Social Media and mHealth 

In the plenary presentation Social Media to Increase HIV Testing Uptake in China, Weiming Tang from Dermatology Hospital of Southern Medical University China described the benefits and drawbacks of social media, and identified an evidence based way of harnessing social media to develop effective interventions to promote HIV testing. Benefits included:

• Low, if any, cost
   
• Easy access, large audience and quick communication
   
• Interactive, engaging and providing of peer/social support 

Drawbacks included: 

• Only short term impact
   
• Privacy concerns
   
• Social stigma
   
• Difficult to measure impact
   
• Messages brief, may be misleading 

Weiming described the ways in which social media interventions can be applied to promote HIV testing:

• Develop HIV testing intervention materials, using a crowd sourcing, utilising social media to promote the contest, encourage community engagement, solicit submission, and allow the general public to become the judges of the intervention material.
   
• Establish virtual peer mentored communities:
  • Project HOPE – using facebook groups and trained peer leaders to promote HIV testing and prevention was described as a success amongst key populations inPeru and the US. The Lancet HIV article on the trial can be found at https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(14)00006-X/abstract
  • other studies have occurred in Taiwan and the US

• Provide social media based self-testing service
  • One tested model includes pre-test counselling, HIV self-test kit application, test result return and post test counselling all done online.

• Disseminate interventions – social media platform for delivering interventions through online networks
  • Examples across England, Australia and China include internet-based social marketing (UK), pop up rapid HIV testing model (AUS), crowd sourcing intervention programs to promote HIV testing among MSM (China)

Weiming also highlighted the importance of both process evaluation and outcome evaluation in social media intervention research. 

In his presentation on his systematic review of social media HIV interventions,  Bolin Cao from Shenzhen University China also highlighted the general advantages of social media interventions, in the context asking whether these types of interventions are effective in HIV. 

 Bolin identified general advantages to the medium as:

• Reaching a more diverse audience
   
• Reducing cost
   
• Opportunity for repeated exposure to messages
   
• Allows collection of real time feedback
   
• Encourage direct engagement with messaging materials 
   

Excitingly, Bolin’s systematic review of 18 observational and 8 randomised controlled trials did confirm the power of specific social media features in HIV intervention. The major roles of social media in HIV intervention in the literature were identified as to:

• Establish virtual communities
   
• Disseminate information
   
• Deliver services
   
• Develop intervention materials 

Bolin found social media interventions were effective in promoting HIV services, especially in increasing HIV testing rates, in high income countries, and aimed at MSM populations. 

The issue of stigma was raised as a significant issue in China, and a potential barrier to sharing information across the medium. He also identified STI testing as the main focus of social media interventions to date, and wondered if ART adherence may be the next target. It will be interesting to see as smartphones become increasingly available across developing counties whether social media can be as powerful in those settings.

Finally, although not directly in the social media and mHealth plenary, in the Laurindo Garcia presentation on Be Inclusive app was definitely a eHealth eye opener for me Be Inclusive identifies safe, accessible and welcoming businesses and places for groups of people vulnerable to exclusion. The app targets the needs of specific groups, using the app and location data to find businesses in geographic areas that meet the accessibility needs of the user, and welcome and support the group they identify with. Currently it is targeted towards LGBTI people, and people with a disability, and is intended to be rolled out to other groups vulnerable to exclusion. His presentation was moving and inspiring, promoting the importance of inclusion for all. He reminded us everyone has different needs, and everyone, particularly those who are too often excluded, should be easily able to find and access a place they will be welcomed.