HIV Prevention: Using Social Networking

Sean D. Young, PhD, MS Assistant Professor In-Residence Center for Behavioral and Addiction Medicine Department of Family Medicine University of California, Los AngelesMedicalResearch.com Interview with:
Sean D. Young, PhD, MS
Assistant Professor In-Residence Center for Behavioral and Addiction Medicine Department of Family Medicine University of California, Los Angeles

Dr. Young: Here’s the main take-home point:

There is a lot of excitement about the possibility of using technologies, big data, and mHealth to improve health outcomes and change behavior. However,

1) little work has been done on this topic using sound research methods (for example, studies have asked people to report whether a technology changed behavior rather than objectively measuring whether it actually changed behavior.

2) technologies have not been shown to create sustainable behavior change (i.e., the effects go away with time), and 3) it is unclear whether the people who really need to change behavior and improve health would use these technologies as intended.

Results are below. Study findings suggest that it is possible to use technologies to create sustainable health behavior change, however, only if the approach integrates the science behind how to change behavior. We validated that our approach combining behavioral science and social media can create sustainable health behavior change.

Press Release:

Social Networking Technologies as an Emerging Tool for HIV Prevention: A Cluster Randomized Trial

Contact: Enrique Rivero (erivero@mednet.ucla.edu)

Behavioral psychology + social media = A scientifically-proven approach to increase HIV testing and prevention behaviors

Technique may also apply to other diseases, prevention efforts

Can social media and online communities be used to create sustainable health behavior change?

A new UCLA study published Sept. 3 in the peer reviewed journal Annals of Internal Medicine finds that combining behavioral science with social media/online communities can lead to sustainable health behavior change. The authors’ evidence-based approach for using social media and online communities not only leads to increased HIV testing and encourages significant behavior change among high risk groups, but also turns out to be one of the best HIV-prevention and testing approaches on the Internet.

 

And it’s not just applicable to HIV prevention efforts, said Sean D. Young, assistant professor of family medicine and director of innovation for the center for behavior and addiction medicine at the David Geffen School of Medicine at UCLA and the study’s lead investigator.  We found similar effects for general health and well-being. Because our approach combines behavioral psychology with social technologies, these methods might be used to change health behaviors across a variety of diseases.

 

The authors found that people in the study were highly engaged  and maintained active participation in the study. “Internet HIV prevention interventions and mobile health applications have had very high dropout rates and problems getting people engaged, and this effect is even more pronounced among high-risk groups such as minority populations and men who have sex with men,” Young said. “However, our approach appeared to overcome these issues and changed behavior.”

The study is published Sept. 3 in the peer reviewed journal Annals of Internal Medicine.

A previous study published in February, also led by Young, found that social media could be useful in HIV and STD prevention efforts by increasing conversations about HIV prevention.

The researchers recruited 112 men who have sex with men either through banner ads placed on social networking sites such as Facebook, through a Facebook fan page with study information, through banner ads and posts on Craigslist, and from venues such as bars, schools, gyms and community organizations in Los Angeles. Of the participants, 60 percent were African American, 28 percent were Latino, 11 percent were white and 2 percent were Asian.

Each was randomly assigned to either an HIV group or a general health group on Facebook, the latter serving as the control, and then randomly assigned to two peer leaders within their groups. Participants were under no obligation to engage with peer leaders or other participants or to even remain members of their respective Facebook groups. They were also allowed to adjust their Facebook settings in order to control the amount of personal information they shared with other group members.

Throughout the study, participants were able to request and receive home-based HIV self-testing kits. At baseline and again at 12 weeks, participants completed a 92-item survey that included questions about Internet and social media usage, including their use to discuss health and sexual risk behaviors; general health behavior like exercise and nutrition; and sex and sexual health behaviors including HIV testing and treatment.  Among other things, the researchers looked for evidence of behavior change, such as reduction of sexual partners, and requests for home-based HIV test kits with follow-ups to obtain test results.

Among the findings:

  • 95 percent of the intervention participants voluntarily communicated on Facebook, along with 73 percent of the controls
  • 44 percent (25 of 57)  of the intervention group requested the testing kits, compared with 20 percent (11 of 55) of the controls
  • Nine of the 57 intervention group participants took and mailed back the test kits to receive their results, compared with 2 of the 55 control group members, suggesting a greater likelihood that their approach can successfully lead one to take an HIV test.
  • The intervention group members chatted and sent personal messages with much higher frequency than did the control group members
  • African American and Latino men who have sex with men, who are at higher risk for becoming infected with HIV compared with the rest of the population, find social networks to be an acceptable platform for HIV prevention
  • African Americans and Latinos also find home-based tests to be an acceptable HIV testing method
  • Retention at follow-up was more than 93 percent, in contrast to the high dropout rates from other Internet-based HIV-prevention interventions.

The researchers note some limitations to the study. Among them are that they used only two Facebook communities per condition, meaning these methods should be tested with more people before implementing them . In addition, no best practices regarding the use of social networking for HIV communication have been established.

The next step will be to assess how this method might generalize to other populations, diseases, and prevention efforts, Young said. “We have created a potential paradigm for health behavior change using new social technologies,” he said. “We are beginning to explore this approach in other areas.”

Study co-authors are William G. Cumberland, Sung-Jae Lee, Devan Jaganath, Greg Szekeres, and Thomas Coates, all of UCLA.

Grants from The National Institute of Mental Health (K01 MH090884), the UCLA Center for HIV Identification, Prevention and Treatment Services (CHIPTS), and the UCLA AIDS Institute funded this study.

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