Social support exchanges in a social media community for people living with HIV/AIDS in China

Gay Dating Apps in China: Do They Alleviate or Exacerbate Loneliness? The Serial Mediation Effect of Perceived and Internalized Sexuality Stigma

Gay dating apps have become increasingly popular and been intensively used. However, studies that closely examine the effects of gay dating app usage on mental health outcomes are few. This study tackles an unsolved question on whether gay dating apps alleviate or exacerbate loneliness through perceptions of sexuality stigma. A cross-sectional online survey from 371 Chinese gay or bisexual men found that the intensity of gay dating app usage is positively associated with loneliness. The association between gay dating app usage intensity and loneliness is sequentially mediated by perceived sexuality stigma and internalized sexuality stigma. That is, increased intensity of gay dating app usage strengthens perceived sexuality stigma, which in turn reinforces internalized sexuality stigma, further exacerbating loneliness. This study echoes the "alone together" phenomena and uncovers the feasibility of using stigma perceptions as a mechanism to understand the mental health of gay dating app users.

The Interactive Effects of Parental Mediation Strategies in Preventing Cyberbullying on Social Media

Purpose

Applying the parental mediation theory, this study investigates the main effects and interactive effects of three parental social media strategies, ie, active mediation, restrictive mediation, and non-intrusive inspection, on cyberbullying among teenagers. A matched child-parent survey was conducted with 642 secondary-school students aged 13-18 and their parents in China.

Results

The results showed that active mediation was negatively associated with both cyberbullying victimization and perpetration. Restrictive mediation was not significantly associated with cyberbullying. Non-intrusive inspection was positively associated with cyberbullying perpetration but not associated with cyberbullying victimization. Moreover, the two-way interaction between active and restrictive mediation as well as the three-way interaction between the three parental mediation strategies significantly affected cyberbullying perpetration and victimization. Specifically, the combination of high-level active mediation and non-intrusive inspection with low-level restrictive mediation was the most effective strategy for preventing cyberbullying.

Conclusion

This finding significantly contributes to the parental mediation literature and provide theoretical guidelines for parental intervention to prevent cyberbullying among teenager.

Is social media a panacea for social marketing communication? A scoping review

Recognizing the potential of social media as an integral driver of communication that facilitates two-way conversations, this scoping review seeks to identify and synthesize salient benefits and challenges of social media usage reported in social marketing communication. Following a systematic literature review procedure, 31 social marketing studies utilizing social media communications channels were identified. The findings were thematically grouped under eight main topics: targeted reach and raising awareness, continuous consumer insight, ongoing interaction and dialogue, promoting behavior change, cost and time efficiency, discussing sensitive issues, building relationships and social media challenges. Identified taxonomies inform future research.

Identity-based hate and violence as trauma: Current research, clinical implications, and advocacy in a globally connected world

Hate-based violence is increasingly recognized as an urgent social justice and human rights issue that is pervasive across geographical and socioeconomic boundaries. There is a growing body of research that demonstrates the traumatic impact of hate-based violence on the victim's mental and physical health. This review focuses on examining scientific knowledge and prevalence data on identity-based hate and violence exposure. A framework for conceptualizing hate-based violence as a traumatic event or series of traumatic events is offered as a means to understand research findings and intervention approaches. The importance of research, advocacy, and human rights training is highlighted in the efforts to address the traumatic impact of identity-based hate and violence.

Health literacy among Malawian HIV-positive youth: a qualitative needs assessment and conceptualization

Despite growing evidence of the significance of health literacy in managing and coping with acquired immune deficiency syndrome (HIV), it is not yet an integrated part of HIV/AIDS-related health promotion research and practice in Africa. This article contributes to addressing the gap in research on health literacy and HIV in Sub-Saharan Africa. We aimed to assess health literacy-related needs of young people living with HIV (YPLHIV) and adapt existing health literacy frameworks to the context of HIV/AIDS in Malawi. We used focus group discussions to collect data from a sample of the membership of the national association of YPLHIV. Twenty-four HIV-positive youth (18-29 years) participated in focus group discussions. Participants came from three regions of Malawi. Additionally, we conducted three in-depth interviews with key informants. We used a thematic framework approach to analyse data in MAXQDA. We contextualized definitions of four dimensions of health literacy: functional, interactive, critical and distributed health literacy, which we used as an a priori analytical framework. To further contextualize the framework, we revised it iteratively throughout the analysis process. We identified the need for comprehensive information about HIV and sexual reproductive health, skills to interact with healthcare providers and navigate the health system, and skills to appraise information from different sources, among others. The identified needs were translated into nine action recommendations for the national association of YPLHIV, and with relevance within the wider HIV sector in Malawi and beyond. We found that the dimensions in our analytical framework operate on the individual, system and public policy levels.

