Volume 4 [Issue 1], 2012


Introduction - The HIVe: Harnessing digital technologies to challenge the dominant HIV and AIDS paradigm

Judith D. Auerbach


In the fourth decade of the global AIDS epidemic, the digital universe has solidified itself as a new setting for HIV and AIDS risk, prevention, and community response. This is particulary true among gay and other men who have sex with men and transgenders (G/MSM/TG). As the papers in this special issue detail, networked and digital technologies are used in multiple ways in the global fight against HIV and AIDS. These include education, the design and conduct of research and prevention programmes, and fomenting community mobilisation.

Prevention is a solution: Building the HIVe

Gurmit Singh & Christopher S. Walsh


This Special Issue of Digital Culture and Education (DCE), Building the HIVe, offers relevant and applicable examples of digital technologies being leveraged, positioned and practiced towards community-based and led HIV prevention as a solution in a digital era. The contributors to this Special Issue, frontline workers, activists, researchers and educators alike, have taken risks as they have explored innovative prevention approaches with and through digital technologies, and documented and analysed their pedagogical innovations in different cultural contexts. Importantly this Special Issue also includes the critical voices and leadership of individuals living with HIV as designers of prevention as a solution. Their timely insights, advice and understandings of HIV prevention as a solution merit close scrutiny as evidence of resourceful, imaginative and critical endeavour; they are offered to share successful interventions and stimulate further discussion.

Bringing sexy back into gay men’s community empowerment for HIV prevention, care and support: The Poz & Proud approach

Leo Schenk and Gurmit Singh


The fact that HIV prevention initiatives are likely to fail without the involvement of communities of people living with and affected by HIV is well known. Internationally, there are a variety of intervention programs designed to address this problem with a wide range of outcomes. Frequently, sustainable approaches are hampered by entrenched stigma and discrimination towards people living with HIV. This paper describes Poz&Proud in the Netherlands, a continuous community empowerment initiative that exemplifies how gay men living with HIV addressed this problem. It outlines the project context, rationale and design, and examines how Poz&Proud used the Internet to support real-time events to overcome the stigma and discrimination that prevented their community from enjoying and accessing rights to sexual, mental health and emotional well being. We argue that new digitally supported approaches, like Poz&Proud, can challenge the entrenched stigma and discrimination facing communities of people living with and affected by HIV. This is because Poz&Proud’s approach connects with the lived realities of people living with and affected by HIV through ongoing, inclusive and relevant activities and events. Poz&Proud provides a replicable model by which other sexual minority and vulnerable communities can more effectively contribute to the public health goals of HIV prevention and care over current community mobilisation approaches more frequently reported on in the literature.


Local languages, global exchange: Digital networking, communication and collaboration for the health and human rights of men who have sex with men

Jack Beck, Lily May Catanes, Pato Hebert, Goldie Negelev and George Ayala


Gay men and other men who have sex with men (MSM) are at significantly greater risk for HIV than the general population in many low- and middle-income countries. In most parts of the world, civil society organisations are at the front lines of the fight against HIV among MSM, often with little or no support from local governments. Despite their central role in addressing this public health crisis, many of these organisations lack crucial information, funding, and connections with high-level partners that are essential to an effective response. To respond to these challenges, the Global Forum on MSM & HIV (MSMGF) has developed MSMGF.org, an online platform designed to strengthen the civil society response to HIV among MSM by increasing grassroots access to timely research, reports and opportunities, while simultaneously building networks among community members and key decision-makers. Using a unique translation system to offer full access in Arabic, Chinese, English, French, Portuguese, Russian, and Spanish, this innovative platform now has more than 3,000 members from over 140 countries. Evaluation results indicate that MSMGF.org has enhanced local advocacy efforts and programmes to provide HIV prevention, care, and treatment for MSM in low- and middle-income countries. We argue that this platform represents a powerful approach to advocacy and capacity building, leveraging networked and digital communication and collaboration to provide civil society organisations with rapid access to valuable knowledge, resources and support to improve the health and human rights of MSM, particularly in hostile contexts.

The use of the Internet in male sexual encounters by men who have sex with men in Cameroon

Emilie Henry, Yves Yomb, Lionel Fugon, Bruno Spire


While data and observations from the field suggest the Internet is a medium wherein disclosure, communication and encounters between men who have sex with men (MSM) are made possible, few studies have examined this question in Africa’s Sub-Saharan countries. The objective of our study was to define the proportion and profile of persons having access to the Internet as a means of encountering male sexual partners among a group of MSM living in the city of Douala, Cameroon. The study draws on data from both a survey on the sexual activity and practices of MSM set up in Douala in 2008 and from an online HIV outreach and prevention pilot study. The survey data were collected among a convenience sample of 168 MSM during face-to-face interviews with trained interviewers. A total of 52 individuals (34%) reported having met their partners over the Internet during the previous six months. In the multivariate analysis, having a university education level, not having a lucrative activity and having had a larger number of partners during the course of the previous six months were independent correlates of having met sexual partners on the Internet. Qualitative data from the chats show that the perception of risk of exposure to and infection with HIV and AIDS was not widespread in persons encountered in the Internet-based prevention, especially hidden MSM who were also the most reticent about going to the association’s center when provided a referral. This community-based research is the first study on MSM in Cameroon and their Internet use to find male sexual partners. Results underline the need to further investigate the use of the Internet by MSM in African contexts in order to adapt prevention strategies and interventions.

