What is the activity?
Many agencies delivering HIV prevention interventions to gay men, bisexual men and other men that have sex with men have a website that describes their work and promotes their agency.
More recently, dedicated websites targeting MSM have been developed as an intervention in themselves or as an element of a particular campaign. Good online interventions aim to make the most of the setting, by providing appropriate links and referrals, and allowing some interactivity. This means they are more than simply a repeat of text that is already available in printed interventions such as small media or mass media.
Strengths and limitations
One of the major beneﬁts of any website is that it extends the potential reach of interventions beyond what face-to-face interactions can achieve. The potential to offer people up-to-date, relevant referrals to other sources of information and services is vast, and can be tailored speciﬁcally to their own needs. Also, those who may be less likely to approach workers or services directly (due to embarrassment or concerns about stigma) may access information in the relative anonymity of the internet. Online resources can be interactive, and are also not necessarily linear. This means that people can directly access an element of an intervention that is of greatest use to them personally.
With careful attention to design, the needs of people with diverse linguistic and disability access requirements can be met online at a comparatively low cost.
Online interventions will not reach those without computer skills, or who lack easy access to the internet. However, internet access in the home is increasingly common in the UK, and as many other people will use internet cafés, places of employment, libraries or educational institutions to go online
Where does it happen?
Web-based interventions take place on the internet. What requires close attention, however, is what particular websites or web-searches will encourage the target audience to visit the site. Even the best websites will be of limited value if there is little attention paid to their promotion.
Frequently delivered alongside ...
Issues to consider
Simply placing materials designed for a print-based (small media or mass media) campaign on the internet is not necessarily effective. Playing to the strengths of the medium requires interactive websites which add value and attract users.
Exciting and innovative websites are of no use if the target audience is not aware of their existence. Careful attention must be paid to recruitment and motivation to spend time on the website. This will require an advertising strategy that is diverse, carefully targeted, and that occurs mainly online, as people click-through to websites rather than remembering to follow-up on websites that they have heard about through printed (ofﬂine) media. This will require extensive research about the internet habits and most popular sites among the target group before planning promotion. Where funding means that the target audience covers only a very small geographic area, a dedicated website is unlikely to be the best means of reaching people.
Website hosting and updating arrangements must be in place for the duration of an intervention and planned from the outset. Systems for error reporting are also essential.
Aims and outcomes
The aims and likely outcomes of websites are usually knowledge-based, but they can address motivation and simple skills such as using a condom appropriately, and they may help to alter attitudes and perceived norms of behaviour. The list below offers some examples of the aims and outcomes associated with websites, but is not exhaustive.
- Increased motivation to avoid HIV exposure and transmission (see associated choice and some of the basic information, opportunities and resources and skills needed).
- Increased uptake of STI screening and HIV testing (see associated choice and potential aims associated with HIV testing knowledge; STI knowledge; and the testing opportunities and skills required).
- Increased understanding that different sexual activities carry differing risks of HIV transmission (see associated choices such as avoiding anal intercourse or using condoms for anal intercourse and aims such as knowing the risks associated with anal intercourse and the benefits of condom use).
- Increased conﬁdence to openly discuss sex, sexuality, and sexual health with partners and in social networks, including the resources and skills to share information with partners and to decline sexual contact.
- Increased confidence to decline any unwanted sexual activity or defer having new sexual partners and associated aims, such as knowing the increased risks associated with having higher numbers of male partners.
- Increased understanding of the alternatives to risky behaviour (see associated choices such as avoiding anal intercourse or using condoms for anal intercourse and aims such as knowing the risks associated with anal intercourse and the benefits of condom use).
- Increased control over involvement in HIV exposure and transmission in their lives (see associated choices such as declining or deferring a new sexual partner or choosing monogamous rather than open regular relationships with men) and aims such as knowing the increasing risks associated with having higher numbers of male partners.
- Increased understanding of means of HIV risk reduction when unprotected anal intercourse does occur (see associated choices such as withdrawal before ejaculation and the knowledge and skills required).
- Increased requests for (and uptake of) PEP following sexual exposure to HIV (see associated choice and the potential aims associated with PEP knowledge, opportunities and skills).
Monitoring and evaluation
In terms of outcomes and impact, very little priority is given to evaluation of websites. Hoever, trafﬁc to a website can be easily monitored, and it is also possible to keep track of what referring / advertising websites the user arrived from. Funders may want evidence that website users are within a speciﬁc geographic area, meaning that recording numbers of visitors, or page views, alone is probably not sufﬁcient.
Site trafﬁc can also be monitored in relation to particular distribution spikes pertaining to different forms of promotion (such as online, or face-to-face interventions). Simple online evaluation tools can be used to ask a random (or purposefully sampled) selection of visitors to the website about their views on the site, and what they found to be of most and least use. Results can be viewed and analysed immediately, and can feed into ongoing development of the website.
Page last updated: 17 June 2013
YouTube and Twitter
As use and awareness of social media increases, Yorkshire MESMAC has developed its services to MSM in West and North Yorkshire by communicating with men via Twitter and by posting short films on YouTube. Both provide information on how to access Yorkshire MESMAC services, links to news stories, and up-to-date information, including current campaigns such as Count Me In. Not only are these social media a contemporary way ofcommunicating, they allow MESMAC to reach individuals who may not access traditional services or their local gay scene. This is especially important in an area with a large and dispersed rural population.
Terrence Higgins Trust's MyHIV website for people with diagnosed HIV can be tailored according to the users needs and aspires to put users at the centre of their HIV management. Once registered, users can track their CD4 and viral load counts; enter details of their HIV medications ; and programme electronic reminders to take pills. Moderated online forums and message boards allow users to discuss disclosure of HIV status; sexual health; and navigating the welfare benefits system. Trained health advisors can be contacted via email or phone and by using web cams, with a facility for online appointment reminders.
Count Me In
GMFAs Count Me In campaign asks gay men to commit to a five point action plan to reduce HIV. Video clips posted on Youtube and Facebook show men’s accounts of why preventing HIV infection is important them, and the challenges and solutions they face. Men are invited to post their own videos and to comment on current videos. At the heart of the intervention is an understanding that preventing HIV comes from within communities of gay men. Men are invited to sign-up to publically support the action plan and to ask their friends to do the same.
CHAPS THIVK website
In summer 2009 Terrence Higgins Trust launched the Think HIV (THIVK) website as part of a CHAPS mass media campaign to promote HIV testing services and the benefits of HIV testing. The website brought information into one site that had previously been spread across different websites and allowed for the download of small media resources on HIV and sexual health. The site included ‘new’ information on symptoms of HIV sero-conversion illness and the availability of rapid HIV tests. Users can enter their postcode or location to find their nearest local sexual health clinic.