HIV Stigma in Social Media: The Double-edged Sword of Information Dissemination

Background. While biomedical advances hold promise in reaching an AIDS-free generation, stigma and discrimination persist towards the HIV-infected and those at risk. Stigmatization may hinder efforts to screen, test, identify, and link HIV-positive individuals with care. Public sentiment and discrete emotions expressed through social media can be a driving force for stigmatization and should be examined.   

Methods. Sentiment analysis of 282,244 public stream Twitter referencing HIV/AIDS in a 23-day period that encompassed before, during and after the International AIDS Conference (IAC) 2012 was conducted.  This time period was specifically selected as this was the first time IAC was being held in the United States (since the US HIV travel ban was lifted) and social media coverage would presumably be extensive. Tweets were analyzed for polarity (positive, negative, neutral) using SENTIWORDNET and classified by seven stigma-related emotions (disgust, surprise, anger, shame, pride, happiness, amusement, sadness) based on machine-learning algorithms of psychometrically-validated text samples.  The sample was restricted to English-language tweets.

Results.  Results show Twitter is used extensively for public discourse on HIV/AIDS.  Overall, 34% of HIV-related messages were retweeted (indicating interest); of which 11% were retweeted more than 50 times. The overall polarity of messages was neutral, indicating information dissemination. However, the top three expressed emotions were: disgust, amusement, and anger-three emotions associated with stigmatization (Schweder, 1992). Expressed amusement correlated with negative polarity (r=.143, p=000), contained negative jokes/humor around HIV/AIDS and increased from 3.5% of the tweets pre-IAC to 5.2% post-IAC (X2 =772.38, p=.000).  Neutral tweets increased during IAC indicating usage of Twitter as a dissemination vehicle, however, expressed anger also increased during IAC (X2 =107.13, p=.000). A sub-analysis of anger-tweets showed two expressed-types: anger at HIV-positive individuals and “social-justice” anger.  Furthermore, anger was more readily retweeted than disgust or amusement. Very low numbers of tweets expressed internally-directed (shame, pride) emotions.

Conclusions.  The International AIDS Conference 2012 event did have an immediate and highly specific effect in public sphere expressions regarding HIV/AIDS.  Twitter can serve as a predictor of public sentiment and can be used to shape public discussions of HIV/AIDS. These results should be considered in light of how anti-stigma campaigns as well as intervention recruitment messages should be framed in order to continue to accelerate efforts to end AIDS.