Providing Online‐Based Sexual Health Outreach to Gay, Bisexual, and Queer Men in Ontario, Canada: Qualitative Interviews with Multisectoral Frontline Service Providers and Managers

Abstract The Internet is a common tool for gay, bisexual, and other men who have sex with men (MSM) to find sexual partners and sexual health information. Given persistently high human immunodeficiency virus (HIV) infection rates among MSM, it is important to examine the role of online outreach for MSM as part of HIV prevention and care. We provide an overview of the unique perspectives of online sexual health outreach, delivered through AIDS Service Organizations (ASOs) through sociosexual Internet sites and mobile applications. Data were drawn from the qualitative arm of the community‐based Cruising Counts study conducted across Ontario from December 2013 to January 2014. ASO online outreach providers and managers (n = 22) were recruited to complete a 1‐h in‐person/telephone interview to explore in‐depth their experiences with, and perspectives on, delivering online outreach services for MSM in Ontario. Thematic analyses were conducted inductively using NVivo 10. Service providers suggested a high demand for online outreach services for MSM. Strengths and advantages of online outreach over face‐to‐face outreach included anonymity, instant access to services, peer model, and accessing hard‐to‐reach populations of MSM. Barriers included consistent quality of service, collaborations between companies that own online technologies and outreach service agencies, budgetary and staff capacity issues, and uncertainty of best practices and evaluation parameters for online outreach. Findings from these interviews can inform service providers, policy makers, and researchers on how online sexual health outreach can play a greater role in HIV prevention by better acknowledging and addressing the opportunities and barriers experienced by service providers working with MSM communities online.

[1]  N. Lachowsky,et al.  The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers , 2017, BMC medical ethics.

[2]  J. Parsons,et al.  Using Online Settings to Identify Gay and Bisexual Men Willing to Take or With Experience Taking PrEP: Implications for Researchers and Providers. , 2016, AIDS education and prevention : official publication of the International Society for AIDS Education.

[3]  Stefan D Baral,et al.  The global response to HIV in men who have sex with men , 2016, The Lancet.

[4]  P. Saberi,et al.  The Use of Mobile Health Applications Among Youth and Young Adults Living with HIV: Focus Group Findings. , 2016, AIDS patient care and STDs.

[5]  C. Beckwith,et al.  Using a Mobile Health Intervention to Support HIV Treatment Adherence and Retention Among Patients at Risk for Disengaging with Care. , 2016, AIDS patient care and STDs.

[6]  T. McCoy,et al.  Using Social Media to Increase HIV Testing Among Gay and Bisexual Men, Other Men Who Have Sex With Men, and Transgender Persons: Outcomes From a Randomized Community Trial. , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  N. Lachowsky,et al.  Online Outreach Services Among Men Who Use the Internet to Seek Sex With Other Men (MISM) in Ontario, Canada: An Online Survey , 2015, Journal of medical Internet research.

[8]  Jeremy P. Birnholtz,et al.  Seeing and being seen: Co-situation and impression formation using Grindr, a location-aware gay dating app , 2015, New Media Soc..

[9]  Sheana Bull,et al.  A Systematic Review of Recent Smartphone, Internet and Web 2.0 Interventions to Address the HIV Continuum of Care , 2015, Current HIV/AIDS Reports.

[10]  B. Mustanski,et al.  Feasibility, Acceptability, and Initial Efficacy of an Online Sexual Health Promotion Program for LGBT Youth: The Queer Sex Ed Intervention , 2015, Journal of sex research.

[11]  Joseph D. Tucker,et al.  Gay Apps for Seeking Sex Partners in China: Implications for MSM Sexual Health , 2015, AIDS and Behavior.

[12]  R. Wolf,et al.  Innovative programmatic approaches to HIV prevention and care services for gay men other men who have sex with men (MSM) and transgender persons using information and communication technology (ICT). , 2014 .

