JMIR Publications

ABSTRACT

Background:

Background:

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

Objective:

To investigate technology utilization, internet access, and HIV information acquisition and use among YBMSM.

Methods:

An online survey and semi-structured 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% of participants self-reported living with HIV, 43.4% were HIV-negative, and 15.6% were unsure of their HIV-status. Most participants (95%) acquired HIV information through the Internet while using a mobile phone. Online HIV information was intentionally sought from consumer health information websites (37.3%), government health information websites (30%), and social media sites (17%). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating applications (65.39%), postings on social media sites from their online social ties (53.84%), and advertisements while browsing the Internet (48.72%). Despite the Internet being the top source of HIV information, healthcare providers were the most preferred (50.6%) and trusted (96%) source of HIV information. HIV information was used to facilitate the utilization of HIV prevention and treatment services. The qualitative sample included YBMSM across a range of ages and at different points of engagement in HIV prevention and treatment. 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 stigma in healthcare settings. Participants used HIV information to assess their risk for HIV/AIDS, support their self-efficacy for HIV prevention and treatment, 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 website censorship policies, and the “stigmatizing” tone of HIV information presented in mass media campaigns.

Conclusions:

YBMSM in this sample had high utilization of the internet and mobile technologies for HIV information acquisition and use, but diminished access to their preferred and most trusted source of HIV information: healthcare providers. Future eHealth and mHealth HIV prevention and treatment interventions should support communication between patients and healthcare providers. Findings demonstrate the need for culturally appropriate HIV messaging, and online spaces for informational support exchange among YBMSM.