A Pilot Intervention Utilizing Internet Chat Rooms to Prevent HIV Risk Behaviors among Men Who Have Sex with Men

Objectives. Chat room-based prevention interventions for human immunodeficiency virus (HIV) are being implemented to reduce the risk of HIV exposure, infection, and re-infection among men who have sex with men (MSM). Methods. Our community-based participatory research partnership implemented a chat room-based intervention known as Cyber-Based Education and Referral/Men for Men (CyBER/M4M). We collected both quantitative and qualitative data to describe the characteristics of chat-room participants (“chatters”) and their HIV risks and prevention needs, and to document intervention delivery. Results. Of the 1,851 chatters who participated in the 18-month intervention, 210 completed the online assessment. The mean age was 30 years. Although the majority self-identified as gay, 25.8% self-identified as bisexual. More than half self-identified as white and one-third as black or African American. A total of 8.6% reported being HIV-positive and 14.8% reported never having been tested for HIV. Grounded theory analysis of transcripts from chat-room instant-message discussions identified 13 thematic categories related to chatter characteristics, prevention needs, and intervention delivery. Chatters were looking for sexual partners, were not open about their orientation, lacked basic information about HIV, had questions about how to be tested, and perceived a lack of general community resources to meet their needs. Furthermore, CyBER educators had to understand and respect the online culture, build trust, and deliver well-crafted and focused messages. Conclusions. Chat room-based interventions hold promise to systematically reach Internet communities of MSM, a group that is particularly at risk for infection with HIV and other sexually transmitted diseases.

[1]  Diana I. Rios,et al.  Cyberghetto or Cybertopia? Race, Class, and Gender on the Internet , 1999 .

[2]  K. Horvath,et al.  Virtual and physical venues as contexts for HIV risk among rural men who have sex with men. , 2006, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[3]  Kermit C. Whaley,et al.  America's Digital Divide: 2000–2003 Trends , 2004, Journal of Medical Systems.

[4]  Robert Garofalo,et al.  Tip of the Iceberg: young men who have sex with men, the Internet, and HIV risk. , 2007, American journal of public health.

[5]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[6]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[7]  M. McFarlane,et al.  The Internet as a newly emerging risk environment for sexually transmitted diseases. , 2000, JAMA.

[8]  J. Bernhardt,et al.  Health education and the digital divide: building bridges and filling chasms. , 2000, Health education research.

[9]  J. Klausner,et al.  Tracing a syphilis outbreak through cyberspace. , 2000, JAMA.

[10]  Jason Corburn,et al.  The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes. , 2008, American journal of public health.

[11]  G. Kok,et al.  A new meeting place: chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men , 2005, AIDS.

[12]  S. Kalichman,et al.  Men Who Have Met Sex Partners via the Internet: Prevalence, Predictors, and Implications for HIV Prevention , 2002, Archives of sexual behavior.

[13]  H. Hospers,et al.  Chatters on the Internet: a special target group for HIV prevention , 2002, AIDS Care.

[14]  Sheldon D. Fields,et al.  Internet Chat Rooms: Connecting With a New Generation of Young Men of Color at Risk for HIV Infection Who Have Sex With Other Men , 2006, The Journal of the Association of Nurses in AIDS Care : JANAC.

[15]  Wendy Macias,et al.  Health-Related Message Boards/Chat Rooms on the Web: Discussion Content and Implications for Pharmaceutical Sponsorships , 2005, Journal of health communication.

[16]  M. McFarlane,et al.  The process of seeking sex partners online and implications for STD/HIV prevention , 2004, AIDS care.

[17]  Jonathan Hallett,et al.  Changing Communities, Changing Spaces: The Challenges of Health Promotion Outreach in cyberspace , 2007, Promotion & education.

[18]  M. McFarlane,et al.  Soliciting sex on the Internet: what are the risks for sexually transmitted diseases and HIV? , 2000, Sexually transmitted diseases.

[19]  M. Chiasson,et al.  A Comparison of On-Line and Off-Line Sexual Risk in Men Who Have Sex With Men: An Event-Based On-Line Survey , 2007, Journal of acquired immune deficiency syndromes.

[20]  M. McFarlane,et al.  Sex and the internet. , 2001, AIDS.

[21]  Bosah L. Ebo Cyberghetto or Cybertopia?: Race, Class, and Gender on the Internet , 1998 .

[22]  G. Burstein,et al.  Sexually transmitted diseases treatment guidelines , 2003, Current opinion in pediatrics.

[23]  K. Hergenrather,et al.  Using Community-Based Participatory Research to Develop a Chat Room-Based HIV Prevention Intervention for Gay Men , 2007, Progress in community health partnerships : research, education, and action.

[24]  J. Elford,et al.  Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms , 2001, AIDS.

[25]  K. Hergenrather,et al.  Comparing MSM in the southeastern United States who participated in an HIV prevention chat room-based outreach intervention and those who did not: how different are the baseline HIV-risk profiles? , 2007, Health education research.

[26]  Meredith Minkler,et al.  Community organizing and community building for health , 1997 .

[27]  M. Gilbert,et al.  Seeking sexual partners on the internet: a marker for risky sexual behaviour in men who have sex with men. , 2008, Canadian journal of public health = Revue canadienne de sante publique.

[28]  R. DiClemente,et al.  Risk among men who have sex with men in the United States: a comparison of an Internet sample and a conventional outreach sample. , 2002, AIDS education and prevention : official publication of the International Society for AIDS Education.

[29]  J Elford,et al.  Use of gay Internet sites and views about online health promotion among men who have sex with men , 2004, AIDS care.

[30]  D. Schoech,et al.  Use of the Internet for Community Practice , 2000 .

[31]  M. Chiasson,et al.  HIV Behavioral Research Online , 2006, Journal of Urban Health.

[32]  M. Ross,et al.  Technological tearoom trade: characteristics of Swedish men visiting gay Internet chat rooms. , 2003, AIDS education and prevention : official publication of the International Society for AIDS Education.

[33]  S. Rhodes Hookups or health promotion? An exploratory study of a chat room-based HIV prevention intervention for men who have sex with men. , 2004, AIDS education and prevention : official publication of the International Society for AIDS Education.

[34]  Daniel P. Lorence,et al.  Racial disparities in health information access: resilience of the digital divide , 2006, Journal of Medical Systems.

[35]  K. Hergenrather,et al.  Collecting behavioural data using the world wide web: considerations for researchers , 2003, Journal of epidemiology and community health.

[36]  P. Freire Education for Critical Consciousness , 1973 .

[37]  M. Ross,et al.  Differences between Internet samples and conventional samples of men who have sex with men: implications for research and HIV interventions. , 2000, Social science & medicine.

[38]  Graham Bolding,et al.  Web-Based Behavioral Surveillance Among Men Who Have Sex With Men: A Comparison of Online and Offline Samples in London, UK , 2004, Journal of acquired immune deficiency syndromes.