JMIR Publications

ABSTRACT

Background:

Human immunodeficiency virus (HIV) disproportionately affects young black men who have sex with men (YBMSM) in the United States. Electronic health (eHealth) holds significant potential for supporting linkage and engagement in HIV prevention and care, and the delivery of HIV information to YBMSM.

Objective:

This study aimed to investigate HIV information acquisition and use among YBMSM who use the Internet.

Methods:

An online, self-administered survey and semistructured interviews were conducted. Survey findings informed the development of the interview guide. Descriptive statistics were used to characterize the survey sample, and interview data was analyzed thematically using modified grounded theory methodologies.

Results:

Among the internet sample (N=83), the average age was 29.2 years, 41% (34/83) of participants self-reported living with HIV, 43% (36/83) were HIV-negative, and 15% (13/83) were unsure of their HIV-status. Most participants (95%, 79/83) acquired HIV information through the Internet while using a mobile phone. Online HIV information was intentionally sought from consumer health information websites (37%, 31/83), government health information websites (30%, 25/83), and social media sites (17%, 14/83). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating applications (65%, 54/83), postings on social media sites from their online social ties (53%, 44/83), and advertisements while browsing the Internet (48%, 40/83). Despite the Internet being the top source of HIV information, healthcare providers were the most preferred (50%, 42/83) and trusted (96%, 80/83) source of HIV information. HIV information was used to facilitate the utilization of HIV prevention andcare 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 due to its ease of accessibility, the ability to maintain anonymity while searching for sensitive information, and to mitigate against multiple stigmas in healthcare settings. Participants used HIV information to assess their risk for HIV and acquired immunodeficiency syndrome (AIDS), support their skills building for HIV prevention, inform patient-doctor communication, and to learn about HIV prevention and treatment options. Men expressed concerns about their diminishing access to online spaces for HIV information exchange among YBMSM due to censorship policies on social media sites, and the “stigmatizing” framing and tone of mass media HIV-prevention advertisements they 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: healthcare providers. Future eHealth HIV interventions culturally tailored for YBMSM should support patient-provider communication. Findings demonstrate the need for community-informed, culturally tailored HIV messaging, and online spaces for informational support exchange among YBMSM.