Find articles by Philip A. Karina Santamaria Find articles by E. We present the advertising prices and corporate social responsibility CSR programs of the top five sites used by newly diagnosed HIV-positive MSM to meet sexual partners: Craigslist offered universal free advertising.
Scruff offered free online advertising to selected nonprofit organizations. Grindr and Manhunt offered reduced, but widely varying, pricing for nonprofit advertisers. Opportunities for public health agencies to promote HIV-related health messaging on these sites were limited. Partnering with hookup sites to reach high-risk MSM for HIV prevention and treatment messaging is an important public health opportunity for reducing disease transmission risks in Rhode Island and across the United States.
MSM are up to seven times more likely than non-MSM to have sex with a partner they met online, 5 and an estimated 3—6 million MSM meet sexual partners using Internet-based technology. A study found that MSM who used apps to meet sexual partners had greater odds of testing positive for gonorrhea and chlamydia compared with MSM who did not meet their partners online, but did not find any increased risk for syphilis or HIV.
We then contacted the most commonly identified hookup sites about pricing for online advertising for HIV prevention and testing messages, as well as their corporate social responsibility CSR programs. CSR focuses on implementing or supporting programs that take responsibility for the company's actions and encourage or support a positive impact on the community.
Patients were recruited from all major HIV outpatient clinics in the state. Demographic, behavioral, and laboratory information were obtained from standardized survey questions and review of clinical data. We conducted individual interviews to collect in-depth contextual data, including where patients met sexual partners in the 12 months preceding their HIV diagnosis and where they met the person they believed infected them with HIV.
Interviews were conducted in person by research staff members at The Miriam Hospital Immunology Center, which was the primary study site. Based on in-depth interviews, we determined the single most likely risk factor for HIV infection for each patient based on the following risk groups: MSM, males who have sex with females, females who have sex with males, and injection drug users IDUs.
Groups were mutually exclusive; IDUs engaging in one of the specified categories of sexual behavior were grouped on the basis of IDU behavior. We requested pricing estimates for advertising, including promoting information about HIV testing and treatment, PrEP and postexposure prophylaxis, and other prevention messaging.
Our inquiries focused on pricing for various advertising options, including banner advertisements, bulk e-mails, and pop-up advertisements. This term refers to the percentage of all online content and conversations for a message relative to other messages.
Some companies base pricing on share of voice, while others base pricing on CPM. Open in a separate window aA total of 74 people were newly diagnosed with HIV in Rhode Island in , of whom 70 people were interviewed and included in the analysis. Percentages may not total to due to rounding. Pricing and services offered by these five hookup sites varied widely. Only Craigslist and Scruff provided mechanisms for free public health advertising, either for all public health organizations Craigslist or for selected nonprofit organizations on an application basis Scruff Table 2.
Scruff had a formal CSR policy readily accessible to the public and was the only site with a formal program for free public health advertising for nonprofit organizations.
Characteristics of hookup websites and apps used by newly diagnosed HIV-positive men who have sex with men, Rhode Island, aTwenty-six of 43 newly diagnosed MSM reported meeting sexual partners online in the 12 months prior to HIV diagnosis. Cost per thousand impressions is a metric used to price the cost per number of consumer views of messages; this term refers to the total price of advertising per 1, views. Advertise with Grindr [cited Dec 30]. Benevolads [cited Dec 30].
Craigslist [cited Dec 30]. Grindr also offered broadcast messaging, or pop-up text advertisements, viewable at first login to the mobile app. Grindr did not offer e-mail advertising Table 2. Manhunt offered advertising at a lower contract minimum to nonprofit organizations than rates for corporate advertisers.
Manhunt did not offer pop-up advertising on desktop or mobile devices. Adam4Adam did not respond to multiple inquiries about advertising prices. Although partnerships between health-promotion agencies and hookup sites offer an opportunity to reach high-risk MSM, we encountered challenges in communicating with companies. For example, one company did not respond to multiple inquiries about pricing and CSR programs. Although Craigslist offers free advertising and Scruff moved toward a free advertising model for selected organizations following an application process, many companies' current prices may be prohibitively high for health-promotion agencies and may present barriers for disseminating prevention messaging.
