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Tailoring HIV-Prevention to Meet the Needs of Gay, Bisexual, and Queer Adolescent Males:
Online Focus Groups as an Innovative Tool for Participatory Research
Zachary DuBois1, Michele Ybarra2, Tonya Prescott2, & Brian Mustanski1
1The IMPACT Program, Department of Medical Social Sciences, Northwestern University, 2Center for Innovative Public Health Research, San Clemente, CA
Participants were recruited to reflect a range of geographic location, race,
ethnicity, and age (Table 1). Recruitment was conducted online through ads
placed on Facebook, TrevorSpace, and GLSEN. In addition to being 14-18 years
old, eligibility criteria required participants to be male sex, identify as GBQ, have
a cell phone, and use text messaging for more than 6 months.
Participants were stratified by self-reported sexual experience (i.e., ever had
vaginal or anal sex, or never having either type of sex). Online focus groups with
GBQ (n=75) youth 14-18 years old were conducted in November 2012 (n=37)
and January 2013 (n=38; see Figure below).
INTRODUCTION
METHODS
The G2G program will focus on HIV preventative behavior (e.g., condom use;
delaying sex) and sexual decision-making. Using an asynchronous online focus
groups methodology (Hillier et al. 2012), the study presented here aimed to
engage youth community members in order to confirm intervention program
components (e.g., Text Buddy, SOS Tonight) and logistics (e.g., optimal message
delivery time, promoting participant safety/ privacy). We also explored the
saliency of intended program topics and word choice.
BENEFITS: Online Focus Groups for Community Engagement
We posted questions twice daily for three consecutive days. The password-protected
bulletin board was asynchronous, meaning that people could log on whenever it was
convenient for them. (Figure 3). Participants used anonymous usernames and posted
responses, responded to moderator probes, and interacted with each other. Topics
included: text-messaging habits, privacy issues , relationship experience, condom use, and
experiences with sex education.
Group 1 (n=37) Group 2 (n=38)
Inexperienced
(n=18)
Experienced
(n=19)
Inexperienced
(n=18)
Experienced
(n=20)
Age (Mean years) 16.38 16.15 15.94 16.15
Race
Asian 0% 11% 11% 0%
Black or African American 11% 5% 0% 5%
Mixed racial background 17% 21% 6% 30%
Native American or Alaskan native 0% 0% 0% 5%
Other 11% 26% 17% 5%
White or Caucasian 61% 37% 67% 55%
Hispanic ethnicity 11% 26% 22% 35%
Sexual
Orientation
Bisexual 22% 11% 17% 5%
Gay 72% 89% 83% 95%
Gay/Bisexual 6% 0% 0% 0%
Urbanicity
Rural 11% 26% 39% 40%
Urban 89% 74% 61% 60%
N=37 N=38
Figure 2: Structure of Focus Groups (N=75)
Sexually experienced
n=19
inexperienced
n=18
Sexually experienced
n=20
inexperienced
n=18
Benefits of using this online forum emerged from the data. Although the sample only
included GBQ youth, these benefits seemed to be particularly powerful because safety
and privacy may be an issue. For example, this methodology:
 Invites youth to “talk” freely and interact within a familiar framework
Overall, the level of engagement and willingness to respond to our questions seemed
to reflect a high level of comfort with talking online versus talking in-person. The online
bulletin board functioned much like a moderated chat-room where guys freely
interacted in an informal way with one another, sharing experiences as well as
resources (Figure 3). They even initiated chatting in a “free space” on the board.
• Provides an opportunity for social connection and positive reinforcement for
healthy behavior
“I never am around other LGBT people so it was rather interesting to hear other
people's viewpoints and realize how similar they are to mine…”
“This discussion has helped me realize just how many guys out there want
to wait for the right guy for sex…”
 Allows participants to “arrive” and “leave” at their convenience
Unlike traditional (in-person) focus groups, participants can engage in online groups at
anytime. Many of the young men in our study logged on multiple times over the course
of the day, including late at night when they had privacy and the time to write freely.
This flexibility fostered what felt like an ongoing ‘conversation’ and allowed for guys to
share stories and experiences at length.
 Facilitates moderation
The asynchronous style of the bulletin allowed participants to respond to questions
without eclipsing other’s opportunity to “speak.” This lack of ability to “interrupt” one
another meant that moderators could focus entirely on the content of the discussion
, submit follow-up questions and draw out less active participants.
Figure 3: Bulletin Board
CONCLUSIONS
Asynchronous online focus groups were an innovative tool for participatory research.
We were able to effectively elicit information needed to design a program that will
address the healthy sexuality education needs of the community we aimed to reach.
Focus Group 1 Focus Group 2
Table 1: Participant characteristics
Adolescent gay, bisexual, and queer (GBQ)
males are alone in facing increasing
incidence of HIV/AIDS (Fig 1)—with most
transmission occurring through unprotected
sex. Nonetheless, the majority of prevention
programs focus primarily on GBQ adults and
heterosexual youth. To address this
gap, Guy2Guy (G2G) is a text-messaging-
based HIV-prevention project that will be
designed specifically for GBQ adolescents.
Figure 1: HIV Diagnoses by Age
Citation: Hillier, L., Mitchell, K.J., & Ybarra M.L. (2012). The internet as a safety net: Findings from a series of online focus
groups with LGB and non-LGB young people in the United States. Journal of LGBT Youth, 9, 225-246.
Funding: R01 MH096660-01A1 from the National Institutes of Mental Health.
Acknowledgements: We would like to thank all the youth who participated in this research.
* Thank you for your interest in this presentation. Please note that analyses included herein are preliminary. More recent, finalized analyses may be available by contacting CiPHR for further information.

