Improving safer sex interventions through digital media research

Research at Sussex on the use of social media and sexual risk behaviours among gay and bisexual men has led to a new understanding of the role of digital media in health interventions and is changing health promotion and intervention practices of sexual health charities and statutory services. This is exemplified in the development of a new information website and intervention toolkit by the Terrence Higgins Trust, which have been designed to reduce the spread of HIV among populations engaged in unsafe sexual behaviours and are now being used in health promotion training across the UK.

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‘ [Following Porn Laid Bare (PLB) our practice] has changed. We are equipped with the tools to look at this subject and speak about it with authority. The toolkit definitely has provided us with a framework for delivering interventions, and I think it will continue to do so. And as an organisation I think it’s our duty – prevention is what the Terrence Higgins Trust does, to reduce infection rates… It’s been invaluable, really.’

Marc Tweed
Head of Terrence Higgins Trust, Brighton

 

Digital media researchMowlabocus’ work has helped identify the need for sexual-health promotion for the gay and bisexual population to acknowledge digital subcultures and incorporate webbased and social media platforms in its intervention strategies.

Overview

Gay and bisexual men, as well as non-self-identifying men who have sex with men (MSM), continue to form the UK community most at risk of contracting HIV. Research suggests that among this population, transmission rates cannot be understood as simply arising from a lack of knowledge and/or education on harm-reduction strategies, and indicates that conventional health al behaviour. The 2010 publication Making it Count 4, by HIV Prevention England, outlined a series of strategic objectives that included a pledge to investigate the opinions that gay and bisexual men hold in highest regard and to encourage positive attitudes among these populations toward reducing HIV transmission.

Within this context, Dr Sharif Mowlabocus (Senior Lecturer in Media Studies/Digital Media at the University of Sussex) has conducted research on how gay and bisexual men use digital media in their personal negotiations of sexual identity and sexual practices. Using textual analyses and a body of digital sexual material, including pornography and sexual social media use, Mowlabocus identified common themes, generic conventions and sexual ‘markers’. This research supported the development of specific interview questions about sexual identity and practice in relation to this material, which were subsequently tested using pilot groups and larger focus groups. This work led to a further research collaboration between Mowlabocus and the Terrence Higgins Trust (THT), the UK’s largest HIV prevention charity.

Mowlabocus’ work has helped identify the central role of digital communication in gay/bisexual/MSM negotiation of sexual identities and practices, highlighting the need for health promotion to acknowledge digital subcultures and incorporate web-based and social media platforms in its intervention strategies. His research has also raised awareness of the challenges faced by these men when reporting unsafe sexual preferences and/or practices, including the difficulties they face in articulating desires that are contrary to their understanding of how to have safe sex, and censorship (by themselves and others) that occurs in health promotion and other contexts. Importantly he has revealed the role of pornography in the lives of these men and the challenges that the recent rise of ‘bareback’ pornography (imagery that does not include condom use) poses to men when negotiating sexual desires and healthy sexual practices that may well be mutually exclusive.

Achieving impact

The major impact of Mowlabocus’ research has been to inform and change the approach to health promotion by the major beneficiaries of his research, namely sexual-health charities such as THT and statutory health services offered by the Brighton and Hove City Primary Care Trust. The latter covers an area that has the highest percentage lesbian, gay, bisexual and transgender (LGBT) population in the UK, as well as a very high incidence of HIV infection.

In 2010, Mowlabocus organised a workshop – coinciding with the publication of his research monograph Gaydar Culture – that was attended by healthcare providers from the NHS, THT and UNISEX. Subsequently, THT invited him to partner with them in a new research project. Through this collaboration, Mowlabocus’ research fed into shaping THT Brighton’s policy on addressing bareback pornography and sex through outreach and online intervention, and culminated in the development of an information website and intervention toolkit - Porn Laid Bare - which launched in April 2013. PLB is now being used in the charity’s training of health-promotion workers across its 31 regional offices.

The PLB intervention toolkit provides practical advice and recommendations, including a set of questions and guidance notes, on how to facilitate discussions about pornography consumption and behavioural change; the latter focuses on the challenges posed by pornography in the context of reducing the incidence of unprotected sex. The toolkit is freely available to sexual-health and LGBT community organisations, among others, and is currently being used by the Claude Nicol Centre (Sexual Health), Brighton, and THT Brighton. 

Project findings from PLB and Mowlabocus’ research were shared with health-promotion experts and clinicians at a further workshop in Brighton in 2012, based on which key stakeholders developed a series of recommendations to be adopted in new and existing health-promotion work. These recommendations described the need for discussions of bareback pornography to take place during health interventions, the need to acknowledge that all porn (including bareback) is an ordinary part of gay men’s lives, and that the popularity of bareback pornography among gay men could open up useful space for discussing motivations for having unprotected intercourse and safer sex with the potential to promote behavioural change.

Some stakeholders immediately began to implement these findings, opening up informal and supportive non-judgemental discursive spaces that allow service users to articulate their desires for and explore concerns and questions regarding consumption of bareback pornography in order to mitigate unsafe behaviour. Mike Jones, Sexual Health Advisor at the Claude Nicol Centre and Lawson Unit (HIV), Outpatients, Royal Sussex County Hospital, Brighton, and Dr Daniel Richardson, Consultant in HIV/GUM, Brighton NHS Trust, have both reported concrete changes to their clinics’ practices as a result of their engagement with PLB. At the Claude Nicol Centre, for example, a new clinic – Clinic M – had been set up to enact these changes.

Future impact

The success of PLB led to further collaboration between Mowlabocus and THT on a new project, Reaching Out Online (ROO): Digital Literacy and the Uses of Social Media in Health Promotion, which began in June 2013 and was funded by the Communities and Culture Network + (CCN+) and the Big Lottery Fund. This parallel user-centred study aims to examine the use of online social media tools and platforms by outreach workers during sexual-health interventions and to explore users’ experiences of online health-promotion work. In July 2014, Mowlabocus received further funding from CCN+ to undertake further impact-related work. Thus, in 2015, he will be holding workshops, seminars and meetings with the Albert Kennedy Trust (the leading national charity working with homeless LGBT youth), local LGBT stakeholders in Brighton, creators of GiFi (a next-generation social App that is using cutting-edge technology to create an alternative to standard social media platforms), and Black and Minority Ethnic populations at risk of HIV infection.

Funding and partnership

Porn Laid Bare was a collaborative research project, between the University of Sussex and THT. The project was funded by THT’s Informed Passions project, which is funded by a grant from the Big Lottery Fund.

Reaching Out Online was a similarly collaborative project, funded in part by Informed Passions and also by the CCN+, an initiative of the EPSRC.

Working with us

If you are interested in working with us, please contact:
Dr Ian Carter
Director of Research and Enterprise
Sussex House
University of Sussex
Falmer, Brighton BN1 9RH
E impact@sussex.ac.uk
T +44 (0)1273 877718

More information about Dr Mowlabocus' research

This case study is also available for download as a PDF:

Improving safer sex interventions through digital media research [PDF 80.54KB]