Lessons learned from implementing and evaluating Internet chat room-based interventions to reduce HIV risk among MSM

Issue: The Internet has emerged as a potentially effective tool for HIV prevention outreach. Chat room-based interventions are being implemented by public health departments, clinics, and other community-based organizations. However, there are distinct challenges that must be recognized to ensure the success of the implementation and evaluation of chat room-based interventions.

Description: Our community-based participatory research (CBPR) partnership has been implementing and evaluating Internet chat room-based interventions targeting men who have sex with men (MSM) since 2002. Our NIMH-funded CyBER/testing intervention has been found to increase HIV testing among chatters.

Lessons Learned: Overall, we have discovered that (1) Internet and chat room use change rapidly and seemingly unpredictably over time; (2) distinct practical challenges exist to implementation (e.g., building trust, maintaining chatter interest, lack of nonverbal cues, protecting chatters); (3) chatters have broad and varied prevention needs; (4) online prevention efforts are difficult to evaluate; and (5) there are interventionist characteristics (e.g., being a member of the target community, being creative, juggling multiple chat simultaneously, chatting about non-prevention topics) and intervention approaches that seem key to success.

Recommendations: Because the Internet and chat rooms in particular have been shown to be a potentially successful strategy to reach MSM, research and practice must come together to further understand and overcome challenges associated with the strategy. Furthermore, we should move beyond documenting online behavior and its relationship to risk and determine how to intervene most effectively within various online applications (e.g., chat rooms,).