Earlier this year, San Mateo County Health System officials were taken to task by LGBT bloggers and activists for creating false profiles on a gay mobile dating application to expand HIV and Hepatitis C testing, though recent numbers highlighting the program’s success shows little divide within the health and science community.
The application, Grindr, is well-known in the gay community for anonymous sex, and is akin to Google in terms of mobile popularity. San Mateo County health officials set up false profiles and, when contacted, would provide information about sexually transmitted infections testing rather than the expected response. The practice came to light after the Bay Area Reporter published a March article that exposed how they were doing outreach.
“It is deceptive. It’s also patronizing,” blogged Peter Lawrence Kane of The Bold Italic. “Who wants to click on a hot dude’s profile only to find that it’s actually someone in an office who assumes you’re too irresponsible to take care of yourself and wants to give you a little talking-to about safe sex.”
San Mateo County’s health officials defend the effort to reach a community that at one time they had no access.
“We use a stock image with little to no information about the profile or the person. It just says ‘Hi’,” said Darryl Lampkin, HIV prevention coordinator for San Mateo County. The two county employees who use the accounts engage in “passive outreach,” meaning that they let users come to them, not visa versa. Officials have also used Scruff and Craigslist the same way.
“Our main goal is to respect the fact that people are not there to get STI information,” said Lampkin. “If someone hits us up and they don’t want to talk, we understand that. We’re there to socialize and build connections and try to be as non-invasive as possible.”
In many ways, health officials contend going online is a more effective way to get important information out there rather than through fliers or other outreach.
There are more than 13,000 lesbians, gays and bisexuals living in San Mateo County, according to a 2011 study done by the Williams Institute at UCLA. But in many respects, the group is fairly invisible.
“We have an LGBTQ community, it’s just not as prevalent as in San Francisco,” said Megan O’Day, executive director of the AIDS Community Research Consortium based in Redwood City, and there are no LGBT-focused groups that work on preventing STI infections, which are growing.
Hepatitis C infections in San Mateo County have increased, specifically among gay men, but outreach to the gay community is limited due to funds, a higher focus on testing and the gay community having no social presence in San Mateo County, according to O’Day.
“We have no clubs or gay bars,” said O’Day.
Gay bars are attractive to public health officials who set up rapid HIV and Hep C testing sites that also act as education centers. Since there are no gay bars in San Mateo County, county health officials like Lampkin have been left at a standstill in expanding reach to the gay community.
“We had the idea to use [mobile applications] beforehand,” said Lampkin. But after seeing the success researchers down at UCLA had with using mobile applications for HIV studies, “we were given authorization to pilot the program,” he said.
Thousands of users
During interviews with newly-diagnosed syphilis patients, Lampkin found that 40 percent of those infected had found their partners online, with a large majority that named the mobile application Grindr.
Grindr is a GPS-based mobile application that shows users where other gay men are in proximity to their location. For every person, there is a picture with a small bio and users can send messages, photos and their location within the app.
There are well over a dozen similar applications that exist including Scruff, Jack’d and Growlr, but Grindr is by far the most popular, with over 6 million users worldwide, according to its website. It’s unknown how many are in San Mateo County, however there are over 286,000 users in San Francisco alone, according to Grindr reports. Los Angeles has more users than San Francisco at 346,000.
The apps have made many health officials worried, since they’re notorious for being used for anonymous and sometimes unprotected sex. And after epidemiologists at UCLA and the Los Angeles Department of Health found that those who use them are at a significantly higher risk of contracting sexually transmitted infections, there has been a need for public health departments to find a way and combat STI growth within the gay community by modernizing.
Dr. Eric Rice, assistant professor at USC who specializes in technology and HIV, agreed with the county’s approach and said that public health departments need to make outreach “a bit sexier with social media.” Rice said that the traditional ways of fliering at clinics is dated as more people get their information for testing on the web. “That’s what guys did in the ‘90s, it’s not what modern guys do,” he said.
In 2009, Rice conducted studies with homeless LGBT youth, which found that by using social media outlets (back then the largest was MySpace) to tell people about HIV testing, there was a significant jump in the number of people reached opposed to traditional ways of street fliering.
“You can have one guy on Grindr and reaching dozens of people in an hour, versus standing on a street corner even in a dominant gay neighborhood won’t reach nearly as much,” Rice said.
Lampkin echoed a similar correlation. Engagement with gay men — getting across the message for continued testing and safe sex — has surged from 60 men a year, to over 900 as of March, according to Lampkin.
Other efforts, privacy concerns
And other counties have started mirroring San Mateo, in hopes to get similar results.
Marin County’s gay community is equally as shadowed. With no gay bars and a very low turnout of gay men in testing centers, the Marin AIDS Project, a community-based organization that has a partnership with Marin County’s Department of Health and Human Services, also use Grindr and Craigslist for outreach. They have seen a 300 percent increase in outreach.
“It’s my thoughts that because of the increase of business at the Marin AIDS project, that the geo-locating programs are contributing to the increase,” said Andy Fyne, prevention and testing coordinator for the Marin AIDS Project.
Some researchers who have used Grindr in a similar manner for gathering information on the gay community look back with concern.
“We’ve learned not to do that for future research,” said Dr. Ian Holloway, an assistant professor at UCLA who was the lead author of a study that used Grindr to assess men’s willingness to take part in HIV-education.
During his research, there were a few Grindr users who complained about being contacted, and even once got the team blocked from the app altogether. But Holloway’s research demonstrated that most participants were willing to take part in prevention via smartphone apps and that collaboration between app developers and prevention groups should be a main course of action, though a line should be drawn at public institutions who interfere with the user experience.
“I don’t think that’s an ideal way to do prevention,” said Holloway. “That’s sub-optimal.”
There’s also been worry about privacy and what information is being recorded from users on the app, though Lampkin doggedly refused that any personal information is being recorded beyond the interface of the app.
“Our main motivation is because we want to address the needs of those who are affected by HIV,” Lampkin said. “Knowing that more people are using the internet to find health information, it’s a great opportunity to target the needs of our community. We’re a part of this community and we think it’s our responsibility to engage in it.”