Commentary

Social Nets Tied to HIV Increase in Philippines

Social media has huge potential for doing good -- or rather, for enabling people to do good. But it also enables plenty of, um, not-so-good. Just consider a recent study from the Philippines’ Department of Health, which linked social networks to a rise in cases of HIV in that country.

Social networks are contributing to the spread of HIV in the Philippines principally by enabling Filipino men who have sex with men (MSM, in clinical parlance) to seek each other out and set up meetings for casual -- and sometimes anonymous -- sex online. In the Philippines, as in the U.S. and elsewhere, casual or anonymous sex is often also unsafe sex.

In a survey of 180 Filipino MSM, 124 said they regularly used online social networks for dating and sex, and 133 said they had sex with people they met through an online network. A majority of these respondents said they did not use a condom consistently.

An article in the Philippine Daily Inquirer quoted Dr. Eric Tayag, director of the country’s National Epidemiology Center, as saying: “Through online networking sites, MSM can meet without fear of negative social consequences.”

Indeed, this phenomenon illustrates the dual nature of social media. On one hand, it can have a liberating effect for gay men in the Philippines, where social and religious mores often force them to hide their identities and activities. On the other hand, by allowing them to maintain complete anonymity it also encourages unsafe behavior, and may make it harder for health care professionals to reach them with safe sex messages (although promoting safe sex in ads on the social networks might be a way to turn the phenomenon to advantage).

The same basic factors can be seen at work in other parts of the world, including the U.S. Last month I wrote about a report from the Houston Department of Health and Human Services which blamed social media for a rise in syphilis cases in Harris County -- again by facilitating unsafe sex between MSM. Minority populations are disproportionately affected, with almost 60% of new cases in Harris County involving African-American men, and 23% involving Hispanics. Previous studies have shown that STD transmission rates are higher among closeted African-American men, who are less likely to use condoms when having anonymous sex “on the DL” (“down-low”).

There’s also some good news out there: as needed in a previous post, a new article published in the November issue of the American Journal of Preventive Medicine suggests that social media can increase condom use by young adults -- at least for a while. The article, authored by Sheana S. Bull, Ph.D., M.P.H. and several colleagues from the from the Colorado School of Public Health in Denver, describes a study which involved recruiting a total of 1,758 participants ages 16-25, in large part through existing networks of friends (a core group was recruited and then asked to recruit three friends, who also recruited three friends, and so on). A test group was then exposed to safe sex and STD-prevention messages on Facebook via an online community called Just/Us, including video links, quizzes, blogs and discussion threads; meanwhile the control group was exposed to news and discussion around topics of general interest to young adults.

A follow-up survey conducted two months later determined that the group exposed to safe sex messages was more likely to use condoms, with 68% of the test group reporting using condoms versus 56% for the control group. But the effect tailed off rapidly, with no significant difference between the groups at the six month mark.

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