AIDS fight turns to virtual outreach

Four years ago, researchers at the University of Minnesota developed a sexually explicit, interactive gaming and information website called Sexpulse to educate gay men about safer sex and HIV.

The provocative experiment came under fire from social conservatives, who called it government-supported gay porn and tried to kill its funding.

But the project survived, and this week the team will present its research on HIV and social media at the International AIDS Conference in Washington, D.C., which featured remarks Sunday by former President George W. Bush and U.S. Health Secretary Kathleen Sebelius.

Among the university's findings since Sexpulse launched:

•Men who seek other men online have twice as many partners and more unprotected sex than those who stick with the physical world.

•Traditional public health techniques, like pamphlets and outreach at gay bars, are losing relevance. Online meet-up services such as Adam4Adam.com are available 24/7, and mobile apps like Grindr, which use location tracking, have become the "gaydar" of the digital age. Of roughly 2,700 gay men surveyed by the U researchers, less than half had ever attended an offline HIV seminar.

•Gay men won't visit an AIDS website unless it's competitive with other websites. The U researchers asked gay men what would make an educational site attractive, and the majority said explicit images were a must.

As AIDS research enters its fourth decade, advocates are still seeking new tools to stop the disease and help its victims. The number of new HIV cases in Minnesota peaked in the early 1990s, but the virus continues to spread and threaten new populations.

Social media tools can be especially effective at reaching young gay men like Jay, a 19-year-old Minneapolis resident who learned that he was HIV-positive at 17.

By then, he had had dozens of partners. "I wasn't really surprised," he said. "But it took a lot out of me."

Jay, who did not want his last name published, often jumped into sexual relationships with older men before he learned he was HIV-positive. He rarely used condoms, and like many other gay men, he sometimes surfed the Internet to find a quick hook-up.

After depression, hope

Controlling the virus for people who are HIV-positive requires a strict daily regimen of medications. Jay sets an alarm on his phone as a reminder, but others are not as disciplined. Other research into social media has found that text messaging can help increase adherence to medication.

Whether social media tools will permanently change sexual behavior remains to be seen, but they have arrived at a timely moment.

HIV cases among gay and bisexual men have been on the rise in Minnesota, especially among African-born, black and Latino men, since around 2006. Although the reasons are not entirely understood, experts suspect a growing sense of complacency, in part because breakthroughs in anti-retroviral drugs mean that AIDS is no longer a death sentence.

Often, teenagers and young adults feel physically well, so they don't keep up with their medications, said Julio Mendez, an infectious disease specialist at the Mayo Clinic in Jacksonville, Fla. That puts them at risk of becoming drug-resistant and makes it more likely they'll pass the virus to other people, he said.

At the very least, the new social media platforms do seem to foster conversation.

But the Internet and social media also can be sources of stigmatizing messages that depict HIV-positive people as "dirty," said Phill Wilson, executive director of the Black AIDS Institute. That stigma "denies young people access to critical information that might save their lives," he said.

Jay says he's not yet comfortable telling most people he's gay, on or offline. "People commit suicide when they find out they have HIV," he said. "For me, it still feels awkward to sit and talk to everyone about it."