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[This corrects the article DOI: 10.2196/10695.].
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BACKGROUND: According to a 2015 report from the Pew Research Center, nearly 24% of teens go online almost constantly and 92% of teens are accessing the internet daily; consequently, a large part of adolescent romantic exploration has moved online, where young people are turning to the Web for romantic relationship-building and sexual experience. This digital change in romantic behaviors among youth has implications for public health and sexual health programs, but little is known about the ways in which young people use online spaces for sexual exploration. An examination of youth sexual health and relationships online and the implications for adolescent health programs has yet to be fully explored. OBJECTIVE: Although studies have documented increasing rates of sexually transmitted infections and HIV among young people, many programs continue to neglect online spaces as avenues for understanding sexual exploration. Little is known about the online sexual health practices of young people, including digital flirting and online dating. This study explores the current behaviors and opinions of youth throughout online sexual exploration, relationship-building, and online dating, further providing insights into youth behavior for intervention opportunities. METHODS: From January through December 2016, an exploratory study titled TECHsex used a mixed-methods approach to document information-seeking behaviors and sexual health building behaviors of youth online in the United States. Data from a national quantitative survey of 1500 youth and 12 qualitative focus groups (66 youth) were triangulated to understand the experiences and desires of young people as they navigate their sexual relationships through social media, online chatting, and online dating. RESULTS: Young people are using the internet to begin sexual relationships with others, including dating, online flirting, and hooking up. Despite the fact that dating sites have explicit rules against minor use, under 18 youth are using these products regardless in order to make friends and begin romantic relationships, albeit at a lower rate than their older peers (19.0% [64/336] vs 37.8% [440/1163], respectively). Nearly 70% of youth who have used online dating sites met up with someone in person (44.78% [30/67] under 18 vs 74.0% [324/438] over 18). Focus group respondents provided further context into online sexual exploration; many learned of sex through pornography, online dating profiles, or through flirting on social media. Social media played an important role in vetting potential partners and beginning romantic relationships. Youth also reported using online dating and flirting despite fears of violence or catfishing, in which online profiles are used to deceive others. CONCLUSIONS: Youth are turning to online spaces to build sexual relationships, particularly in areas where access to peers is limited. Although online dating site use is somewhat high, more youth turn to social media for online dating. Sexual relationship-building included online flirting and online dating websites and/or apps. These findings have implications for future sexual health programs interested in improving the sexual health outcomes of young people. Researchers may be neglecting to include social media as potential sources of youth hookup culture and dating. We implore researchers and organizations to consider the relationships young people have with technology in order to more strategically use these platforms to create successful and youth-centered programs to improve sexual health outcomes.
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BACKGROUND: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 carry the nation's highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. OBJECTIVE: Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants' social networks. A social work interventionist then meets with the SC and SC-participant dyad to activate and maintain HIV-specific social support. METHODS: Project nGage is operating in two phases. In Phase I, the Team refined study protocols based on pilot testing. In Phase II, 94 HIV infected YBMSMT ages 16-29 will be recruited, enrolled and randomly assigned to receive Project nGage or treatment as usual (TAU). The primary outcome is appointment attendance; the secondary outcomes are medication adherence and viral load. RESULTS: Implementation challenges include coordinating sites, managing dyadic intervention logistics, and recruiting non-adherent patients or those who have fallen out of care. The team continues to address implementation issues as the study progresses. CONCLUSIONS: Project nGage is addressing a gap in HIV care-related research by focusing on supportive relationships as a mechanism through which to promote retention in care. Pending study results, a larger RCT would compare the relative effectiveness of the Project nGage intervention versus TAU over 18 to 24 months.
