Building Healthy Online Communities: From Formative Evaluation to Coordination of Public Health and Dating/Hook-up Sites and Apps' Efforts to Support HIV/STD Prevention Online

Background:  Dating sites and apps’ reach and impact on sexual networks make them a high priority for reducing STD/HIV transmission among gay and bisexual men. Coordination of public health efforts, gaining input from users, and respectful engagement of owners are imperative for reducing multiple and conflicting requests to owners, saving resources, and implementing interventions that users will utilize. We conducted formative evaluations of owners, users, and public health to inform messaging, internet partner services (IPS), and integration of self-sustaining features (i.e., health-related profile options) on sites and apps. An earlier survey of 3000 users, 18 owners, and 82 STD/HIV directors identified eight interventions that had the support of a majority of all three groups (Wohlfeiler/Hecht, 2013).

Methods:  We then convened the first-ever meeting of representatives of seven sites and public health leaders that identified steps to advance interventions. In 2016 we surveyed 80 US STD/HIV program directors to further assess online activities, successes, and challenges. 

Results:  In our 2016 survey, HIV/STD directors reported ad budgets ranging from $0 to $300,000 with 77% agreeing to share campaign materials; varying levels of success in messaging, recruiting to services, and reaching men of color, and some success, despite bureaucratic and technical barriers, in IPS, particularly in adapting it to apps. Despite data showing a majority of users accept IPS, we found ongoing concerns among owners about privacy, legal issues, and perceptions of judgment of users. To date, collaboration with owners has resulted in free messaging promoting STD/HIV testing and PrEP, integrating PrEP and other health-related information into sites’ profile screens, and integrating a PrEP storyline into a webseries.

Conclusions:  Our surveys and experience in stakeholder engagement underscore the importance of ongoing collaboration with owners; ongoing education of owners and users about IPS; identifying ways to adapting IPS to apps; coordinating messaging development and placement; and evaluating interventions.