Provision of online HIV-related information to gay, bisexual and other men who have sex with men: a health literacy-informed critical appraisal of Canadian agency websites

Abstract

Background HIV risk and prevention information is increasingly complex and poses challenges for gay, bisexual and other men who have sex with men (GBMSM) seeking to find, understand and apply this information. A directed content analysis of Canadian HIV websites to see what information is provided, how it is presented and experienced by users, was conducted. Methods: Eligible sites provided information relevant for GBMSM on HIV risk or prevention, were from community or government agencies, and were aimed at the public. Sites were found by using a Google search using French and English search terms, from expert suggestions and a review of links. Eligibility and content for review was determined by two reviewers, and coded using a standardised form. Reading grade level and usability scores were assessed through Flesch–Kincaid and LIDA instruments. Results: Of 50 eligible sites, 78% were from community agencies and 26% were focussed on GBMSM. Overall, fewer websites contained information on more recent biomedical advances (e.g. pre-exposure prophylaxis, 10%) or community-based prevention strategies (e.g. seroadaptive positioning, 10%). Many sites had high reading levels, used technical language and relied on text and prose. And 44% of websites had no interactive features and most had poor usability scores for engageability. Conclusions: Overall, less information about emerging topics and a reliance on text with high reading requirements was observed. Our study speaks to potential challenges for agency website operators to maintain information relevant to GBMSM which is up-to-date, understandable for a range of health literacy skills and optimises user experience.

Sexual health literacy among gay, bisexual and other men who have sex with men: a conceptual framework for future research

“…Applying specifically to sexual health, it builds on Nutbeam's three-part model of functional, interactive and critical health literacy (Nutbeam 2000), and the broader definitions of health literacy that recognise dynamic and societal influences (Sørensen et al 2012;Nutbeam 2000;Rootman and Gordon-El-Bihbety 2008;Zarcadoolas, Pleasant, and Greer 2005;Nutbeam 2008). It extends the existing and limited field of sexual health literacy research (Freeman et al 2018;Vamos et al 2018;Lin, Zhang, and Cao 2018;Haruna et al 2019;Kaczkowski and Swartout 2019), particularly among gay, bisexual and other men who have sex with men (Rosenberger et al 2011;Eliason, Robinson, and Balsam 2018;Oliffe et al 2019;Manduley et al 2018;Gilbert et al 2019;Brookfield et al 2019;Rucker et al 2018), by advocating a multi-level approach to enable men to attain sexual health literacy in the context of social and cultural practices and forces that shape it. There is a challenge for communities to manage sexual health within the wider context of social stigma and shrinking healthcare services, while increasingly being asked to become (bio)medical experts in their own sexual healthcare.…”

“…Some studies have applied (existing and tailored) health literacy measures to our understanding of treatment adherence and health outcomes among people living with HIV (Perazzo, Reyes, and Webel 2017;Reynolds et al 2019). Much of this research has focused on young people and/or the individual-level (Haruna et al 2019;Freeman et al 2018;Vamos et al 2018;Lin, Zhang, and Cao 2018;Kaczkowski and Swartout 2019) and while a few studies have begun to examine health literacy inequities among gay, bisexual and other men who have sex with men (Rosenberger et al 2011;Manduley et al 2018;Gilbert et al 2019;Brookfield et al 2019;Rucker et al 2018;Eliason, Robinson, and Balsam 2018;Oliffe et al 2019), sexual health literacy as a concept remains under-developed.…”

Delivering HIV pre-exposure prophylaxis (PrEP) care online: A scoping review

“…Sixteen studies delivered PrEP-related elements of care in the context of PrEP, [24,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] 38 delivered an aspect of HIV testing online without being explicitly related to PrEP, [25][26][27] one study provided renal test results online outside a PrEP context, [78] and four studies reviewed existing online content. [79][80][81][82] We have grouped our findings depending on whether or not PrEP is explicitly incorporated into each service given the possible higher relevance of the studies that delivered care in a PrEP context.…”

Strategies to support HIV literacy in the roll-out of pre-exposure prophylaxis in Scotland: findings from qualitative research with clinical and community practitioners

“…7 While health literacy has received increasing attention in recent years, 16 there has been less focus on HIV and sexual health literacy. [29][30][31] This is especially important given the increasing role of biomedical HIV prevention and its role in sustainable contemporary HIV prevention efforts. Parker et al 2 argue that 'little has been done to articulate the pedagogical approaches through which knowledge about these existing tools might be best transmitted -let alone how decision might be made about which tools to use 2 ' (p. 2).…”