Outreach with the unreachables: Why online outreach is so important

I once was at a sexual health conference where the presenter said that there was no such thing as a difficult to reach population, but just the wrong methods to reach the population. More than ever this seems accurate when you think of the way outreach has changed over the last few years. Previously sexual health outreach was all face-to-face in bars, clubs and other locations whereas now it is a mixture of online – in chat rooms, on apps and on profile sites – and in more traidtional, physical locations. But why is this so important and what are the benefits of doing online outreach specifically?

The main reason online outreach is vital is because of the prevalence of internet use as a means to meet sexual partners. Indeed, a UK study that is now nearly 10 years old showed that even at the turn of the 21^st century over 80% of men who have sex with men used the internet to meet sexual partners and this number is certain to be even higher today. (See here ). The most common reason to use gay profile sites online, undoubtedly, is to find sexual partners. Not only is the internet used as a way to contact men to have sex with (the plethora of sites and apps for this purpose demonstrate that), but also, importantly, the internet now the key setting where the negotiation (or not) of safer sex and drug use takes place. You only need to send a few messages and wait a few minutes and suddenly chat conversations starting something like ‘Interested in BB (bareback)?’ and ‘Into chem sex?’ start to appear. On the one hand, MSM (men who have sex with men) seem more likely to engage in negotiation online rather than face-to-face (see this article), which could indicate safer sexual practice. However, on the other there is some anecdotal evidence that when bareback sex or drug use is suggested online there is more likelihood that this will be agreed to rather than face-to-face and also that once a conversation and decision about the nature of sex had happened online it was unlikely to be changed once a subsequent in-person meet happens (see here).

There is also evidence that there is a link between the number of sexual partners among profile site users engaging in chat online and the likelihood of unprotected sex. Although the reasons for this need to be explored it shows the importance of better understanding the link between internet use and ‘in-flesh’ sexual behaviour by those doing HIV prevention work. Finally, the internet is the key site for meeting to do sex and drugs (especially crystal meth, G and mephadrone). It is online that discussions about using drugs take place and where arrangements are made about PnP (see our previous blog here) sex parties and there are even groups and forums for guys specifically seeking to meet for this reason.

The internet then, is an important site for promoting safer sex amongst MSM and is where the discussions around safer sex (and specifically safe-sex and drug use) are most commonly happening today. For this reason we do online outreach on a variety of sites used by gay and bisexual men in London. We do not actively send messages to site users, rather we announce in general rooms that we are online and available if anyone has sexual health questions. We are always online twice per week and this always includes Friday afternoons and evenings. For more information about the online outreach please contact  Malachy.Donnelly@hounslow.gov.uk or Ibrahim.Ismail@hounslow.gov.uk .

GMI Partnership provide free sexual health counselling, mentoring and advice to gay and bisexual men in London. Please see our website for more information http://www.gmipartnership.org.uk/ . The article above represents the views of the author and does not necessarily represent those of GMI.

For issues around drug-taking and safe sex the Antidote website (London’s only LGBT specific drugs and alcohol project) and the CODE clinic which runs every Tuesday 5-7pm at 56 Dean St clinic, Soho London (see here ).