(see Poster Gallery) Attitudes and Experiences Towards Online Sexual Health Outreach Workers Among Gay, Bisexual, Two-Spirit and Other Men Who Have Sex with Men (GB2M)

Background and Purpose: Since HIV/STI rates remain a disparity among GB2M, health promotion agencies are using online sexual health outreach (OSHO) to provide access to sexual health information/services. OSHO involves having online outreach workers (OOWs) available to provide health information in online socio-sexual environments such as websites (e.g., Squirt.org) and applications (e.g., Grindr, Scruff). This mixed-method study sought to understand GB2M’s attitudes towards and experiences with OSHO/OOWs.

Methods: Participants were 910 GB2M who completed a baseline questionnaire and lived or worked in Ontario, Canada. They were asked about their willingness to interact with an OOW on online platforms. Participants with a previous interaction with an OOW were also queried on that experience, including the content and quality of their latest interaction. In the qualitative arm of the study, 79 participants (overrecruited for those with OSHO/OOW experience) completed semi-structured interviews to further describe their experiences with OSHO. Frequency analyses were run with quantitative data and thematic analysis was conducted with the qualitative interview data.

Results: Among all 910 GBSM, 468 (51.4%) stated they were comfortable being contacted by an OOW on a hook-up website, 521 (57.3%) on a hook-up app (e.g., Grindr, Scruff). Most (n=484;53.2%) felt any interaction with OSHO/OOW would be private and they could discuss sex/sexual health.

Interactions with OSHO/OOW were reported by 83 (9.1%) participants. Most were gay (62.7%), White (63.9%), non-immigrants (72.3%), HIV-negative (66.3%). The most frequent topics reported were: healthy sex (36.1%); HIV/STI testing (36.1%), prevention (28.9%), transmission risk (18.1%), viral load (being undetectable;15.7%), and PrEP (20.5%). Participants rated their latest OOW interaction “easy to understand” (67.5%), “relevant” (78.3%), and “up-to-date” (57.8%). Participants reported behavioral outcomes because of OSHO including having sought: STI testing (49.1%), HIV testing (49.1%), increased condom usage (30.1%), PrEP (24.1%), PEP (13.3%), and counseling (20.2%). Also, 16.9% sought treatment for non-HIV STIs and 10.8% sought treatment for HIV.

Among the 79 interviewees, 22 (28%) reported OSHO/OOW experience. Results from the thematic analysis mostly aligned with the survey findings. Primary themes related to (1) the content of OSHO/OOW interactions and (2) the feelings participants reported (positive/negative/neutral) about OOWs being in online GB2M socio-sexual spaces, with the majority of views being positive. The main content of interactions involved HIV/STI testing, and general sexual health information. Regarding attitudes towards OSHO in socio-sexual online spaces, participants with positive attitudes stated OSHO was a (1) beneficial resource that can provide (2) anonymous and (3) accessible health information. They also reported OSHO was particularly salient in (4) already-sexualized online spaces, where health information dissemination was deemed appropriate/useful. Negative attitudes towards OSHO were (1) concerns with confidentiality, (2) a desire to not interact with OOWs, and (3) the online sexualized environment was not appropriate for OSHO.

Conclusions and Implications: These findings offer insights into guidance for OSHO with GB2M and suggest most GB2M are open to having OOWs available as a resource in socio-sexualized online spaces. The results provide insights into the most frequent content of past interactions and suggested guidelines for OSHO best practices.