Search

Background: The mpox outbreak resulted in 32,063 cases and 58 deaths in the United States and 95,912 cases worldwide from May 2022 to March 2024 according to the US Centers for Disease Control and Prevention (CDC). Like other disease outbreaks (eg, HIV) with perceived community associations, mpox can create the risk of stigma, exacerbate homophobia, and potentially hinder health care access and social equity. However, the existing literature on mpox has limited representation of the perspective of sexual minority men and gender-diverse (SMMGD) individuals., Objective: To fill this gap, this study aimed to synthesize themes of discussions among SMMGD individuals and listen to SMMGD voices for identifying problems in current public health communication surrounding mpox to improve inclusivity, equity, and justice., Methods: We analyzed mpox-related posts (N=8688) posted between October 2020 and September 2022 by 2326 users who self-identified on Twitter/X as SMMGD and were geolocated in the United States. We applied BERTopic (a topic-modeling technique) on the tweets, validated the machine-generated topics through human labeling and annotations, and conducted content analysis of the tweets in each topic. Geographic analysis was performed on the size of the most prominent topic across US states in relation to the University of California, Los Angeles (UCLA) lesbian, gay, and bisexual (LGB) social climate index., Results: BERTopic identified 11 topics, which annotators labeled as mpox health activism (n=2590, 29.81%), mpox vaccination (n=2242, 25.81%), and adverse events (n=85, 0.98%); sarcasm, jokes, and emotional expressions (n=1220, 14.04%); COVID-19 and mpox (n=636, 7.32%); government or public health response (n=532, 6.12%); mpox symptoms (n=238, 2.74%); case reports (n=192, 2.21%); puns on the naming of the virus (ie, mpox; n=75, 0.86%); media publicity (n=59, 0.68%); and mpox in children (n=58, 0.67%). Spearman rank correlation indicated significant negative correlation (ρ=-0.322, P=.03) between the topic size of health activism and the UCLA LGB social climate index at the US state level., Conclusions: Discussions among SMMGD individuals on mpox encompass both utilitarian (eg, vaccine access, case reports, and mpox symptoms) and emotionally charged (ie, promoting awareness, advocating against homophobia, misinformation/disinformation, and health stigma) themes. Mpox health activism is more prevalent in US states with lower LGB social acceptance, suggesting a resilient communicative pattern among SMMGD individuals in the face of public health oppression. Our method for social listening could facilitate future public health efforts, providing a cost-effective way to capture the perspective of impacted populations. This study illuminates SMMGD engagement with the mpox discourse, underscoring the need for more inclusive public health programming. Findings also highlight the social impact of mpox: health stigma. Our findings could inform interventions to optimize the delivery of informational and tangible health resources leveraging computational mixed-method analyses (eg, BERTopic) and big data., (©Yunwen Wang, Karen O’Connor, Ivan Flores, Carl T Berdahl, Ryan J Urbanowicz, Robin Stevens, José A Bauermeister, Graciela Gonzalez-Hernandez. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.08.2024.)

Purpose of Review: The purpose of this scoping review was to summarize literature regarding the use of user-generated digital data collected for non-epidemiological purposes in human immunodeficiency virus (HIV) research., Recent Findings: Thirty-nine papers were included in the final review. Four types of digital data were used: social media data, web search queries, mobile phone data, and data from global positioning system (GPS) devices. With these data, four HIV epidemiological objectives were pursued, including disease surveillance, behavioral surveillance, assessment of public attention to HIV, and characterization of risk contexts. Approximately one-third used machine learning for classification, prediction, or topic modeling. Less than a quarter discussed the ethics of using user-generated data for epidemiological purposes. User-generated digital data can be used to monitor, predict, and contextualize HIV risk and can help disrupt trajectories of risk closer to onset. However, more attention needs to be paid to digital ethics and the direction of the field in a post-Application Programming Interface (API) world., (© 2023. The Author(s).)

