In response to “Activists: CDC ‘plodding’ in its response to rising HIV infection rates among gay men, trans women” (June 20, 2014), I applaud the efforts of the detailed team of activist in challenging the CDC’s HIV prevention efforts. As we continue to see upticks in HIV transmission rates especially among young gay men, it is truly beyond time to design and deploy prevention efforts that align and respond with the reality(ies) of those populations at highest risk. The offered “Atlanta Principles,” outlined by the activists, provide a framework for the design of more responsive prevention efforts, and at the core of this framing, as detailed by Craig Washington of AID Atlanta during the meeting, is the need for prevention efforts to “speak in the real language and context of the way gay men live their lives.” And one key factor changing the context and language of how young gay men, in particular, navigate and negotiate their sexual encounters are geosocial networking applications – GSN apps (dating/hook-up mobile apps such as Grindr).
Truly, these apps are evolving the “dance” — for good and maybe not so good. For good, the means often afforded by many these apps (e.g. offering a dedicated field on one’s profile to state status and/or safer sex intentions), conceptually, offers the basis for a more focused discussion during the face-2-face (f2f) meeting and/or encounter (e.g. putting stated status information in context within last sexual encounters). Not so good is the fact that the provided profile information, often inaccurate (http://projecthot.org/tag/grindr/), is the only insight used in the decision making around the sexual encounter. Truly, a more complex communications landscape exists; and current CDC efforts such as its “Start Talking” campaign, with minimal content on the realities of the new dance, offers little help in this growing computer mediated disclosure/intentions context.
Both the role and prevention opportunities that these technologies offer, contextually, as a mediator of the “dance” cannot be discounted and warrant greater exploration and more explicit prominence on the CDC’s HIV prevention agenda. Supporting this recommendation, I would even go so far as to suggest that the CDC should be leading efforts in the design and development of a next generation dating/hook-up mobile app, the next Grindr. Just imagine the possibilities; a bottom up design grounded in prevention – helping people make better decisions – yet rooted in the reality of both constituent use and needs.
Ultimately, a shift from a more reactive to proactive response paradigm by the CDC, as this type of undertaking reflects, is what is needed to facilitate and offer the sort of imaginative and innovative responses needed to finally reverse infection trends. I recognize that this sort of shift is not easy. It’s a systems problem. Federal constraints and associated bureaucracy, funding cycles and mechanisms, and often a lack of understanding and appreciation of interdisciplinary, private and public explorations often are barriers. But as the activists have boldly suggested, if we are ever going to witness the end of this evolving epidemic, it’s time for the CDC to stop plodding and restructure and retool to engage with the realities of HIV transmission in the true context of people’s lives.
Woodrow W. Winchester, III, PhD