The public health perspective: Building The HIVe
Just over ten years ago researchers in Europe and the USA reported that an increasing
number of gay men were using the Internet to meet sexual partners. Our own research
among gay men in London found that in 2000 just over a quarter of the men we
surveyed in gyms had used the Internet to meet sexual partners during the previous 12
months. More than ten years on, that figure has more than doubled.
The initial public health focus was whether the Internet represented a new risk
environment. Several studies had found increased levels of high-risk behaviour among
gay men who looked for—and found—sexual partners through the Internet. But the
underlying processes and drivers were not understood.
The association between seeking sex on the Internet and high-risk sexual behaviour
raised a number of important questions at the time. Did the excess risk for HIV and
other sexually transmitted infections (STIs) occur with sexual partners whom men
actually met through the Internet? Or did the association reflect the fact that high-risk
men were selectively using the Internet to look for sex? In other words, did the Internet
somehow amplify risk or did self-selected groups of men use the Internet for meeting
partners? Did the Internet attract a constituency of men who had little contact with the
established gay scene or health promotion agencies? For example, men who did not use
bars and clubs, bisexual men, or men from remote geographic regions? And in the
midst of all this, what was the Internet’s potential for HIV education, prevention and
sexual health promotion?
Over a decade later, we have some answers to these questions. Concerning risk, the
Internet appears to provide opportunities for risk reduction as well as for risk
enhancement. It has become evident that the Internet provides an important platform
for gay men living with HIV to meet one another and to mutually disclose their HIV
status in a relatively safe environment. The Internet has also become an important
source of information on HIV and other STIs while the opportunities for HIV
prevention and online interventions appear to be unlimited particularly among men who
would otherwise be hard to reach. The papers in this issue of Digital Culture & Education
(DCE) are testimony to the Internet and other digital technologies’ potential for
community-led interventions with a public health focus.
In addition the Internet provides new opportunities for conducting population
surveys among gay men. Most European countries now conduct behavioural
surveillance among gay men by means of online surveys accessed through a myriad of
websites. The EMIS project (European Men’s Internet Survey) demonstrated the
power of the Internet as a research tool by recruiting more than 180,000 men who have
sex with men from 38 European countries in just a few months in 2010. One of the
advantages of online surveys is their ability to reach men who do not use gay
community venues or who are geographically dispersed.
A recent editorial in a British newspaper noted that the Internet “makes the
argument for the power of collaboration over competition, for openness over secrecy”.
Nowhere is this better illustrated than in the papers of this special issue of Digital Culture
& Education (DCE) on Building The HIVe.
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