[13]  Meihua Jin,et al.  Prevalence of unprotected anal intercourse in men who have sex with men recruited online versus offline: a meta-analysis , 2014, BMC Public Health.

[14]  R. Weiss,et al.  Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles county , 2014, Sexually Transmitted Infections.

[15]  Jasmine Travers,et al.  eHealth Interventions for HIV Prevention in High-Risk Men Who Have Sex With Men: A Systematic Review , 2014, Journal of medical Internet research.

[16]  J. Bauermeister,et al.  Gay and Bisexual Men's Use of the Internet: Research from the 1990s through 2013 , 2014, Journal of sex research.

[17]  Eric Rice,et al.  Acceptability of Smartphone Application-Based HIV Prevention Among Young Men Who Have Sex With Men , 2014, AIDS and Behavior.

[18]  Sean D. Young,et al.  The Relationship between Online Social Networking and Sexual Risk Behaviors among Men Who Have Sex with Men (MSM) , 2013, PloS one.

[19]  Alex Carballo-Diéguez,et al.  Successes and challenges of HIV prevention in men who have sex with men , 2012, The Lancet.

[20]  Cathy J. Reback,et al.  Text Messaging Reduces HIV Risk Behaviors Among Methamphetamine-Using Men Who Have Sex with Men , 2012, AIDS and Behavior.

[21]  M. Mimiaga,et al.  Limited Awareness and Low Immediate Uptake of Pre-Exposure Prophylaxis among Men Who Have Sex with Men Using an Internet Social Networking Site , 2012, PloS one.

[22]  J. D. de Wit,et al.  When do online sexual fantasies become reality? The contribution of erotic chatting via the Internet to sexual risk-taking in gay and other men who have sex with men. , 2011, Health education research.

[23]  E. Eng,et al.  A CBPR Partnership Increases HIV Testing Among Men Who Have Sex With Men (MSM): Outcome Findings From a Pilot Test of the CyBER/testing Internet Intervention , 2011, Health education & behavior : the official publication of the Society for Public Health Education.

[24]  R. Guy,et al.  Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men , 2011, Sexually Transmitted Infections.

[25]  K. Horvath,et al.  Reasons for non-use of condoms among men who have sex with men: a comparison of receptive and insertive role in sex and online and offline meeting venue , 2011, Culture, health & sexuality.

[26]  Daniel C. Ehlman,et al.  Evaluation of an Innovative Internet-based Partner Notification Program for Early Syphilis Case Management, Washington, DC, January 2007–June 2008 , 2010, Sexually transmitted diseases.

[27]  J. Lau,et al.  Comparison of risk behaviors and socio-cultural profile of men who have sex with men survey respondents recruited via venues and the internet , 2010, BMC public health.

[28]  Michele L. Ybarra,et al.  Current trends in internet-and cell phone-based HIV prevention and intervention programs , 2007, Current HIV/AIDS reports.

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

[30]  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.

[31]  Gary Marks,et al.  Meta-analytic Examination of Online Sex-Seeking and Sexual Risk Behavior Among Men Who Have Sex With Men , 2006, Sexually transmitted diseases.

[32]  M. McFarlane,et al.  Internet-Based Health Promotion and Disease Control in the 8 Cities: Successes, Barriers, and Future Plans , 2005, Sexually transmitted diseases.

[33]  C. Kent,et al.  Risk Factors for Early Syphilis Among Gay and Bisexual Men Seen in an STD Clinic: San Francisco, 2002–2003 , 2005, Sexually transmitted diseases.

[34]  C. Kent,et al.  Internet-based site-specific interventions for syphilis prevention among gay and bisexual men , 2004, AIDS care.

[35]  M. Ashton,et al.  An outbreak no longer: factors contributing to the return of syphilis in Greater Manchester , 2003, Sexually transmitted infections.

[36]  C. Ciesielski.  Sexually transmitted diseases in men who have sex with men: An epidemiologic review , 2003, Current infectious disease reports.