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Tailoring HIV-prevention to meet the needs of gay, bisexual, and queer adolescent males: Online focus groups as an innovative tool for participatory research

  • 1. Tailoring HIV-Prevention to Meet the Needs of Gay, Bisexual, and Queer Adolescent Males: Online Focus Groups as an Innovative Tool for Participatory Research Zachary DuBois1, Michele Ybarra2, Tonya Prescott2, & Brian Mustanski1 1The IMPACT Program, Department of Medical Social Sciences, Northwestern University, 2Center for Innovative Public Health Research, San Clemente, CA Participants were recruited to reflect a range of geographic location, race, ethnicity, and age (Table 1). Recruitment was conducted online through ads placed on Facebook, TrevorSpace, and GLSEN. In addition to being 14-18 years old, eligibility criteria required participants to be male sex, identify as GBQ, have a cell phone, and use text messaging for more than 6 months. Participants were stratified by self-reported sexual experience (i.e., ever had vaginal or anal sex, or never having either type of sex). Online focus groups with GBQ (n=75) youth 14-18 years old were conducted in November 2012 (n=37) and January 2013 (n=38; see Figure below). INTRODUCTION METHODS The G2G program will focus on HIV preventative behavior (e.g., condom use; delaying sex) and sexual decision-making. Using an asynchronous online focus groups methodology (Hillier et al. 2012), the study presented here aimed to engage youth community members in order to confirm intervention program components (e.g., Text Buddy, SOS Tonight) and logistics (e.g., optimal message delivery time, promoting participant safety/ privacy). We also explored the saliency of intended program topics and word choice. BENEFITS: Online Focus Groups for Community Engagement We posted questions twice daily for three consecutive days. The password-protected bulletin board was asynchronous, meaning that people could log on whenever it was convenient for them. (Figure 3). Participants used anonymous usernames and posted responses, responded to moderator probes, and interacted with each other. Topics included: text-messaging habits, privacy issues , relationship experience, condom use, and experiences with sex education. Group 1 (n=37) Group 2 (n=38) Inexperienced (n=18) Experienced (n=19) Inexperienced (n=18) Experienced (n=20) Age (Mean years) 16.38 16.15 15.94 16.15 Race Asian 0% 11% 11% 0% Black or African American 11% 5% 0% 5% Mixed racial background 17% 21% 6% 30% Native American or Alaskan native 0% 0% 0% 5% Other 11% 26% 17% 5% White or Caucasian 61% 37% 67% 55% Hispanic ethnicity 11% 26% 22% 35% Sexual Orientation Bisexual 22% 11% 17% 5% Gay 72% 89% 83% 95% Gay/Bisexual 6% 0% 0% 0% Urbanicity Rural 11% 26% 39% 40% Urban 89% 74% 61% 60% N=37 N=38 Figure 2: Structure of Focus Groups (N=75) Sexually experienced n=19 inexperienced n=18 Sexually experienced n=20 inexperienced n=18 Benefits of using this online forum emerged from the data. Although the sample only included GBQ youth, these benefits seemed to be particularly powerful because safety and privacy may be an issue. For example, this methodology:  Invites youth to “talk” freely and interact within a familiar framework Overall, the level of engagement and willingness to respond to our questions seemed to reflect a high level of comfort with talking online versus talking in-person. The online bulletin board functioned much like a moderated chat-room where guys freely interacted in an informal way with one another, sharing experiences as well as resources (Figure 3). They even initiated chatting in a “free space” on the board. • Provides an opportunity for social connection and positive reinforcement for healthy behavior “I never am around other LGBT people so it was rather interesting to hear other people's viewpoints and realize how similar they are to mine…” “This discussion has helped me realize just how many guys out there want to wait for the right guy for sex…”  Allows participants to “arrive” and “leave” at their convenience Unlike traditional (in-person) focus groups, participants can engage in online groups at anytime. Many of the young men in our study logged on multiple times over the course of the day, including late at night when they had privacy and the time to write freely. This flexibility fostered what felt like an ongoing ‘conversation’ and allowed for guys to share stories and experiences at length.  Facilitates moderation The asynchronous style of the bulletin allowed participants to respond to questions without eclipsing other’s opportunity to “speak.” This lack of ability to “interrupt” one another meant that moderators could focus entirely on the content of the discussion , submit follow-up questions and draw out less active participants. Figure 3: Bulletin Board CONCLUSIONS Asynchronous online focus groups were an innovative tool for participatory research. We were able to effectively elicit information needed to design a program that will address the healthy sexuality education needs of the community we aimed to reach. Focus Group 1 Focus Group 2 Table 1: Participant characteristics Adolescent gay, bisexual, and queer (GBQ) males are alone in facing increasing incidence of HIV/AIDS (Fig 1)—with most transmission occurring through unprotected sex. Nonetheless, the majority of prevention programs focus primarily on GBQ adults and heterosexual youth. To address this gap, Guy2Guy (G2G) is a text-messaging- based HIV-prevention project that will be designed specifically for GBQ adolescents. Figure 1: HIV Diagnoses by Age Citation: Hillier, L., Mitchell, K.J., & Ybarra M.L. (2012). The internet as a safety net: Findings from a series of online focus groups with LGB and non-LGB young people in the United States. Journal of LGBT Youth, 9, 225-246. Funding: R01 MH096660-01A1 from the National Institutes of Mental Health. Acknowledgements: We would like to thank all the youth who participated in this research. * Thank you for your interest in this presentation. Please note that analyses included herein are preliminary. More recent, finalized analyses may be available by contacting CiPHR for further information.