Peer Group Focused eHealth Strategies to Promote HIV Prevention, Testing, and Care Engagement

PURPOSE OF REVIEW

Electronic communication platforms are increasingly used to support all steps of the HIV care cascade (an approach defined as eHealth). Most studies have employed individual-level approaches in which participants are connected with information, reminders, or a healthcare worker. Recent growth in use of social media platforms, which create digital communities, has created an opportunity to leverage virtual peer-to-peer connection to improve HIV prevention and care. In this article, we describe the current landscape of peer group eHealth interventions in the HIV field, based on a review of published literature, an online survey of unpublished ongoing work, and discussions with practitioners in the field in an in-person workshop.

RECENT FINDINGS

We identified 45 published articles and 12 ongoing projects meeting our inclusion criteria. Most reports were formative or observational; only three randomized evaluations of two interventions were reported. Studies indicated that use of peer group eHealth interventions is acceptable and has unique potential to influence health behaviors, but participants reported privacy concerns. Evaluations of health outcomes of peer group eHealth interventions show promising data, but more rigorous evaluations are needed. Development of group eHealth interventions presents unique technological, practical, and ethical challenges. Intervention design must consider privacy and data sovereignty concerns, and respond to rapid changes in platform use. Innovative development of open-source tools with high privacy standards is needed.

Exchanges in a Virtual Environment for Diabetes Self-Management Education and Support: Social Network Analysis

BACKGROUND

Diabetes remains a major health problem in the United States, affecting an estimated 10.5% of the population. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and clinical outcomes. Widespread internet connectivity facilitates the use of eHealth interventions, which positively impacts knowledge, social support, and clinical and behavioral outcomes. In particular, diabetes interventions based on virtual environments have the potential to improve diabetes self-efficacy and support, while being highly feasible and usable. However, little is known about the patterns of social interactions and support taking place within type 2 diabetes-specific virtual communities.

OBJECTIVE

The objective of this study was to examine social support exchanges from a type 2 diabetes self-management education and support intervention that was delivered via a virtual environment.

METHODS

Data comprised virtual environment-mediated synchronous interactions among participants and between participants and providers from an intervention for type 2 diabetes self-management education and support. Network data derived from such social interactions were used to create networks to analyze patterns of social support exchange with the lens of social network analysis. Additionally, network correlations were used to explore associations between social support networks.

RESULTS

The findings revealed structural differences between support networks, as well as key network characteristics of supportive interactions facilitated by the intervention. Emotional and appraisal support networks are the larger, most centralized, and most active networks, suggesting that virtual communities can be good sources for these types of support. In addition, appraisal and instrumental support networks are more connected, suggesting that members of virtual communities are more likely to engage in larger group interactions where these types of support can be exchanged. Lastly, network correlations suggest that participants who exchange emotional support are likely to exchange appraisal or instrumental support, and participants who exchange appraisal support are likely to exchange instrumental support.

CONCLUSIONS

Social interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support. Network data can provide valuable insights into the design of novel and effective eHealth interventions given the unique opportunity virtual environments have facilitating realistic environments that are effective and sustainable, where social interactions can be leveraged to achieve diverse health goals.

HIV-Related Stigma Among People Living With HIV in Liangshan Yi Autonomous Prefecture, China

HIV-related stigma is a worldwide phenomenon that can lead to a series of negative outcomes. Our aim was to determine the prevalence of HIV-related stigma and its associated factors among people living with HIV in Liangshan Yi Autonomous Prefecture, China. A cross-sectional study was performed between September and December 2017. A total of 318 participants were included. The mean participant score on the Berger HIV Stigma Scale was 105.13 (SD = 21.58), showing a moderate level of stigma. In multivariable regression analysis, HIV-related stigma was more severe for participants with no religious beliefs, a shorter period since HIV diagnosis, nondisclosure of HIV status to sexual partners or friends, more affective support, and less emotional/information support. To reduce HIV-related stigma, health care providers should draw more attention to targeted interventions to assist those who may have a greater risk of stigma.

Using EPPM to Evaluate the Effectiveness of Fear Appeal Messages Across Different Media Outlets to Increase the Intention of Breast Self-Examination Among Chinese Women

The current study aims to examine the influence of fear appeal messages across different media outlets on Chinese women's intention of breast self-examination using the Extended Parallel Processing Model (EPPM). A two-by-two-by-two factorial experiment is designed to examine the effect of threat and efficacy level of stimulus on different media outlets on behavioral intention. The sample includes 488 Chinese women who are between 25 and 50 years old. The results revealed that there were significant main effects of both threat and efficacy on the intention to performing breast self-examination. Moreover, the significant two-way interaction effect between threat and efficacy was detected, which indicated that Chinese women who received messages containing both high threat and high efficacy had the highest intention of breast self-examination. Besides, the results demonstrated that there was no significant difference in the effectiveness of fear appeal messages on between traditional and social media.

