Op-ed: Digital Ways of Preventing HIV Are the Best Medicine

More and more gay men are hooking up online. The explosion of "Gaydar culture" through Xtube, Manhunt, Adam4Adam, and Grindr can increase risky sexual behavior, spawning fears of a new wave of HIV infections, particularly among young gay men. Yet, as new digital technologies change the way we enjoy sex and experience relationships, they are also changing the face of the AIDS response in remarkable ways.

In recent years, the global AIDS establishment has become fixated on medical approaches to HIV prevention. The success of antiretroviral therapies and new clinical trials on pre-exposure prophylaxis (PrEP) have transformed the field, and "Treatment as prevention" is now promoted by the US PEPFAR, UNAIDS and the WHO.

The prospect of ending the HIV epidemic with a simple pill is seductive - but falsely so.

Fuelled by disparity and discrimination, HIV slams communities on the margins of society. Gay men have experienced this since the beginning of the epidemic, yet the medical establishment continues to advocate for chemical "quick fixes" to an exceedingly complex social problem. We cannot let these medical - albeit important - scientific advances distract us from what social science researchers have been telling us for years: the roots of this epidemic lie in the lack of health and human rights for gay men, other men who have sex with men (MSM) and transgender people in the developed and developing world.

Fortunately, just as we did at the beginning of the AIDS epidemic, our communities are taking the lead in tackling these fundamental challenges. As digital technologies become integral to our lives, they have become equally central to innovative HIV education, prevention and care efforts. These technologies enable us to work together in ways never before possible, offering unprecedented opportunities to tackle the many barriers that make our communities vulnerable to HIV.

Recognizing the importance of this global shift, a group of frontline workers, activists, professionals, educators and researchers have come together to build The HIVe, an online community that unites and shares these innovations. The HIVe was built through collaborative research, mentoring, and capacity building across eight countries during the last two years. Examples of these community-based efforts to combat HIV have been published this week in a special issue of the international peer-reviewed journal Digital Culture & Education (DCE), www.digitalcultureandeducation.com.

The interventions featured in the special issue demonstrate the power of digital solutions to address factors that have underpinned the epidemic among gay men for decades. In the Netherlands, gay men living with HIV mobilize through Facebook and blogs to fight stigma and discrimination. Peer educators in Thailand provide targeted online counseling on sexual and legal rights to gay men, other MSM and transgender people. In India, MSM communities build strategic networks to share vital information and advocate online. The Global Forum on MSM and HIV recognizes and supports these local efforts through digital tools and resources for collaborative solutions to practical problems.

By emphasizing the experiences of gay men and MSM in their daily use of digital technologies, these innovations challenge mainstream top-down public health approaches to HIV prevention. Because these initiatives put the tools for change in the hands of community members on the frontlines of the fight for health and human rights, they are building the foundations for our communities to design our own future.

Without this radical work, the development of new HIV prevention programs - medical or otherwise - will simply add to the mass of resources to which most of our community members around the world have no access to.

We are at a historic juncture. The digital era offers enormous potential for rethinking and designing an exciting, collaborative and contextualized prevention revolution. The evidence base of The HIVe shows that high-quality HIV prevention must be resistant, sexy and transgressive - leveraging the same digital technologies gay men use to experience pleasure and meet new partners.

Successfully ending the HIV epidemic now requires renewed political and cultural activism. We must challenge the medical illusion that gay men are politically apathetic bodies passively waiting for a pill to take. Digital technologies offer a new opportunity for the empowerment and activism of gay communities to experience health and human rights through open-source, free, and relevant HIV prevention and education solutions. Only by acknowledging the realities of our digital lives will our communities achieve the future that we deserve.

GURMIT SINGH and CHRISTOPHER S. WALSH are co-founders and facilitators of The HIVe. To join a global community project to build the HIVe, learn more and contact us through Facebook . The creators of The HIVe will present their work at the upcoming MSMGF Pre-Conference: "From Stigma to STRENGTH: Strategies for MSM, Transgender People and Allies in a Changing AIDS Landscape," taking place on July 21 in Washington, D.C. before the International AIDS Conference, held in partnership with FHI 360 and the National Black Gay Men's Advocacy Coalition. More information on this event can be found at www.msmgf.org/aids2012.