What is Twitter

Social scientists have much to contribute to the analysis of the real and potential contribution of pre-exposure prophylaxis (PrEP) to HIV prevention around the world. Beyond just a matter of clinical efficacy and getting pills into people's mouths, PrEP raises a number of important social-psychological questions that must be attended to in order to translate biomedical and clinical findings into uptake of PrEP among enough people at risk of HIV infection to produce population-level effectiveness. PrEP is a dynamic phenomenon with "dialectical" attributes that invite both optimism and cynicism as a desirable and effective HIV prevention strategy. PrEP disrupts traditional notions of "safe" and "unsafe" sex; it confers on its users a level of agency and control not generally achieved with condoms; and it affects sexual practices and sexual cultures in meaningful ways. As these dynamics play out in different contexts, and as new modes of PrEP administration emerge, it will be important for social scientists to be engaged in assessing their impact on PrEP implementation and effectiveness.

https://onlinelibrary.wiley.com/doi/pdf/10.7448/IAS.18.4.19983

Beyond “getting drugs into bodies”: social science perspectives on pre‐exposure prophylaxis for HIV

HIV pre-exposure prophylaxis (PrEP) is a safe and effective preventive intervention that could play a central role in ending the HIV epidemic. However, low uptake in general, and among certain social groups in particular, underscores the need to identify and address barriers to PrEP use. PrEP stigma has emerged as a key factor interfering with PrEP interest, uptake, and continuation. The purpose of this article is to describe and contextualize PrEP stigma and to offer recommendations on how to address it in future PrEP implementation initiatives. PrEP users are commonly stereotyped as sexually irresponsible, promiscuous, and immoral. These stereotypes and associated prejudice manifest at multiple levels and discourage PrEP interest and uptake, disrupt PrEP adherence, and motivate PrEP discontinuation. Intersecting forms of stigma may influence the nature, magnitude, and impact of PrEP stigma across social groups and otherwise hinder PrEP use. Current PrEP implementation strategies that narrowly focus on risk and target stigmatized groups with disproportionately high HIV incidence have yielded limited success and are counterproductive to the extent that they perpetuate stigma. Implementation strategies involving more inclusive messaging and further integration of PrEP within healthcare may help to reduce PrEP stigma and mitigate its impact, ultimately increasing PrEP use. PrEP stigma is a barrier to PrEP interest, uptake, and continuation that manifests at multiple levels. Understanding and addressing PrEP stigma requires consideration of its origins and intersections. Targeted, risk-focused implementation strategies perpetuate stigma and undermine use.

Understanding, Contextualizing, and Addressing PrEP Stigma to Enhance PrEP Implementation.

Previous literature has suggested that examining Twitter messages can be productive for studying how the public shares and spreads health information on social media. Preexposure prophylaxis (PrEP) is a promising approach to HIV prevention, yet there are many issues that may influence its effective implementation. This study examined social representations of PrEP on Twitter. One thousand four hundred and thirty-five Tweets were collected and 774 English Tweets were content-analyzed to explore propagation of various issues around daily oral PrEP, as well as characteristics of the sources of those Tweets. We also examined how Twitter message content influenced information propagation. Our findings revealed that PrEP-related information on Twitter covered a wide range of issues, and individual users constituted the majority of the Tweet creators among all the sources, including news media, nonprofit and academic groups, and commercial entities. Using Poisson regression, we also found that a Tweet's affective tone was a significant predictor of message propagation frequency. Implications for health practitioners are discussed.

Propagation of Information About Preexposure Prophylaxis (PrEP) for HIV Prevention Through Twitter

Pre-Exposure Prophylaxis (PrEP) has been promoted among high-risk populations as an effective HIV biomedical intervention. However, limited research is available on the significance of culturally informed biomedical interventions for Latino MSM. A total of 159 self-administered Internet surveys were completed by Latino MSM ages 21-30 in San Antonio, Texas. The purpose of this research was to develop an instrument that measured Latino MSM attitudes and beliefs towards PrEP, identify associations between demographic factors and PrEP related factors and to suggest culturally appropriate strategies for the promotion of PrEP among the Latino MSM population. Research findings revealed implications for PrEP at the structural and individual level for Latino MSM. Structural level indicators emphasized the importance for raising PrEP awareness among Latino MSM in regards to PrEP related expenses, ameliorating stigmatization of high-risk populations, enhancing access to PrEP informed medical providers, and address mistrust of the government and medical providers role on addressing health disparities among Latino MSM. Overall, the findings for individual factors emphasize the need for patient-centered interventions for Latino MSM. Latino MSM currently on PrEP require supplemental resources to enhance PrEP adherence. Latino MSM not on PrEP require alternate options for PrEP delivery and/or cognitive behavioral approaches minimizing HIV risk behavior for Latino MSM concerned with PrEP toxicity, which may require non-biomedical interventions. Integration of Latino MSM currently on PrEP as peer educators provides a valuable resource for developing culturally informed PrEP interventions for Latino MSM. Peer educators are able to share their experiential knowledge of PrEP contextualized through cultural norms, beliefs, and values.

/pdf/prep-awareness-and-decision-making-for-latino-msm-in-san-2afmo6esee.pdf

PrEP awareness and decision-making for Latino MSM in San Antonio, Texas

Daily oral pre-exposure prophylaxis PrEP is a new approach to HIV prevention. The study aims to examine how PrEP has been represented and disseminated on one of the most popular social networking sites - Twitter. We collected 1435 public tweets containing the word "Truvada." After computer-mediated and manual de-duplication, we analyzed 447 unique tweets and calculated weights between two words to measure their co-occurrence in 7-word windows. Semantic networks of PrEP-related tweets were constructed. We found that Twitter was used to generate public discussions and collectively interpret new medical information, especially in frequently propagated tweets and from users with more followers. In the meantime, the results revealed the presence of illicit online pharmacies that marketed and sold PrEP without the need for a prescription. We discussed implications for public health and made urgent call for better regulation of online pharmacies.

/pdf/social-network-representation-and-dissemination-of-pre-1eykhfocoa.pdf

Social Network Representation and Dissemination of Pre-Exposure Prophylaxis PrEP: A Semantic Network Analysis of HIV Prevention Drug on Twitter

Previous literature has suggested that examining Twitter messages can be productive for studying how the public shares and spreads health information on social media. Pre-exposure prophylaxis (PrEP) is a promising approach to HIV prevention, yet there are many issues which may influence its effective implementation. This study examined social representations of PrEP on Twitter. 1,435 Tweets were collected and 774 English Tweets were content-analyzed to explore propagation of various issues around daily oral PrEP as well as characteristics of the sources of those Tweets. We also examined how Twitter message content influenced information propagation. Our findings revealed that PrEP-related information on Twitter covered a wide range of issues, and individual users constituted the majority of the Tweet creators among all the sources including news media, non-profit and academic groups, and commercial entities. Using Poisson regression, we also found that a Tweet’s affective tone was a significant predictor of message propagation frequency. Implications for health practitioners were discussed.

https://papers.ssrn.com/sol3/Delivery.cfm/SSRN_ID2605632_code2397350.pdf?abstractid=2605632&mirid=5

Chih-Wei Hu

Papers

Propagation of Information About Preexposure Prophylaxis (PrEP) for HIV Prevention Through Twitter

Social Network Representation and Dissemination of Pre-Exposure Prophylaxis PrEP: A Semantic Network Analysis of HIV Prevention Drug on Twitter

Propagation of Information About Pre-Exposure Prophylaxis (PrEP) for HIV Prevention Through Twitter