Social Support Seeking on Social Media Among Chinese Gay Men Living with HIV/AIDS: The Role of Perceived Threat

Background: Due to a double stigma against HIV/AIDS and homosexuality, gay men living with HIV/AIDS (GMLHA) have used social media to exchange social support. The current study aims to examine the influence of perceived threat on seeking social support on social media among Chinese GMLHA. Methods: First, Weibo posts from 133 GMLHA were content analyzed to identify the perceived severity of HIV infection and perceived severity of stigma, as well as their social support seeking on Weibo. Then, a 2 × 2 (perceived severity of HIV infection [present, absent] × perceived severity of stigma [present, absent]) between-subject multivariate analysis of variance with social support seeking as the dependent variable was performed. Results: Perceived severity of HIV infection and perceived severity of stigma had main effects on different kinds of social support seeking. Moreover, GMLHA who expressed both perceived severity of HIV infection and perceived severity of stigma on Weibo posted the greatest number of emotional support-seeking messages. Conclusions: This study revealed that perceived threat was one of the motivations of GMLHA to seek online social support.

Weibo friends with benefits for people live with HIV/AIDS? The implications of Weibo use for enacted social support, perceived social support and health outcomes

With the increasing popularity of social media, many people who live with HIV/AIDS (PLWHA) seek social support via Weibo in China. The question arises here as to whether PLWHA perceive higher levels of social support via Weibo than in offline relationships, whether perceived online social support (PSS-ON) is associated with enacted social support, and whether it is effective in predicting better health outcomes. Based on self-reported data from 432 Chinese PLWHA, the authors investigated perceived offline social support (PSS-OFF), PSS-ON, enacted social support, and health outcomes. The empirical results indicate that PSS-ON is significantly associated with employment status, CD4 cell counts, and PSS-OFF. PSS-ON is higher than PSS-OFF for PLWHA, and close Weibo friends are the main source of PSS-ON. Enacted receiving social support and giving social support are relevant, and they contribute as individual predictors of PSS-ON. PSS-ON and PSS-OFF are distinct constructs in predicting the subjective well-being of PLWHA, while PSS-ON is not related to adherence to antiretroviral therapy (ART) and risky sexual behavior in this study. Limitations and future directions are discussed.

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites

Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

Social Support in a Virtual Community: Analysis of a Clinic-Affiliated Online Support Group for Persons Living with HIV/AIDS

Social support can improve outcomes for people living with HIV (PLWH) and could be provided through online support groups. The Positive Links smartphone app is a multicomponent intervention that allows users to interact in a clinic-affiliated anonymous online support group. We investigated how social support was exchanged in a group of 55 participants over 8 months, using an adaptation of the Social Support Behavior Code. Participant interviews assessed their experiences and perceptions of the app. Of 840 posts analyzed, 115 (14 %) were coded as eliciting social support and 433 (52 %) as providing social support. Messages providing support were predominantly emotional (41 %), followed by network (27 %), esteem (24 %), informational (18 %), and instrumental (2 %) support. Participants perceived connection and support as key benefits of the app. Technical issues and interpersonal barriers limited some participants in fully using the app. Mobile technology offers a useful tool to reach populations with barriers to in-person support and may improve care for PLWH.

Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey

Background

Many interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors.

Objective

The objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM).

Methods

In July 2016, a Web-based survey was conducted to recruit MSM in 8 Chinese cities through Blued (Blue City Holdings Ltd.), the world’s largest gay mobile phone app. Data on sociodemographic variables, social media use platforms and behaviors, sexual behaviors, and HIV testing histories were collected. HIV testing–related social media use was defined as having ever engaged with HIV testing content on social media, which was further divided into observing (ie, receiving), endorsing (eg, liking and sharing), and contributing (eg, posting or commenting on HIV testing materials). Confirmatory factor analysis (CFA) was conducted to determine the best division of HIV testing–related social media use. Univariate and multivariable logistic regressions were used to examine the association between HIV testing–related social media use and HIV testing behaviors.

Results

A total of 2105 individuals participated in the survey. Among them, 46.75% (984) were under the age of 24 years, 35.43% (746) had high school education or less, and 47.74% (587) had condomless sex in the last 3 months. More than half of the respondents (58.14%, 1224/2105) reported HIV testing–related social media use. Additionally, HIV testing–related social media use, especially on multifunctional platforms such as WeChat, was found to be associated with recent HIV testing (adjusted odds ratio [aOR] 2.32, 95% CI 1.66-3.24). Contributing on social media was correlated with recent HIV testing (aOR 2.10, 95% CI 1.40-3.16), but neither observing (aOR 0.66, 95% CI 0.38-1.15) nor endorsing (aOR 1.29, 95% CI 0.88-1.90) were correlated.

Conclusions

Our data suggest that social media use, particularly on multifunctional platforms such as WeChat and with contributing behaviors, is correlated with HIV testing among MSM in China. Campaigns that promote active participant contribution on social media beyond passive observation and endorsement of promotional materials are needed. This study has implications for the design and implementation of social media interventions to promote HIV testing.

Understanding interactions in virtual HIV communities: a social network analysis approach

This study investigated the driving mechanism of building interaction ties among the people living with HIV/AIDS in one of the largest virtual HIV communities in China using social network analysis. Specifically, we explained the probability of forming interaction ties with homophily and popularity characteristics. The exponential random graph modeling results showed that members in this community tend to form homophilous ties in terms of shared location and interests. Moreover, we found a tendency away from popularity effect. This suggests that in this community, resources and information were not disproportionally received by a few of members, which could be beneficial to the overall community.