geosocial networking apps and partner services for msm … · •geo-social networking apps and...
TRANSCRIPT
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NCSD Engage
The Marriage of Shoe Leather and Modern Technology: A Skills-Building Workshop for DIS
November 14, 2017
David Katz, PhD MPH
University of Washington
Public Health – Seattle & King County
Geosocial Networking Apps and Partner
Services for MSM
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Outline
• Discussion re: DIS experiences with apps
• Background
• Geo-Social Networking Apps and Partner Services (G-SNAPS) Study
- Focus groups
- Online survey
• Group discussion of results
• Conclusions
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DIS & Program Experiences?
• Have you used apps to trace or notify partners?
• How often are MSM telling you that they met their partner(s) on apps?
- What information do/can they give you about these partners?
- Are you or they able to notify the partners?
• How is your program working to address these issues?
• Has your program used apps for anything else?
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GSN Apps: A Barrier to Partner Services?
• Geosocial networking apps (GSN) are nearly ubiquitous among partner-
seeking MSM
• Pose unique challenges:
- Lack of stable profiles
- Messages stored for limited time
- Profiles only visible by location
- Partners may not exchange other contact information
• Like other IPS strategies:
- Potential user/owner concerns about health department presence
- Confidentiality concerns re: disclosing medical info on apps
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Building Healthy Online Communities
• Consortium of public health leaders and gay partner-seeking websites and apps
• Focus on HIV/STI prevention online
• Founded by Dan Wohlfeiler and Jen Hecht in 2014
• Website/app owners have expressed:
- Commitment to promote health of users
- Interest in collaborating with public health
- Desire for guidance re: health promotion
http://www.bhocpartners.org/
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Supporting App-Based Partner Notification
• Health department profiles on apps to conduct partner services and provide health info
• Apps can make it easier to find previous partners:
- Stable profiles
- Longer storage
- Provide lists of people users have chatted with
• Apps can make it easier to notify partners
- Provide anonymous message
- Contact information for health departments
- Info about partner services
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What Do We Need to Know?
How much of a
barrier are apps to
partner
notification?
What are
acceptable/preferred
approaches for PN
on apps?
What other health
services do MSM
want on apps?
Will having partner
notification on
apps affect app
use?
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GeoSocial Networking Apps and Partner Services Study
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Study Overview
• Collaboration between Building Healthy Online Communities and UW
• Objective: Inform partner notification strategies and sexual health service provision via apps
- Support health department policies and programming
- Inform app owners re: user interests and support of app-based partner notification
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Study Phases
Online focus group discussions
Community norms
Individual experiences
Inform survey
Online survey
Generalizable data
Validate qualitative results
Experiences in sub-populations
Qualitative Phase (1) Quantitative Phase (2)
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Phase 1: Focus Group
Discussions
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Focus group discussion: Methods
• 4 online discussions of 6-8 partners (28 total)
• Chat function of Zoom web conferencing
• Participants = U.S. MSM age 18+ who met a partner via GSN app in last year
• Recruited through Facebook & Instagram
• Stratified by age (≥35 v. <35) and history of HIV/STI
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Focus group discussion: Topics
Attitudes towards
partner services
How MSM meet
and communicate
with partners via
GSN apps
Thoughts re:
strategies for
notifying partners
using apps
Thoughts re:
health department
presence on apps
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Focus Group Summary
• Felt responsible for telling partners of HIV/STI exposures themselves
• Just want to be notified, regardless of who tells them or how
• Thought notification through health department profile was generally acceptable
- Need a way to verify authenticity of profile
- May be less acceptable to those living in rural communities or in anti-LGBTQ political environments
• Health departments need to build trust with the gay community on the apps
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Phase 2: Online Survey
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Online Survey: Methods