ICT & HIV prevention: Experiences from a biomedical HIV prevention trial among men who have sex with men (MSM) in Cape Town, South Africa

Andrew Scheibe, Ben Brown and Linda-Gail Bekker


HIV prevalence among men who have sex with men (MSM) in South Africa has been shown to be disproportionately higher than among the general population. Increased vulnerability to HIV among MSM has been associated with structural, social and individual factors. While information and communication technologies (ICT) now commonly mediate the sexual practices of many MSM, little research exists on how to design and deliver effective biomedical and combination HIV prevention interventions targeting MSM that consider the role of ICT in this context. In this paper, we describe the use and impact of ICT for a biomedical HIV prevention trial in South Africa as part of the larger Global iPrEX trial. We outline the research rationale, design and results and examine how SMS, email, social networking sites, and the Internet were used to target MSM. Drawing on our experience, we argue that the low cost and wide usage of various components of ICT among MSM offer significant potential for future targeted HIV prevention efforts.


Digital media and the Internet for HIV prevention, capacity building and advocacy among gay, other men who have sex with men (MSM), and transgendered people: Perspectives from Kolkata, India

Rohit K Dasgupta


Increasing HIV infections among gay men, other men that have sex with men (MSM) and transgender communities coupled with the low impact of traditional HIV prevention and capacity building approaches in enabling access to health services are a serious problem in India. This paper reports on how an HIV capacity building charity, Solidarity and Action Against the HIV Infection in India (SAATHII), used digital media and the Internet to transform HIV prevention across India. Beginning from Kolkata, India, I describe the design and launch of the SAATHII website and an online resource centre. The project illustrates how through digital media and the Internet, SAATHII was able to widen access, advocacy and information dissemination among multiple audiences to complement traditional community mobilisation HIV prevention approaches. To conclude I reflect on SAATHI’s work with digital media and the Internet from a brief overview of postcolonial and queer perspectives on Indian masculinity and sexuality. I provide my reflections as an emerging South Asian digital queer scholar based on my experiences in Kolkata to disrupt dominant approaches to HIV prevention in India so as to better meet the challenges of developing AIDS-resilient communities.

Innovative digital HIV and AIDS education and prevention for marginalised communities: Philadelphia’s Frontline TEACH

Val Sowell, Juliet Fink, and Jane Shull


In the last decade many HIV and AIDS education and prevention resources have been adapted for use on the Internet in the form of fact sheets, news feeds and educational videos. Despite these online resources, the educational needs of marginalised communities at risk of HIV are still not being met in Philadelphia, Pennsylvania, USA. Many individuals from marginalised communities often lack the digital literacy skills required to engage effectively with the overwhelming and diverse online resources available about HIV education and prevention. To address this problem this paper describes Frontline TEACH—an adaptation of Project TEACH—which combines face-to-face and online education for a population of HIV-negative people who have a need for targeted HIV education. Drawing on our experiences and evaluation results, we argue the Frontline TEACH course design and delivery improved upon existing online HIV education and prevention approaches by integrating Moodle and YouTube to widen community access and participation. We outline recommendations for Open Distance Flexible Learning (ODFL) formats to design innovative digital HIV and AIDS education and prevention for marginalised communities.

The social technographics of gay men and other men who have sex with men (MSM) in Canada: Implications for HIV research, outreach and prevention

Dan Allman, Ted Myers,Kunyong Xu, Sarah Jane Steele


Current research characterises differential patterns of the use of social media as social technographics. Social technographics suggests new media users can be classified on multi-point hierarchies. This paper considers this concept within the context of HIV research, prevention and outreach in Canada. It explores four diverse data sets in order to demonstrate how understanding patterns of social media use can inform this work. Analyses were conducted on Forrester’s North American Technographics® Benchmark Survey (2008), the Canadian Internet Use Survey (2007), the M-Track Ontario [Lambda] Survey (2007) and the Ontario Men's Survey (2002). Data analysis software was used to explore the associations of men’s age with social media use for sexual and non-sexual purposes. Analysis of these datasets suggests that in Canada, the age-related social technographics of gay men and other men who have sex with men (MSM) are clearly structured. Younger men are more likely to use and spend time on the Internet, to chat, blog or instant message, and to seek sex. Interpreting these findings in relation to current literature describing the social web, the younger the age categories of men considered in these analyses, the more likely men in those age categories were to be creators, innovators or active consumers of social content. Conversely, the older the age categories of men, the more likely men in those age categories were to be spectators only or inactive consumers. We argue that HIV research, prevention and outreach that employ social media have a better likelihood of impact when targeted to younger men in Canada; whereas activities aimed at older men will have a greater likelihood of impact when utilising more traditional forms of communication. Our analyses highlight the ways that gay men and other MSM’s patterns of social media use for social and sexual purposes will continue to evolve as different and more varied social media communication applications become available. HIV research, prevention and outreach will need to continue to monitor these developments in order that they may shift accordingly.


