Creating a community dialogue on HIV stigma reduction: An innovative web-based forum for gay and bisexual men
Barry D Adam1, James Murray2, Suzanne Ross3, Jason Oliver4, Stephen G Lincoln4 and Vicki Rynard3
1 University of Windsor & Ontario HIV Treatment Network, 2 Ontario Ministry of Health and Long Term Care, 3 Health Policy Strategies, 4 Ontario AIDS Network
An intervention to address stigmatizing behaviours directed toward HIV+ men and enhance the sexual health of gay and bisexual men was developed through a community-based process involving HIV prevention workers, public health, government, and researchers, representing a range of ethnocultural, francophone, HIV+, and transgender communities in Ontario, Canada. A well-publicized website, hivstigma.com, was created to invite gay and bisexual men to address experiences of HIV stigma in their communities. Eight bloggers moderated lively debates over 6 months. There were 20,844 unique visits to the site averaging more than 5 minutes each; 4,384 visitors returned more than 10 times. The site succeeded in providing a forum that generated sometimes impassioned discussions of the sources, forms, and consequences of HIV stigma; what stigma and rejection mean and how they might be better conceptualized; problems of avoiding HIV versus avoiding HIV-positive persons and the relational and emotional consequences of the latter; parallel and intersecting stigmas experienced around homophobia, age, race, and trans/gender; how HIV stigma and rejection might be challenged; the ethics and practicalities of disclosure; implied versus explicit disclosure; the difficulty and situationality of disclosure; responsibility and (informed) consent in HIV transmission; ideals and divisions in making gay community; community building versus stigma; and the morality of disclosure and HIV risk taking. In the contemporary situation, where there are few opportunities for community-wide forums, the site stimulated a dialogue where men could reflect and debate how HIV stigma impacts personal interactions, HIV transmission, and the well-being of community members. An evaluative survey conducted through a separate popular cruise website showed significantly greater awareness of stigma issues faced by HIV+ men following the intervention.