New research suggests Facebook can be effective in promoting condom use among young adults — at least in the short term.
The findings suggest social media can help inform young adults who often receive little education on sexuality or guidance on HIV and other sexually transmitted diseases (STDs).
Researchers say social media may provide a viable alternative to promote safe sex using online networks of friends. The study will be published in the November issue of the American Journal of Preventive Medicine.
“The use of social media to influence sexual risk behavior in the short term is novel. It is a first step in considering how to reach the overwhelming numbers of youth online, and how to maximize approaches to technology-based interventions,” said lead investigator Sheana S. Bull, Ph.D., M.P.H., of the Colorado School of Public Health.
Researchers initially recruited study participants in community settings and through postings on popular blogs and websites, as well as advertisements in college and local papers in U.S. cities with higher than average rates for sexually transmitted infections (STI) and HIV.
Investigators focused their recruitment efforts on African-American and Latino youth given the disparity of infections between these groups and other young adults.
Each recruit was given an incentive to recruit three friends to participate, and each new recruit was also incentivized to recruit three friends, for five recruitment waves. Participants and those they recruited were randomly assigned as a network to either an intervention group or a control group.
The intervention group signed up to “Like” and receive news from Just/Us, a Facebook community developed to promote sexual health.
Each week a new topic such as communicating about sexual history, skills building for condom negotiation and use, and how to access STI testing was discussed on the site, with updates each day from youth facilitators in the form of video links, quizzes, blogs, and threaded discussions.
The control page was called “18-24 News,” and shared news that happened during the hours of 6 p.m. to midnight on the 24 hour clock that was of interest to 18-24 year olds.
Investigators collected demographic information and baseline information on condom use at last sexual encounter and the proportion of sex acts protected by condom use in the last 60 days at the beginning of the study.
For the study, 636 people were enrolled in the 18-24 News intervention and 942 in the Just/Us intervention.
Researchers survey participants two months into the study and discovered 68 percent of the Just/Us group reported using a condom during the last sex act, versus 56 percent of the controls.
The proportion of sex acts protected by condom use in the last 60 days was 63 percent for the Just/Us group versus 57 percent for controls.
The effects decreased over time and a survey six months after the intervention found no difference between the two groups. There was no evidence that any demographic characteristics influenced response to the intervention.
“The effect size from the short-term outcomes match or exceed those observed in other Internet interventions, suggesting Facebook for sexual health interventions is at least equally effective as other technology-based mechanisms, and these effects match those observed for more traditional HIV prevention programs delivered in real-world settings,” Bull said.
Results also show success in recruitment of youth of color and youth living in geographic regions with high STI and HIV prevalence, and success in reaching large numbers of people with STI- and HIV-related content through Facebook.
There is little evidence that youth actively seek out and engage with organizations on Facebook. Thus approaches like that of Just/Us to push messages out offer one way to get them in front of a large number of young people.
Bull said that the study relied on self-reporting, and condom use may have been over-reported. Another concern is that the number of active participants declined over time, as did the treatment effect.
“Although this type of attrition has been documented in other online STI-related research, it underscores the need to redouble efforts to attract and engage higher-risk youth in prevention efforts using social media. Future work should explore approaches to keep audiences engaged in social media content related to sexual health,” she said.
In a commentary accompanying the article, Nathan K. Cobb, M.D., noted, “For health behavior change intervention designers, Facebook offers something unprecedented —direct access to an individual’s social network, in real time, and without the need for tedious network enumeration by participants.
“However, such approaches require multidisciplinary teams that include social media specialists, marketers and software developers as equal partners in design and intervention development. Building such teams will undoubtedly require changes to traditional funding and development models, but the potential is too large to be ignored or minimized.”
Source: Elsevier Health Sciences