Cruising Counts: Examining the Delivery of Online Sexual Health Outreach for Gay and Bisexual Men in Ontario

Background: The Internet has increasingly become the most common tool for gay and bisexual men (GBM) to find sexual partners. As GBM face the highest burden of HIV infections in North America, some AIDS Service Organizations (ASOs) have started to provide online outreach through socio-sexual networking websites and mobile applications to optimize HIV prevention services for this population. Little is known about the challenges and opportunities this online outreach provides.  In addition, limited research has been conducted on evaluation practices and parameters used to indicate success of this innovative approach to HIV prevention. The aim of this analysis was to investigate the experiences of ASOs and other community-based organizations (CBOs) across Ontario in the planning and implementation of online outreach services for GBM communities.

Methods: From November 2013 to January 2014, ASO/CBO online outreach providers and managers (n = 22) were recruited to complete a 1-hour in-person/telephone interview to explore in-depth their experiences with, and perspectives on, delivering online outreach services for GBM in Ontario. Participants were asked to identify the organizational structures, policies, or programs that are supportive of this work and were asked to comment on the capacities, opportunities, barriers, and challenges for providing online outreach. Participants also commented on their evaluation practices and the parameters they used to indicate success. Interviews were digitally recorded and transcribed verbatim. Thematic analyses were conducted using NVivo10 and were primarily framed by a SWOT analysis (Strengths, Weaknesses, Opportunities and Threats or Challenges).

Results: The findings indicate that service providers consider online outreach a vital tool for HIV prevention. Providers highlighted the strengths and advantages (anonymity, engaging hard-to-reach GBM) of online outreach over face-to-face outreach. Across interviews, the following themes were identified as barriers to providing effective online outreach services: staff capacity and training, confidentiality and privacy of online interactions, safety of participants and staff, uncertainty of best practices, and lack of updated HIV prevention tools.

Conclusion & Implications: This is the first study of its kind to examine GBM’s online outreach contexts from the providers’ perspective. The findings highlight the barriers to and advantages of providing online outreach for GBM. These findings can inform HIV policy makers and funders on how to support ASOs and increase the effectiveness of online outreach to diverse GBM communities. These findings can assist social work and public health practitioners in “meeting clients where they are” – online. This analysis: (1) offers a nuanced understanding of the challenges associated with research and program evaluations of online HIV prevention and outreach services for GBM; and (2) provides a platform to foster dialogues with researchers, community providers and funders to recognize online outreach as an essential HIV prevention service for GBM communities globally.