health applications, which have had high dropout rates and problems regarding to getting participants engaged, the current study overcame most of these problems. Findings showed that the intervention group participants had higher rates of requesting the testing kits, and following up for test results .

Below are some evidences showing the efficacy of the intervention:

  • 44 % of the members of the intervention group requested the testing kits compared to 20% of the control group.
  • African-American and Latino men, who have sex with men and at higher risk of becoming infected, find social networks to be an efficient platform for HIV prevention.
  • 16% of the men in HIV group mailed in the test kit, compared with just 4 % of the men getting general health information.
  • The retention at follow-ups was more than 93%

However, it should be mentioned that this study didn’t assess how this method might generalize to other populations.

Adoption:

  • There are several organizations that have launched pages on Facebook and other social media web sites regarding to HIV related information. For instance, CDC has Facebook pages for HIV prevention and testing such as Act Against AIDS, Reasons, and HIV/AIDs. Health Resource and Service Administration (HRSA), and HIV.gov has also provided information about HIV testing and other related information on their Facebook pages. Increasing in the number of HIV prevention pages in various social networking websites by health related organizations can be very effective in increasing the number of individuals who become members of these pages, get the related information and discuss their beliefs and concerns with the other members of the page. Promoting HIV prevention  methods through social networking websites has been adopted by many health organizations such as Local and state health departments, WHO, health related colleges, stakeholders, gatekeepers

Implementation:

  • In order to be sure that adopting organizations deliver the intervention effectively, they need a multidisciplinary project team including public health researchers who are experienced in sexual health promotion, experts who know how end users interact with technology and a creative production company experienced in online performances. The collaboration between different expertises is necessary in assuring that the content is accurately designed.

One of the other influential factor s in implementing of HIV testing interventions is asking for the assistance of celebrities and scholars since they might have more influence on People especially young adults as role models. For instance, on National HIV Testing Day in 2009, White House released a video of President Obama receiving HIV test in hopes of raising awareness and decreasing stigma.

obama-takes-an-oral-hiv-test

 

Maintenance:

  • One of the challenges of health promotion interventions via social networking sites such as Facebook is sustaining engagement overtime. Posting questions and encouraging comments on posts and launching quizzes and polls can be useful in getting member’s attention for a longer time. Designing the web pages and contents in a way that make larger number of people interested in a post to share it with their friends, who then share it with their friends and so on is the other strategy named “ Internet meme” which helps in maintaining the intervention for a longer period of time. However, ”the law of attrition”, losing participants over time, is pretty common and inevitable among most of the  online interventions

 

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