Digital Public Health Surveillance Tools for Alcohol Use and HIV Risk Behaviors

Garett, Renee; Young, Sean D.

doi:10.1007/s10461-021-03221-z

Cited by 7 publications

(7 citation statements)

References 72 publications

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“…Digital tools, such as mobile applications, electronic health records, and telemedicine often incorporating artificial intelligence and geolocation, have been used in promoting HIV prevention and PrEP uptake for at-risk populations. [15][16][17][18][19] Conversational agents, a type of digital tool, can be in the form of chatbots or virtual assistants (e.g., Alexa, Siri), designed to mimic human-like textual or verbal communications. Simple chatbots and virtual assistants use keywords and pre-defined answers while smart chatbots benefit from natural language processing (NLP) approaches when communicating with the users.…”

Section: Digital Tools and Conversational Agentsmentioning

confidence: 99%

Potential Role of Conversational Agents in Encouraging PrEP Uptake

Hassani

Young

2022

J Behav Health Serv Res

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Approximately 1.2 million people are living with HIV, with many of them unaware of their infection. Pre-exposure prophylaxis (PrEP) is available to minimize transmission among those at high risk for infection, including men who have sex with men, people who inject drugs, and female sex workers. Despite its availability, there is low usage of PrEP. To address this problem, various digital tools have been examined in HIV research. Among those, conversational agents are still underused and their capacity warrants examination to reach at-risk populations. In this paper, we discuss the potential of conversational agents in increasing uptake of PrEP by addressing barriers experienced among those at high risk for infection. BackgroundHIV continues to be a public health crisis. Approximately 1.2 million people are living with HIV in the USA and 14% are unaware of their infection. 1 Approximately 40% of community transmission can be attributed to individuals who are unaware of their infection. 2 Currently, there is no known cure for HIV. However, it is possible to minimize transmission from a person living with HIV to their sexual partner through pre-exposure prophylaxis (PrEP). PrEP decreases the risk of transmission when taken as prescribed, with efficacy increasing as adherence increases. 3,4 In 2016, the number of individuals taking PrEP was more than 77,000, with more males taking PrEP than females. 5 However, despite its availability, prescriptions for PrEP remain low. 6 Lack of awareness of availability by both at-risk individuals and people living with HIV, provider bias and distrust of the healthcare system, 6 stigma, 6,7 and low perception of HIV risk create barriers to uptake of PrEP.

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Section: Digital Tools and Conversational Agentsmentioning

confidence: 99%

Potential Role of Conversational Agents in Encouraging PrEP Uptake

Hassani

Young

2022

J Behav Health Serv Res

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“…Key to efforts to attenuate the HIV epidemic among SMM of all races and ethnicities is the ability to actually observe the aforementioned indicators of HIV risk in individuals before moments of infection and transmission such that prevention can actually occur [19,20]. Traditionally, researchers and public health professionals have relied on surveillance data that suffer from considerable lag time in reporting as they are often captured through large-scale behavioral surveys or clinical case visits, which require extensive resources for collection and analysis [21,22]. Perhaps more importantly, with their reliance on surveys and clinical visits, traditional surveillance strategies inevitably neglect populations that have limited engagement with the health care system because of issues such as low perceptions of personal risk, experiences with stigma and discrimination, and socioeconomic disadvantage.…”

Section: Traditional Hiv Risk Surveillance and Its Limitationsmentioning

confidence: 99%

Social Media Communication and Network Correlates of HIV Infection and Transmission Risks Among Black Sexual Minority Men: Cross-sectional Digital Epidemiology Study

