Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study

Abstract

Background About 46% of US adults obtain recommended HIV screening at least once during their lifetime. There is little knowledge of screening rates among deaf and hard-of-hearing adults who primarily use American Sign Language (ASL), or of social media as a potentially efficacious route for HIV prevention outreach, despite lower HIV/AIDS-specific health literacy and potentially higher HIV seropositivity rates than hearing peers. Objective We investigated both the likelihood of HIV screening uptake among deaf adults in the past year and over one year ago, and the relationship between social media use and HIV screening uptake among deaf adult ASL users. Methods The Health Information National Trends Survey in ASL was administered to 1340 deaf US adults between 2015-2018. Modified Poisson with robust standard errors was used to assess the relationship between social media usage as a predictor and HIV screening as an outcome (screened more than one year ago, screened within the past year, and never been screened), after adjusting for sociodemographics and sexually transmitted disease (STD) covariates. Results The estimated lifetime prevalence of HIV screening uptake among our sample was 54% (719/1340), with 32% (429/1340) in the past year. Being of younger age, male gender, black, lesbian, gay, bisexual, or queer, or having some college education or a prior STD were associated with HIV screening uptake. Adjusting for correlates, social media use was significantly associated with HIV screening in the past year, compared to either lifetime or never. Conclusions Screening falls well short of universal screening targets, with gaps among heterosexual, female, Caucasian, or older deaf adults. HIV screening outreach may not be effective because of technological or linguistic inaccessibility, rendering ASL users an underrecognized minority group. However, social media is still a powerful tool, particularly among younger deaf adults at risk for HIV.

Perception of COVID-19 Physical Distancing Effectiveness and Contagiousness of Asymptomatic Individuals: Cross-sectional Survey of Deaf and Hard of Hearing Adults in the United States

“…Although both education and physical distancing awareness strongly predicted perceptions of the effectiveness of physical distancing, this study did not find evidence for the contribution of age, gender, and race to the development of appropriate perception of physical distancing effectiveness. This finding is consistent with research studies that reported a connection between more years of education and a greater level of health-related awareness or screening uptake [ 6 - 8 ]. Our study also showed that DHH people who have a college degree, as well as knowledge of the effectiveness of physical distancing, were much more likely to believe that an infected person without symptoms is contagious compared to DHH people who did not have a college degree and demonstrated low knowledge of the effectiveness of physical distancing.…”

“…However, most DHH ASL speakers, particularly DHH people with a high school degree or less, depend on information presented in ASL in videos as their go-to source for health information, with Facebook being the most often used source [ 5 ]. Previous studies have shown that DHH people with a high school degree or less have lower human papillomavirus knowledge, genetic testing awareness, and HIV screening uptake, all of which can be remedied with greater accessibility of pertinent information in ASL [ 6 - 8 ].…”

Perception of COVID-19 Physical Distancing Effectiveness and Contagiousness of Asymptomatic Individuals: Cross-sectional Survey of Deaf and Hard of Hearing Adults in the United States (Preprint)

“…Although both education and physical distancing awareness strongly predicted perceptions of the effectiveness of physical distancing, this study did not find evidence for the contribution of age, gender, and race to the development of appropriate perception of physical distancing effectiveness. This finding is consistent with research studies that reported a connection between more years of education and a greater level of health-related awareness or screening uptake [6][7][8]. Our study also showed that DHH people who have a college degree, as well as knowledge of the effectiveness of physical distancing, were much more likely to believe that an infected person without symptoms is contagious compared to DHH people who did not have a college degree and The lower knowledge of physical distancing and COVID-19 among DHH people who do not have a college degree may be in part explained by inadequate, inaccessible, or misleading information presented in ASL on social media.…”

“…However, most DHH ASL speakers, particularly DHH people with a high school degree or less, depend on information presented in ASL in videos as their go-to source for health information, with Facebook being the most often used source [5]. Previous studies have shown that DHH people with a high school degree or less have lower human papillomavirus knowledge, genetic testing awareness, and HIV screening uptake, all of which can be remedied with greater accessibility of pertinent information in ASL [6][7][8].…”

Challenges of Being Deaf and Aging With HIV: Focus Group Findings From Palm Springs, California

“…As highlighted by our participant responses, this population requires more HIV and other health resources in ASL and access to health care interpreters that are adequately trained to work with Deaf older PLWH. Recent research suggests social media may be an effective means of promoting HIV education among Deaf adult ASL users (Argenyi & Kushalnagar, 2019), whereas health care facilities may consider using or adopting Deaf peer educator programs, which have been successful internationally (He et al, 2020).…”