How do you reverse the rising tide of unsafe sex practices and new HIV infections in gay men—and in particular young gay men—without sounding preachy or overly clinical? A new collaborative video web site sets out to do just that.
HIV Big Deal, which launched today, has begun offering a series of 10-minute online videos that try to make HIV prevention and testing messages personal and easy for gay men to relate to by following the fictional case of "Josh," a young gay man who has unsafe sex and has to wrestle with the implications. (See the first video in the series at the bottom of this article.) The series is a collaboration between Dr. Mary Ann Chiasson, an epidemiologist and vice president for research and evaluation with Public Health Solutions, a New York-based non-profit aimed at improving community health, and Francine Shuchat Shaw, a faculty member of the Steinhardt School of Culture, Education, and Human Development at New York University. Together, Chiasson and Shaw have developed web video content designed to reduce high-risk sexual behavior among gay men. "The intent of the project is to go back to the basics. Know your HIV status and discuss it with your partner before making any decisions about sex," Chiasson says.
In other words—ask the tough questions that so many gay men neglect to. "About 25% of those who are HIV positive don't know it,” she says, “and it's estimated that the transmission rate from those that don't know is 3.5 times that of those who do know they're positive."
Some of this may be familiar news to gay men, particularly those who’ve been around the block a few times; but the point of the videos is to try to connect with viewers dramatically while putting into action scientific principles about changing people's attitudes. "The videos are meant to be engaging but are based on principles of learning theory and behavior change," Chiasson says. "We have evaluated the effectiveness of the first episode and found that men who viewed it were more likely to disclose HIV status with their partners and more likely to get tested. The advantage of being online is that the intervention is free, always available, and you don't have to go anywhere to watch it."
Early outcomes are encouraging; a sample of 500 men surveyed three months after viewing the first episode was found to be three times more likely to disclose their status and about 1.5 times more likely to get tested for HIV. Watching the first episode, "The Morning After," one can see why. The episode follows Josh through an online chat, to a club, into bed, and into his trick's medicine cabinet the next morning, where he makes an all-too-familiar discovery—HIV meds. From that point forward, episodes explore the question of individual responsibility—for disclosing one's status, practicing safer sex, and getting tested. Part of the intent of the episodes is to dispel common myths; as Chiasson says, "When you ask specific questions about how men know the status of their partners, it's clear that there's a lot of guessing and assuming—I know him, he looks clean, he wouldn't do that if he weren't already positive." With better information, the creators of the videos hope men will make more informed decisions.
The videos are designed to foster discussion; viewers are encouraged to use the site's comments section to discuss the issues raised in each episode. The site also offers background materials and links to additional resources on HIV prevention, testing, and care. A short documentary, Talking About HIV, is also available to spur discussion.
Want to test out the program? You can see Episode 1 below; go to HIVBigDeal.org to see the follow-up in Episode 2, "The Test." Additional episodes are currently in production.