Online Social Networking for HIV Education and Prevention: A Mixed-Methods Analysis

Background: The purpose of this study is to use mixed (qualitative/quantitative) methods to determine (1) the feasibility and acceptability of using online social networking to facilitate HIV-related discussions and (2) the relationship between HIV-related online discussions and requests for a home-based HIV testing kit among men who have sex with men. Methods: Participants, primarily African American and Latino, were invited to join a secret group on the social networking Web site, Facebook. Peer leaders, trained in HIV prevention, posted HIV-related content. Participants were not obligated to respond to discussions or remain within the group. Participant public group conversations were qualitatively and thematically analyzed. Quantitative methods tested associations between qualitative data, participants' demographic information, and likelihood of requesting a home-based HIV testing kit. Results: Latino and African American participants (n = 57) voluntarily used Facebook to discuss the following HIV-related topics (n = 485 conversations): prevention and testing, knowledge, stigma, and advocacy. Older participants more frequently discussed prevention and testing, stigma, and advocacy, although younger participants more frequently discussed HIV knowledge-related conversations. As the study progressed, the proportion of messages related to prevention and testing and HIV stigma increased. Multivariate analysis showed that participants posting about HIV prevention and testing (compared with those who did not) were significantly more likely to request an HIV testing kit (odds ratio, 11.14; P = 0.001). Conclusions: Facebook can serve as an innovative forum to increase both HIV prevention discussions and HIV testing requests among at-risk groups.