Background: Youth and young adults continue to experience high rates of HIV and are also frequent users of social media. Social media platforms such as Twitter can bolster efforts to promote HIV prevention for these individuals, and while HIV-related messages exist on Twitter, little is known about the impact or reach of these messages for this population., Objective: This study aims to address this gap in the literature by identifying user and message characteristics that are associated with tweet endorsement (favorited) and engagement (retweeted) among youth and young men (aged 13-24 years)., Methods: In a secondary analysis of data from a study of HIV-related messages posted by young men on Twitter, we used model selection techniques to examine user and tweet-level factors associated with tweet endorsement and engagement., Results: Tweets from personal user accounts garnered greater endorsement and engagement than tweets from institutional users (aOR 3.27, 95% CI 2.75-3.89; P<.001). High follower count was associated with increased endorsement and engagement (aOR 1.05, 95% CI 1.04-1.06; P<.001); tweets that discussed STIs garnered lower endorsement and engagement (aOR 0.59, 95% CI 0.47-1.74; P<.001)., Conclusions: Findings suggest practitioners should partner with youth to design and disseminate HIV prevention messages on social media, incorporate content that resonates with youth audiences, and work to challenge stigma and foster social norms conducive to open conversation about sex, sexuality, and health., (©Jimin Oh, Stephen Bonett, Elissa C Kranzler, Bruno Saconi, Robin Stevens. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 17.06.2022.)

Background: A growing amount of health research uses social media data. Those critical of social media research often cite that it may be unrepresentative of the population; however, the suitability of social media data in digital epidemiology is more nuanced. Identifying the demographics of social media users can help establish representativeness., Objective: This study aims to identify the different approaches or combination of approaches to extract race or ethnicity from social media and report on the challenges of using these methods., Methods: We present a scoping review to identify methods used to extract the race or ethnicity of Twitter users from Twitter data sets. We searched 17 electronic databases from the date of inception to May 15, 2021, and carried out reference checking and hand searching to identify relevant studies. Sifting of each record was performed independently by at least two researchers, with any disagreement discussed. Studies were required to extract the race or ethnicity of Twitter users using either manual or computational methods or a combination of both., Results: Of the 1249 records sifted, we identified 67 (5.36%) that met our inclusion criteria. Most studies (51/67, 76%) have focused on US-based users and English language tweets (52/67, 78%). A range of data was used, including Twitter profile metadata, such as names, pictures, information from bios (including self-declarations), or location or content of the tweets. A range of methodologies was used, including manual inference, linkage to census data, commercial software, language or dialect recognition, or machine learning or natural language processing. However, not all studies have evaluated these methods. Those that evaluated these methods found accuracy to vary from 45% to 93% with significantly lower accuracy in identifying categories of people of color. The inference of race or ethnicity raises important ethical questions, which can be exacerbated by the data and methods used. The comparative accuracies of the different methods are also largely unknown., Conclusions: There is no standard accepted approach or current guidelines for extracting or inferring the race or ethnicity of Twitter users. Social media researchers must carefully interpret race or ethnicity and not overpromise what can be achieved, as even manual screening is a subjective, imperfect method. Future research should establish the accuracy of methods to inform evidence-based best practice guidelines for social media researchers and be guided by concerns of equity and social justice., (©Su Golder, Robin Stevens, Karen O'Connor, Richard James, Graciela Gonzalez-Hernandez. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 29.04.2022.)

Background: Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections., Objective: The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population., Methods: We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates., Results: We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; P=.04) on the incidence of HIV infections in the following year in a given county., Conclusions: Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention., (©Robin Stevens, Stephen Bonett, Jacqueline Bannon, Deepti Chittamuru, Barry Slaff, Safa K Browne, Sarah Huang, José A Bauermeister. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.06.2020.)

