Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
Centre for Social Research in Health, UNSW Australia, Sydney, Australia.
Health Sociol Rev. 2020 Nov;29(3):264-278. doi: 10.1080/14461242.2020.1820366. Epub 2020 Sep 16.
The HIV epidemic in the Philippines has been expanding rapidly, with most newly diagnosed cases occurring among 'men who have sex with men' (MSM). New social contexts of HIV are evident in the evolving phenomenon of more MSM seeking partners online via social networking applications ('apps'). This study examines findings from a virtual ethnography of app use among MSM, focus group discussions with community-based healthcare workers, and key informant interviews with healthcare workers, policymakers and researchers in Metro Manila. We argue that participants viewed the expanding epidemic and apps as intimately linked, regarding the apps as 'risky spaces' for 'risky behaviour'. However, such narratives neglected the agentive capabilities of the apps and how they have transformed sexual practice, creating new ways of being as sexual subjects, while perpetuating old imaginaries among healthcare workers of 'hard-to-reach' populations. Such narratives of 'risk' have led to new interventions by healthcare workers on the apps, viewing these technologies as opportunities to reach more MSM for health promotion. However, the interventions have created new complexities by reconfiguring boundaries with target populations. By conducting community-based outreach through encouraging behaviour change in one-to-one interactions with app users, the potential impact of these interventions is limited.
菲律宾的艾滋病毒疫情正在迅速蔓延，大多数新诊断的病例发生在“男男性行为者”（MSM）中。通过社交网络应用程序（“应用程序”）在网上寻找伴侣，这种新的艾滋病毒社会环境在 MSM 中不断发展。本研究通过对 MSM 应用程序使用情况的虚拟民族志、社区卫生工作者的焦点小组讨论以及与马尼拉大都会的卫生工作者、政策制定者和研究人员的关键知情人访谈，考察了研究结果。我们认为，参与者将不断扩大的疫情和应用程序视为密切相关的，认为应用程序是“危险空间”，存在“危险行为”。然而，这些叙述忽略了应用程序的能动能力，以及它们如何改变性实践，为性主体创造新的存在方式，同时在卫生工作者中延续了关于“难以接触”人群的旧观念。这种“风险”的叙述导致了卫生工作者在应用程序上的新干预措施，认为这些技术是为了促进更多 MSM 的健康而提供的机会。然而，通过与应用程序用户进行一对一的互动来鼓励行为改变，这些干预措施在重新配置与目标人群的边界方面带来了新的复杂性。通过在社区中进行外展活动，鼓励与应用程序用户进行一对一的互动，这些干预措施的潜在影响是有限的。
