Pulitzer Center Update August 8, 2016
Can a Dating App Erase HIV Stigma?
In their July 2016 PBS NewsHour series "Ending AIDS," Pulitzer Center grantees William Brangham, Jason Kane, and Jon Cohen documented the challenges of providing HIV testing and treatment to at-risk populations. As reported by CNN, a new study involving the gay dating app Grindr suggests that mobile technology could help bridge this gap.
The study, led by Dr. Lina Rosengren at the University of North Carolina-Chapel Hill, targeted banner ads for HIV test kits to Black and Hispanic Grindr users in Los Angeles. The ads gave these men–whose race and sexual orientation place them at high risk for HIV–vouchers that they could redeem for test kits at pharmacies and vending machines.
Using Grindr to market HIV tests is part of a larger trend in the global fight against AIDS: tailoring treatment and testing to the circumstances of at-risk groups. Similar efforts were under way in several of the locations that Brangham, Cohen, and Kane visited in the course of their reporting.
They found one of the most dramatic successes on Kenya's Mfangano Island in Lake Victoria. As many as 40 percent of the island's fishermen are believed to be HIV positive. But until recently, few had been tested for the disease. According to one Kenyan doctor, "our system doesn't make health care-seeking a manly thing." AIDS expert Dr. Diane Havlir, who has been involved with treating the disease in the area, agrees. "One of the things which, sadly, still exists in HIV, [is that] it remains a highly stigmatized disease," she told the NewsHour reporters. That stigma often dissuades men from getting tested.
Changing this situation has been a main focus Dr. Havlir's program, SEARCH. On the island, the Pulitzer Center grantees visited a late-night clinic—complete with live entertainment—to test returning fishermen, and they watched a canoe race where all the participants had been required to receive HIV testing.
By providing incentives like these, the Mfangano Island SEARCH study has not only worked around the stigma of getting tested for HIV. It's also hit an important milestone in the fight against AIDS: 90 percent of its HIV-positive population knows their status, 90 percent of those are taking antiretroviral treatment, and 90 percent of those have the virus suppressed.
Each stage of this goal, dubbed "90-90-90," presents unique challenges, but it starts with convincing the most at-risk populations to get tested for HIV. In Kenya, that meant providing HIV treatment in a way that both suited fishermen's lifestyles and avoided the stigma of getting tested for the disease. In the United States, it will mean providing privacy and anonymity for gay men to receive HIV testing. While some US cities, like New York and San Francisco, have made progress against the disease, it continues to spread rapidly in the Deep South. On their visit to Atlanta, the journalists found that deep-seated homophobia discouraged many men from getting tested for the disease. As explained by local activist Daniel Driffin, "I thought I did something wrong, being that I'm now HIV-positive, on top of being black, on top of being gay, and in the South."
Using mobile technology to provide anonymous, rapid HIV testing could give individuals like Driffin a way around these prejudices. In the Grindr study, which took place in relatively gay-friendly Los Angeles, CNN reported that 77 percent of participants still preferred the privacy of at-home testing. Scaling this finding up will take time: Out of 4,389 unique users who clicked on the study's Grindr ads, only 333 requested test kits. Increasing the response rate to services like these may prove difficult, but for members of the gay community and other at-risk groups, successful, anonymous testing and treatment will be more than private or convenient. It could prove lifesaving.