Background: Substance use by youth remains a significant public health concern. Social media provides the opportunity to discuss and display substance use-related beliefs and behaviors, suggesting that the act of posting drug-related content, or viewing posted content, may influence substance use in youth. This aligns with empirically supported theories, which posit that behavior is influenced by perceptions of normative behavior. Nevertheless, few studies have explored the content of posts by youth related to substance use., Objective: This study aimed to identify the beliefs and behaviors of youth related to substance use by characterizing the content of youths' drug-related tweets. Using a sequential explanatory mixed methods approach, we sampled drug-relevant tweets and qualitatively examined their content., Methods: We used natural language processing to determine the frequency of drug-related words in public tweets (from 2011 to 2015) among youth Twitter users geolocated to Pennsylvania. We limited our sample by age (13-24 years), yielding approximately 23 million tweets from 20,112 users. We developed a list of drug-related keywords and phrases and selected a random sample of tweets with the most commonly used keywords to identify themes (n=249)., Results: We identified two broad classes of emergent themes: functional themes and relational themes. Functional themes included posts that explicated a function of drugs in one's life, with subthemes indicative of pride, longing, coping, and reminiscing as they relate to drug use and effects. Relational themes emphasized a relational nature of substance use, capturing substance use as a part of social relationships, with subthemes indicative of drug-related identity and companionship. We also identified topical areas in tweets related to drug use, including reference to polysubstance use, pop culture, and antidrug content. Across the tweets, the themes of pride (63/249, 25.3%) and longing (39/249, 15.7%) were the most popular. Most tweets that expressed pride (46/63, 73%) were explicitly related to marijuana. Nearly half of the tweets on coping (17/36, 47%) were related to prescription drugs. Very few of the tweets contained antidrug content (9/249, 3.6%)., Conclusions: Data integration indicates that drugs are typically discussed in a positive manner, with content largely reflective of functional and relational patterns of use. The dissemination of this information, coupled with the relative absence of antidrug content, may influence youth such that they perceive drug use as normative and justified. Strategies to address the underlying causes of drug use (eg, coping with stressors) and engage antidrug messaging on social media may reduce normative perceptions and associated behaviors among youth. The findings of this study warrant research to further examine the effects of this content on beliefs and behaviors and to identify ways to leverage social media to decrease substance use in this population., (©Robin C Stevens, Bridgette M Brawner, Elissa Kranzler, Salvatore Giorgi, Elizabeth Lazarus, Maramawit Abera, Sarah Huang, Lyle Ungar. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 26.03.2020.)

The digital neighborhood is the amalgamation of the spaces online where youth connect with others. Just as Black and Hispanic youth live in neighborhoods that influence their health, they are also influenced by online digital neighborhoods. Youth are exposed to social media content featuring substance use, sexual risk, and violence, yet little is known about the extent to which youth engage with such content. Using a modified venue sampling strategy, we administered CASI surveys to 145 Black and Hispanic youth aged 13-24 living in low-income urban neighborhoods. Across social media platforms, respondents reported high levels of exposure to sexual, alcohol, drug, and violence-related content (65-84%). Users reported lower levels of engagement with risk-related content (on an engagement continuum), ranging from passive exposure to dissemination. While negative risks may be amplified in the digital neighborhood, youth appear to strategically limit their engagement with that content. However, because risk behavior messaging is common in these digital neighborhoods, these spaces provide opportunities for health promotion interventions.

Background: Sexual health is an important area of study-particularly for minority youth and youth living in disadvantaged neighborhoods., Objectives: The purpose of the research was to examine the sources of sexual health information associated with youth adopting sexual risk reduction behaviors., Methods: Data collection took place in a small city in the Northeastern United States using cross-sectional behavioral surveys and modified venue-based sampling. Participants included 249 African American and Latino youth aged 13-24. Participants reported their sources of information about contraception and human immunodeficiency virus/sexually transmitted disease, such as TV/movies, parents, social media; their intentions to have sex; and condom and contraception use during their last sexual activity. Social media use, past pregnancy experience, past sexual history, age, and gender were also measured. Standard tests of bivariate association (chi-square and F tests) were used to examine initial associations between sexual risk reduction behavior and exposure to sexual risk reduction information on social media. Logistic regression models were used to test multivariate relationships between information sources and sexual risk reduction behavior., Results: Youth who were exposed to sexual health messages on social media were 2.69 times (p < .05) and 2.49 times (p < .08) more likely to have used contraception or a condom at last intercourse, respectively. Parents, schools, or traditional media as information sources were not significantly associated with contractive use or condom use at last intercourse., Discussion: Youth sexual behavior is increasingly informed by social media messages. Health practitioners should utilize social media as an important health promotion tool.