Sexperts! Disrupting injustice with digital community-led HIV prevention and legal rights education in Thailand

Nada Chaiyajit and Christopher S. Walsh


In addition to growing epidemics of HIV among men that have sex with men (MSM) and transgenders in Thailand, a low awareness of how to access justice increases their vulnerability. This paper presents unique case studies of how two community-based and led organisations used social networking and instant messaging to address this problem. It describes and analyses how online peer-based HIV education and prevention was integrated with access to justice through free university-based clinical legal education (CLE). It argues that re-designing HIV prevention and education through digital technologies with marginalised gay men, other men that have sex with men (MSM) and transgenders is a sustainable community-based and led approach. Furthermore digital media offer strategic opportunities to overcome on-going political violence alongside entrenched stigma and discrimination that disrupt denial of access to justice for populations disproportionately at risk of HIV


Funder’s Perspective: Building The HIVe

Kent Klindera


As one of the only funders solely supporting grassroots efforts to reducing HIV vulnerabilities amongst gay men, other men who have sex with men (MSM) and transgender individuals in the Global South, I take extreme pride is writing this perspective on building the HIVe. Clearly, gay men, other MSM and transgender individuals have been forgotten in both generalised HIV epidemics and more population specific epidemics, an unfounded scenario that is rooted in stigma and discrimination. As it was in the beginning of the HIV epidemic in the Global North, Lesbian, Gay, Bisexual and Transgender (LGBT) leaders in the Global South have recognised the need to organise on their own to save the lives of their brothers and sisters whom governments and more mainstream civil society colleagues have neglected.

Epilogue - Playing public health: Building the HIVe

Thomas Apperley & Christopher S Walsh


In thinking through the impact of digital media on how frontline workers, activists, practitioners and researchers understand and fight HIV and AIDS, it is important to acknowledge that digital media does not only provide new channels and strategies for communicating information around HIV prevention and education. It also establishes innovative domains for conceiving of, and building, ‘resilient communities’ like The HIVe. Such digital interventions are cultural assets that confront biomedical and behavioural approaches to HIV prevention and education. Immersive and social technologies, network ubiquity and low cost mobile phones provide new tools for aggregating, representing, collecting and disseminating community-based and led data that ‘plays’ public health differently. This play involves fore-fronting the success of social science HIV prevention and education against the essentialist logic of dominant biomedical approaches. ‘Playing public health’ provides an entirely new and comprehensive picture of the agency of the HIV virus that goes beyond the pathology of the individual. This paper proposes the goal of putting HIV prevention back into the ‘game’ of public health and playing it to win by building The HIVe


Advocacy Perspective: Sexuality, sex education and The HIVe in support of advocacy around the world

Ryan Ubuntu Olson and Ron MacInnis


Congratulations to this Special Issue of Digital Culture & Education (DCE) entitled ‘Building The HIVe’ for an innovative and unique approach to global HIV and AIDS advocacy, education and research. Building The HIVe clearly demonstrates the need for digital diversity related to sex education, HIV prevention, and support. It nurtures a strategic network and provides online spaces where ideas can be shared, developed and refined into good practices among researchers, community leaders, academics and policy makers. The HIVe is a digital culture that allows for the “community” to critically and creatively engage with HIV prevention as a solution (Singh & Walsh, this issue). It utilises technology to leverage glo-cal efforts to curb HIV and AIDS infection rates, along with supporting sexual minorities and persons living with and affected by HIV to participate meaningfully. The advocacy challenge for The HIVe is to engage advocates and activitists of varying skills, knowledge and understanding to ensure the new knowledge produced rapidly influences the policy and programming on HIV, sexuality and sex education across communities worldwide. At the same time, while we are availing digital technology to strengthen knowledge sharing and exchange, we should all be mindful of how we can support each other to model the acceptance, tolerance and diversity we wish to see in a just world. For us, this means acknowledging that for more effective HIV prevention and education strategies, we now need to educate communities through developing new and innovative platforms for communication in English/dominant and marginalised vernacular languages.

The public health perspective: Building The HIVe

Jonathan Elford


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.