• Participants = U.S. MSM age 18+ who met a partner via GSN app in last year
• Recruited through Facebook, Instagram, and Snapchat
• Oversampled MSM of color
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Online Survey: Content
Demographics
HIV/STI testing/history
Sexual behavior
GSN app use
Partner notification via GSN
apps
Exchange of contact
information with partners on
apps
Health department presence
on apps
Health services offered via
apps
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Characteristics of 791 Survey Participants
Characteristic % or Median (IQR)
Age (Median, IQR) 28 (21-45)
Race
Non-Hispanic White 53%
Non-Hispanic Black 13%
Hispanic 28%
Other 6%
Census Region
Northeast 15%
Midwest 19%
South 49%
West 26%
HIV-positive 13%
History of STI 27%
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Assessing acceptability and preferences for app-
based notification
• Presented two scenarios:
1. Partner diagnosed with syphilis and notifies respondent
2. Respondent diagnosed with syphilis and notifies partner
• Present possible notification strategies
• Questions:
1. How comfortable would you be with each method
2. Rank the methods from most like to use/have partner use to least like to use/have partner use
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Notification strategies
Partner notifies you You notify partner
Method A: He tells you using his app
profile1: You tell partner using your profile
Method B: DIS tells you using health
department profile
2: DIS tells partner using your profile
3: DIS tells partner using health
department profile
Method C: You receive an anonymous
message in the app
4: Send anonymous, pre-written
message to partner by finding him in the
app on your own
5: Send anonymous, pre-written
message to the partner using the list
provided by the app
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Acceptability and preferences for being notified by
a partner with syphilis
10%
20%
70%
41%
57%
77%
0% 20% 40% 60% 80% 100%
Method C: You receive an anonymousmessage in the app
Method B: Health specialist tells youusing health department profile
Method A: He tells you using his appprofile
Comfortable with Most like partner to use
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Acceptability and preferences for notifying a
partner if diagnosed with syphilis
18%
6%
18%
8%
50%
74%
68%
71%
49%
65%
0% 20% 40% 60% 80% 100%
5: Anonymous message using listprovided by app
4: Anonymous message after findingpartner on app on your own
3: DIS tells using health departmentprofile
2: DIS tells using your profile
1: You tell using your profile
Comfortable with Most like to use
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Health department presence on apps
56%
26%
11%7%
0%
20%
40%
60%
80%
100%
Very comfortable Somewhatcomfortable
Somewhatuncomfortable
Veryuncomfortable
How comfortable would you be with your local health department having a profile
on your favorite dating/hookup app to provide health information and services?
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How often would partners met via apps is there
potential to contact using other info?
48%51%50% 48%
2% 1%0%
20%
40%
60%
80%
100%
Partner Self
Always Sometimes Never
Real first and last name, phone number, email address, home address, work, social media handle
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Other Contact Considerations
% of partners think could contact again 68%
% of partner blocked on apps 15%
Deleted profile in last year 57%
Keeps track of people might want to chat with again 73%
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Survey Summary
• Would prefer to be notified by partner but >half were comfortable being notified by DIS on app
• Would prefer to notify partners on own but generally comfortable with DIS and anonymous messaging in apps
• Most very or somewhat comfortable with health department presence on apps
• Two-thirds thought they could contact partners again
- Deleting accounts and blocking partners pose barriers
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Conclusions
• Health departments should consider conducting partner notification via the apps
- How profiles look matters
- Need to build trust with community
• Apps are not always a barrier to other partner notification methods
- Consider all other options & press for other contact info
• Opportunities for collaboration between public health and app owners to support app-based notification
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Acknowledgments
Research Team
- Marielle Goyette, UW
- Rob Fredericksen, UW
- Dan Wohlfeiler, BHOC
- Jen Hecht, BHOC
- Frank Strona, CDC
- Rachel Kachur, CDC
Others
- Maria Zlotorzynska, Emory
- Kelly Mayor, NCSD
Contact: [email protected]
Funding & Support
- National Coalition of STD Directors
- Building Healthy Online Communities
- Emory University Center for AIDS
Research