The potential of social media to better engage gay and bisexual men in HIV prevention
Reuben Silungwe explains how social media and related online platforms are impacting the HIV response in Zambia.
Without a doubt, gay and bisexual men – a group disproportionately affected by HIV in Zambia - find each other mainly on private social media platforms.
We connect ‘underground’ not only because of stigma and discrimination but also because same-sex relations are criminalised here. These issues also mean that we have limited access to timely and accurate HIV information and essential related services that we really need to stay healthy.
Many regional and international organisations are active on social media, providing and disseminating information on HIV prevention and treatment, reaching their audiences through clear messaging and targeted campaigns. This is vital for gay and bisexual men who meet online who can also access information and education, and signposting to healthcare services offline.
Section 155 of our penal code penalises homosexuality through a vaguely phrased provision: ‘carnal knowledge of any person against the order of nature’ and is punishable by imprisonment up to 14 years. As recently as 2018, two Kapiri Mposhi men were found guilty of homosexual conduct.
This calls for innovative approaches to HIV interventions; reaching people online has become an ever more effective entry point to engage this population. In 2015, a joint survey conducted by ZICTA and the Central Statistical Office found that 71% of smartphone users have access to apps like WhatsApp, Viber, Skype and Twitter – with Facebook being the most popular. This figure continues to rise year-on-year. Consequently, the health sector and community-based organisations are using online platforms more and more to effectively engage gay and bisexual men and avert new HIV infections, especially targeting those that are hard to reach as well as young key populations.
When it comes to sexual health, gay and bisexual men tend to avoid public health centres and HIV campaigns. Commonly, stakeholders argue that gay and bisexual men do not need to identify as such when accessing HIV services. This isn’t the case – tailored services are very important in addressing the disproportionately high infection rates of HIV and other STIs among gay and bisexual men. Tailored services are also needed in response to the prevalent stigma and discrimination that gay men face in public and Christian faith-inclined health centres.
To engage gay and bisexual men via social media and related online platforms, key questions regarding the digital user experience need to be considered:
- How can health service providers ensure the safety of gay and bisexual men in online spaces? For example, although gay men are avid users of Facebook, they are also wary about who they let into their close-knit and carefully protected online spaces. This stems from cases of gay and bisexual men being blackmailed on social media, and general negative social attitudes towards gay men and their communities online.
- How can health service providers engage gay and bisexual men online without causing a backlash among the general population or raising counter-attention from the authorities in Zambia? Although HIV information is available on Facebook pages (where users can find links to WhatsApp groups) which does engage gay and bisexual men effectively, they have remained secret and hidden from the government radar and from those who believe that they are promoting homosexuality (which is illegal in Zambia).
- How should HIV information and health messages be packaged to ensure uptake by users and easy follow-up by community mobilisers – both on social media and networking sites, and then in their physical locations? This is an evolving area of behaviour change communication both in terms of research and practice.
Though the number of new HIV infections decreases year-on-year in Zambia, stigma towards key populations remains high. Breaking down negative cultural norms, pushing for law reform and knowing how to leverage digital and social media to our advantage have become critical to a more effective HIV response.
Despite concerted efforts, hostile environments both on- and offline remain a key challenge to addressing new HIV infections among all gay and bisexual men in Zambia. There is need to tailor information for such stigmatised and discriminated most at risk sub-populations in Zambia. The varied social media platforms commonly accessible and preferred by gay and bisexual men need to be considered all the time.
NB: As of publishing this piece, the two men found guilty of homosexual conduct have been released through a presidential pardon.