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Thursday, December 9, 2010

HIV prevention efforts go mobile

By Matt Baume -

AIDS advocacy organizations are increasingly building high-tech online tools to keep safer sex at the top of San Franciscans’ minds.

Among those new tools are a sex-education app for the iPhone and iPad, condom-locators, a conference on youth media and sexual health, and a revamped website for the San Francisco AIDS foundation.

The digital emphasis coincides with two new studies in the journal AIDS and Behavior that indicate a need for more online outreach.

One study found that men who pursue "online partnerships" are more likely to engage in unsafe sex. Although Internet hookups themselves do not necessarily cause riskier behavior, the authors concluded, online usage may be a "marker" of a tendency towards heightened risk-taking.

Another study found that 85 percent of men who use the Internet to find partners check their partners’ online profiles to determine their HIV status. A close percentage ask verbally prior to sex, but nearly half ask after sex and nearly a third of Internet-using gay men simply guess.

Reaching and educating that third, the study concluded, is critical to stemming the tide of HIV transmissions.

San Francisco’s Department of Public Health hopes to do just that. Local health officials recently unveiled STD411, a new app for the iPhone and iPad that provides users with quick access to information about sexual practices and diseases. The app cost about $4,000 to develop and was paid for with a federal grant from the Centers for Disease Control and Prevention.

Users are presented with a chart that indicates the risk of transmitting various STDs based on different sex acts. An array of multicolored flashing condoms indicates risk levels.

For example, users who tap "oral sex" along with "syphilis" receive the message, "if there is no sore, there may still be an infection. Having routine STD screening every 3 to 6 months is the best way to know."

STD411 can be downloaded from the iTunes store or at

On a recent evening in the Castro, prospective users checked out the new app and mostly gave it high marks.

"It’s a great idea," said San Francisco resident Benni Rodriguez. As he scrolled through the list of STDs, he added, "There’s some stuff I didn’t know about."

"I like that it’s an app," said Brittney Caraway, visiting the Castro from Las Vegas. Caraway pointed out that the interface isn’t intuitive, since the explanation of the color-coded condoms is difficult to find and there’s no indication that lists are scrollable and tappable. As she spent a few minutes browsing the STDs and sex acts, she added, "I don’t even know what half of these things are."

Phillip and Liam, two young men who asked to be identified only by first name, were surprised to learn that even masturbation can carry a risk of transmitting syphilis if sex toys are shared.

They spent a few minutes engrossed by STD411 before closing it with a shrug, saying that they probably wouldn’t use it.

"I learned pretty much everything I need to know in 7th and 8th grade," said Phillip.

The key to connecting with users is approaching them in the proper context, said Deb Levine, executive director of the Oakland nonprofit Internet Sexuality Information Services. For the last decade ISIS has specialized in providing sex education through emerging media channels.

"One of the things we’ve learned at ISIS over the last 10 years is that interventions don’t work in isolation," Levine said. "Technology works best when there’s some physical location component."

One recent ISIS success involved recruitment for a sero-sorting study. Participants were initially approached in person with a survey, rather than online, which doubled the rate of follow-up response.

Levine expressed concern that STD411 would have difficulty gaining widespread adoption, comparing it to outreach that ISIS performed in Toronto for an app called M2Men.

"Here we go back to ’what’s the context,’" she said. "I might take an STD quiz online if there’s a context, but to download to my phone and keep it on my phone, I don’t really understand the benefit of that process. In Toronto, they went out to the community, and said, ’Here you go, download our app.’"

Dr. Susan Philip, deputy health officer and director of STD prevention and control services at San Francisco’s health department, said that her section would engage with users via LGBT media such as the Frameline film festival, and the Bay Area Reporter, as well as with banner ads on adult sites such as Hot House Studios.

Philip said she is also open to sharing STD411 with other organizations.

"We try as much as possible to reach out to partners in our previous work with other websites," she said.

Another online strategy that could see a revamp soon is the long-running "Ask Dr. K" feature on the website of the San Francisco health department’s STD section. The department’s longtime STD chief Dr. Jeffrey Klausner had been the "Dr. K" answering people’s sexual health questions.

Klausner resigned from the job earlier this year to work on AIDS issues in Africa. But he has continued to post responses to people’s queries as an unpaid volunteer.

Philip, who permanently replaced Klausner in July, was asked in a recent interview with the B.A.R. if the online Q&A feature would be renamed "Ask Dr. P." She said she is currently reviewing her section’s web presence and the social media platforms it is using.

"We are looking at all of those things," said Philip. "We know there is a lot of interest in ’Ask Dr. K’ and there are still questions that need to be answered."


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