Given the frequent role of hookup sites for meeting sexual partners among newly diagnosed MSM and their potential association with HIV and other sexually transmitted infection STI risks, health-promotion agencies should do more to engage hookup companies in promoting prevention efforts.
Grindr subsequently announced it would list maps and resources to help Grindr users identify local PrEP providers. In , Scruff commenced its Benevolads advertising program, which is marketed as free, geo-targeted advertising for nonprofits to create, publish, and track data on the reach of advertisements directed toward the MSM community.
Improved and expanded engagement in HIV prevention will require increased spending on messaging by private and public sectors. Our findings suggest that hookup sites already reach populations at highest risk, and public health partnerships should capitalize on this opportunity to promote prevention messaging as well as enhanced screening and treatment services. Implementation science should explore various approaches. Given that most users visit hookup sites with the express purpose of identifying sexual partners, prevention messaging that leads with sex-positive information may resonate more with users than messages that lead or focus exclusively on risk reduction.
Communication strategies that support companies' business goals while appealing to their users and allowing for delivery of important prevention messaging are needed. It may also be important to promote messages that stimulate demand for screening and treatment services at local clinics. Further research is needed to explore which messages resonate most with consumers and respond to their sexual health needs; this research will require collaboration across sectors, including government agencies, hookup sites, users, and researchers.
Our results suggest a need for broad-based CSR programs that focus on reducing disease transmission among MSM using hookup sites. The tobacco, soft drink, and alcohol industries have almost universally adopted CSR programs in response to consumer demands.
Additionally, advertising prices for many companies might be prohibitively high for health promotion. As part of CSR policies, companies should implement deep discounts for advertising for government and nonprofit agencies whose missions are related to health promotion. Limitations This study was subject to several limitations. Patient interviews relied on self-reported behaviors.
To help mitigate recall bias, we encouraged respondents to comment on how they met sexual partners in the previous 12 months. Our results may be subject to recall bias, particularly when we asked individuals who were diagnosed late in the course of their disease where they met the partner who may have infected them.
We also did not ask about frequency of hookup site use and associated coital frequency, which limited our ability to link HIV transmission to specific hookup sites. Additionally, because we were focused on the hookup sites reported by participants rather than sites used by MSM nationwide, it is unclear how representative our findings may be for the broader MSM community.
Lastly, between the time we collected data and the time the study was published, company policies and app use may have changed, particularly given the rapid pace of change in apps.
We nevertheless believe that our findings suggest important and timely opportunities to enhance HIV prevention by partnering with online sites. Results from this study suggest that hookup sites' digital platforms may present opportunities for social marketing programs focused on reducing HIV transmission and engaging HIV-positive men in care earlier in the course of their infection.
These results highlight a public health crisis among MSM and are not intended to further stigmatize an already marginalized community in need of public health resources.
We hope our findings are used as a call to action for greater public health collaboration to address the sexual health needs of MSM. Ubiquitous use of hookup sites nationwide warrants urgent and nationwide public policy attention, innovative research, programmatic partnerships, and investment from the public and private sectors.
Amy Nunn has received consulting fees from Mylan Inc. HIV among gay and bisexual men. Barebacking among MSM Internet users. HIV and sexually transmitted infection risk behaviors among men seeking sex with men on-line. Am J Public Health. Chan J, Ghose A. The future of Internet-based HIV prevention: Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men.
Characteristics of recently HIV-infected men who use the Internet to find male sex partners and sexual practices with those partners. J Acquir Immune Defic Syndr. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an Internet social networking site. Division of Infectious Disease and Epidemiology; Rhode Island Department of Health. Rhode Island Department of Health; Advertising and integrating brand promotion.
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