Understanding why sports and energy drinks remain increasingly popular among adolescents despite declines in other sugar sweetened beverages is critical. This study points to memory for advertising exposure and adolescent athletic identity as two aspects that together help to explain consumption. An online survey of U.S. adolescents aged 14–18 (n = 503) was combined with Nielsen data for television and social media advertising expenditures by sports and energy drink brands in participants' designated market areas (DMAs). Advertisement recall mediates the relationship between social media DMA expenditures and sports and energy drink consumption. Recall for television advertisements is related to consumption but is unrelated to television DMA expenditures. Athletic identity moderated the relationship between recall and consumption such that consumption increased as both recall and athletic identity increased, suggesting a role for motivated memory and motivated processing of ad messages based on athletic identity consistent with the limited capacity model of motivated media message processing. Based on these results, we conclude that effectiveness of expenditures in influencing behavior is dependent upon both ad recall and ad relevance, and that athletic identity is an important factor in ad effectiveness in the context of sports and energy drinks advertising. [ABSTRACT FROM AUTHOR]

In the digital neighborhood, Black and Hispanic youth communicate about issues they face, including sex and substance use. This population of young people is also disproportionately burdened by negative consequences associated with sex and substance use behaviors even when their behavior is less risky. Given the increased likelihood of negative outcomes, we investigated how young people communicate about these behaviors in their digital social networks. This mixed-methods study integrates a behavioral survey with a machine learning-supported, qualitative content analysis of one year of Facebook and Twitter posts from 50 Black and Hispanic youth, with feedback from a youth advisory board. Participants who had previously had sex or drank alcohol were more likely to post about sex or alcohol, respectively. Moreover, compared to male youth , female youth posted significantly more about sex in general and about STIs, HIV, and pregnancy. Posts about sexual behavior often discussed trust in sexual partners and gendered views of sex. Posts linked alcohol and marijuana with stress relief and coping withgrief, community violence, and distress. Understanding how youth think and communicate about sexual risk and substance use can inform the design of effective prevention efforts. Prior State of Knowledge: Social media offers an excellent window into youth perspectives and the ways they broadcast and communicate about their lives, beliefs, and health behaviors to their networked peers. Novel Contributions: In this community-engaged study, we center the experiences of Black and Hispanic youth in their digital neighborhoods to understand how youth talk about sex, drugs and alcohol in their own words. We examined the interplay between posts, social identities and health behaviors. Practical Implications: For practitioners using social media in prevention efforts, integrating youth voices and expertise in the development of online prevention efforts may be more effective in identifying drivers of risk taking and supporting risk reduction behavior. [ABSTRACT FROM AUTHOR]

This study examines the role of social media in the lives of youth living in disadvantaged neighborhoods. Feminist Standpoint Theory, which privileges the voices of marginalized communities in understanding social phenomena, suggests that youth at the margins have specific knowledge that helps us understand social media more broadly. We conducted semi-structured interviews with 30 females and 30 males aged 13–24 years about their social worlds and neighborhoods, both online and offline. The findings reveal a dynamic and somewhat concerning interplay between the geographic neighborhood and the digital neighborhood, whereby negative social interactions in the geographic neighborhood are reproduced and amplified on social media. [ABSTRACT FROM AUTHOR]

There has been significant interest in the role of social media in the lives of adolescents, particularly as it relates to sexual risk. Researchers have focused on understanding usage behaviors, quantifying effects of social media exposure and activity, and using social media to intervene. Much of this work has focused on college students and non-minority youth. In this paper, we examine the growing body of literature around social media use among US minority youth and its intersection with sexual risk behavior. We introduce the concept of the "digital neighborhood" and examine the intersection of social media and sexual health in two domains: 1) sexual content in social media and 2) evidence of social media effects on sexual behavior. Finally, we discuss the opportunities and challenges for researchers and practitioners engaging youth of color. [ABSTRACT FROM AUTHOR]

Social media has changed the landscape of adolescence, altering how young people communicate and connect with peers. This study explores how young women of color living in marginalized neighborhoods perceive, manage, and make meaning of social media threats and conflict. Previous research shows that social media narratives tend to reify gender differences and devalue the experiences of conflict among girls and young women. Focus group discussions among 41 youth, living in a disinvested neighborhood of Hartford, CT, and participating in a development program for adolescents at risk for violence involvement, suggest that girls use social media platforms to define, negotiate, and meet their developmental needs and enhance their wellbeing. These adolescents are intentional in their choices to enter the social media world; they use social media to cultivate their identity, protect their reputation, manage relationships, or simply be seen and heard. While corroborating previous findings concerning perceptions of social media conflicts, these girls were not passive consumers of social media; they had a nuanced sense of this tool and used it to resist violence and benefit their image. Identifying adolescent insights about how particular social media features influence conflict is critical to creating effective interventions. [ABSTRACT FROM AUTHOR]