School of Communication and Information, Rutgers University, New Brunswick, NJ, United States.
Yale School of Public Health, Center for Interdisciplinary Research on AIDS, New Haven, CT, United States.
J Med Internet Res. 2021 May 7;23(5):e22986. doi: 10.2196/22986.
BACKGROUND: HIV disproportionately affects young Black men who have sex with men (YBMSM) in the United States. eHealth holds potential for supporting linkage and engagement in HIV prevention and care and the delivery of HIV information to YBMSM. OBJECTIVE: This study aims to investigate HIV information acquisition and use among YBMSM who use the internet. METHODS: A web-based self-administered survey and semistructured interviews were conducted. The survey findings informed the development of the interview guide. Descriptive statistics were used to characterize the survey sample, and interview data were analyzed thematically using modified grounded theory methodologies. RESULTS: Among the internet sample (N=83), the average age was 29.2 (SD 3.5) years, 41% (n=34) of participants self-reported living with HIV, 43% (n=36) were HIV-negative, and 15% (n=13) were unsure of their HIV status. Most participants (n=79, 95%) acquired HIV information through the internet while using a mobile phone. Web-based HIV information was intentionally sought from consumer health information websites (n=31, 37%), government health information websites (n=25, 30%), and social media (n=14, 17%). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating apps (n=54, 65%), posts on social media sites from their web-based social ties (n=44, 53%), and advertisements while browsing the internet (n=40, 48%). Although the internet is the top source of HIV information, health care providers were the most preferred (n=42, 50%) and trusted (n=80, 96%) source of HIV information. HIV information was used to facilitate the use of HIV prevention and care services. The qualitative sample included YBMSM across a range of ages and at different points of engagement in HIV prevention and care. Qualitative findings included the importance of the internet as a primary source of HIV information. The internet was used because of its ease of accessibility, because of its ability to maintain anonymity while searching for sensitive information, and to mitigate intersecting stigmas in health care settings. Participants used HIV information to assess their risk for HIV and AIDS, support their skill building for HIV prevention, inform patient-doctor communication, and learn about HIV prevention and treatment options. Men expressed concerns about their diminishing access to online spaces for HIV information exchange among YBMSM because of censorship policies on social media sites and the stigmatizing framing and tone of mass media HIV-prevention advertisements encountered while using the internet. CONCLUSIONS: YBMSM in this sample had high utilization of eHealth for HIV information acquisition and use but diminished access to their preferred and most trusted source of HIV information: health care providers. Future eHealth-based HIV interventions culturally tailored for YBMSM should aim to reduce intersectional stigma at the point of care and support patient-provider communication. The findings demonstrate the need for community-informed, culturally tailored HIV messaging and online spaces for informational support exchange among YBMSM.
背景:艾滋病毒在美国不成比例地影响着与男性发生性关系的年轻黑人男性(YBMSM)。电子健康具有支持 HIV 预防和护理的联系和参与以及向 YBMSM 提供 HIV 信息的潜力。
目的:本研究旨在调查使用互联网的 YBMSM 获取和使用 HIV 信息的情况。
方法:进行了基于网络的自我管理调查和半结构化访谈。调查结果为访谈指南的制定提供了信息。使用描述性统计来描述调查样本,使用经过修改的扎根理论方法对访谈数据进行主题分析。
结果:在互联网样本(N=83)中,平均年龄为 29.2(SD 3.5)岁,41%(n=34)的参与者自我报告患有 HIV,43%(n=36)为 HIV 阴性,15%(n=13)不确定他们的 HIV 状况。大多数参与者(n=79,95%)通过使用手机上网获取 HIV 信息。从消费者健康信息网站(n=31,37%)、政府健康信息网站(n=25,30%)和社交媒体(n=14,17%)有意获取基于网络的 HIV 信息。大多数男性偶然通过社交媒体网站和地理空间约会应用程序上的广告(n=54,65%)、社交媒体网站上来自其网络社交关系的帖子(n=44,53%)和浏览互联网时的广告(n=40,48%)获取 HIV 信息。尽管互联网是获取 HIV 信息的主要来源,但卫生保健提供者仍然是最受欢迎(n=42,50%)和最值得信赖(n=80,96%)的 HIV 信息来源。HIV 信息被用于促进 HIV 预防和护理服务的使用。定性样本包括年龄不同、在 HIV 预防和护理中处于不同参与阶段的 YBMSM。定性研究结果包括互联网作为 HIV 信息主要来源的重要性。使用互联网是因为它易于访问,因为它在搜索敏感信息时能够保持匿名,并且可以减轻医疗保健环境中交叉的耻辱感。参与者使用 HIV 信息来评估他们感染 HIV 和艾滋病的风险,支持他们进行 HIV 预防技能的培养,告知医患沟通,并了解 HIV 预防和治疗选择。男性对他们在 YBMSM 中获取 HIV 信息的在线空间的访问减少表示担忧,因为社交媒体网站上的审查政策以及在上网时遇到的带有污名化和刻板印象的大众媒体 HIV 预防广告。
结论:本研究样本中的 YBMSM 高度利用电子健康获取和使用 HIV 信息,但他们获取和使用他们最喜爱和最信任的 HIV 信息来源:卫生保健提供者的机会减少。未来针对 YBMSM 的基于电子健康的 HIV 干预措施应该旨在减少护理点的交叉耻辱感,并支持患者与提供者的沟通。研究结果表明,需要针对 YBMSM 开展社区知情、文化适宜的 HIV 信息宣传和在线空间,以支持他们之间的信息支持交流。
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