Young¹,

Tang²,

Nan³

2022

JMIR Form Res

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Background In the United States, HIV disproportionately affects Black cisgender sexual minority men (BSMM). Although epidemiological and behavioral surveillance are integral to identifying BSMM at risk of HIV infection and transmission, overreliance on self-reported data, inability to observe social contexts, and neglect of populations with limited engagement in health care systems limits their effectiveness. Digital epidemiological approaches drawing on social media data offer an opportunity to overcome these limitations by passively observing in organic settings activities, beliefs, behaviors, and moods that indicate health risks but are otherwise challenging to capture. Objective The primary aim of this study was to determine whether features of Facebook communication and networks were associated with biological, behavioral, and psychological indicators of HIV infection and transmission risk. Methods Facebook and survey data were collected from BSMM aged 18 to 35 years living in Chicago (N=310). Participants’ Facebook posts were characterized using 4 culturally tailored topic dictionaries related to aspects of HIV protection and risk among BSMM (sexual health; substance use; sex behavior; and ballroom culture, a salient subculture in lesbian, gay, bisexual, transgender, and queer communities of color). Social network methods were used to capture structural features of BSMM’s Facebook friendships (centrality, brokerage, and local clustering) and Facebook group affiliations. Multivariable regressions revealed relationships between these Facebook features and 5 ground truth indicators of HIV infection and transmission risk (sexually transmitted infection incidence, condomless sex, sex drug use, biomedical prevention, and depression). Results Although analysis of participants’ Facebook posts revealed that HIV-related topics occupied a small portion of the total messages posted by each participant, significant associations were found between the following HIV risk indicators and Facebook features: Condomless sex, including communication about sexual health (odds ratio [OR] 1.58, 95% CI 1.09-2.29), ballroom culture (OR 0.76, 95% CI 0.63-0.93), and friendship centrality (OR 0.69, 95% CI 0.52-0.92); Sex drug use, including communication about substance use (OR 1.81, 95% CI 1.17-2.79) and friendship centrality (OR 0.73, 95% CI 0.55-0.96) and brokerage (OR 0.71, 95% CI 0.51-0.99); Biomedical prevention, including communication about ballroom culture (OR 0.06, 95% CI 0.01-0.71); and Depression, including communication about sexual health (β=–0.72, 95% CI −1.42 to −0.02), ballroom culture (β=.80, 95% CI 0.27-1.34), friendship centrality (β=−0.90, 95% CI −1.60 to −0.21), and Facebook group affiliations (β=.84, 95% CI 0.25-1.43). Facebook features provided no significant explanatory value for sexually transmitted infection incidence. Conclusions Finding innovative strategies to detect BSMM at risk of contracting or transmitting HIV is critical to eliminating HIV disparities in this community. The findings suggest that social media data enable passive observance of social and communicative contexts that would otherwise go undetected using traditional HIV surveillance methods. As such, social media data are promising complements to more traditional data sources.

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“…Social media and search engine (e.g., Google) data have been used to monitor infectious diseases such as sexual health, including HIV, opioids/substance use, Zika, measles, and chronic conditions such as asthma, depression, and sleep issues. [8][9][10][11][12] Because social media data can be available in near real-time, are often publicly available, and have massive amounts of data, they can potential supplement existing public health surveillance efforts by providing information that might not be feasible or cost-effective through traditional methods, such as surveys, interventions and case reports. 13,14 Studies show that approximately 65% of research using social media surveillance correlated well with existing surveillance programs 15 providing support of social media surveillance.…”

Section: Social Media As a Data Source For Surveillancementioning

confidence: 99%

“…Social media use has been rapidly growing, allowing it to be used by researchers and health departments as a tool in public health research. Social media and search engine (e.g., Google) data have been used to monitor infectious diseases such as sexual health, including HIV, opioids/substance use, Zika, measles, and chronic conditions such as asthma, depression, and sleep issues 8‐12 . Because social media data can be available in near real‐time, are often publicly available, and have massive amounts of data, they can potential supplement existing public health surveillance efforts by providing information that might not be feasible or cost‐effective through traditional methods, such as surveys, interventions and case reports 13,14 …”

Section: Social Media As a Data Source For Surveillancementioning

confidence: 99%