HIV Cyber-Educators Meet Hidden Populations Where They Are

By Paola Chavez-Zurita and Emma Halper, PSI

Edited by Alejandra Cabrera, PASMO

Marcos Rodas loves social media.

And he’s certainly not alone. As a young Guatemalan, Marcos is one of 102 million Facebook users in Central America and Mexico, a region where 59 percent of internet users have active social media accounts.

Central America is also facing another growing population—people living with HIV. In this region, one person per hour becomes infected with HIV. This epidemic disproportionately affects men who have sex with men (MSM) and transgender people, with prevalence rates 10-20 times higher than the general population.  And what’s more, these groups are often hard to reach due to high levels of stigma and discrimination towards LGBT communities in Central America, the existence few support networks and the lack of LGBT-friendly sites.

Faced with this challenge, PSI’s network member in Latin America, the Pan American Social Marketing Organization (PASMO), hired social media gurus like Marcos as “cyber-educators,” part of an initiative under the USAID Combination Prevention Program. As peer outreach workers trained to conduct social and behavior change communication interventions online, cyber-educators work with at-risk and young MSM in danger of contracting HIV, especially those who do not self-identify as gay or who are bisexual.

Watch this video to learn more about the initiative:

Marcos’ love of social media has led him to become one of PASMO’s first cyber-educators. The PASMO team grew quickly; he now coordinates a group of approximately 40 cyber-educators as the Regional Social Media Coordinator at the PASMO regional office in Guatemala.

PSI recently spoke Marcos to find out why he and his peers are so excited about using social media to teach more people about HIV:

  1. How did you get involved with PASMO and the cyber-educator program?

While I was at university, my radio program hosted a festival and VIVE condoms was a partner there. That was my first exposure to PASMO and the work they did. After the festival, I was invited to become a youth volunteer and participate in their weekly radio program – “Club en Conexión” (Club in Connection), which focused on sexual and reproductive health. That’s how my association with PASMO began. I later transitioned into working for PASMO full-time and brought my passion for social media and digital media to the regional office.

In 2012, the cyber-education initiative was created under the Combination Prevention Program for HIV to help reach “difficult to access” MSM with prevention services and interventions through innovative and new channels. At the time, the “Gay Guatemala” chat room was one of very few but very active online chats for MSM.  With the guidance and support of PASMO’s Sussy Lungo and Karla Oliva, we had already begun to discuss how we could adapt face-to-face outreach to online settings.  One day, we conducted a quick pilot and I posted the following question in the chat room: “Who wants to know more information about HIV?”. Within just two hours, we received over 78 messages and realized the immense potential for this platform!

  1. What is it like to be a cyber educator?

The cyber-educator provides much more than just information, he or she becomes an online specialist focused on providing key health interventions to vulnerable populations. They are responsible for capturing, informing, and engaging at-risk individuals within the gay, bisexual and trans communities and for providing referrals to follow-up to services such as HIV testing.  They can generate an online voucher for these referrals, and use social media platforms such as WhatsApp, Facebook (profiles, closed groups, and Fan Pages), to identify, engage and interact with at-risk users.

On a day-to-day basis, this translates into identifying new “high-risk” groups in WhatsApp and Facebook, designing and posting creative online content designed to attract at-risk individuals and motivate them to learn their HIV status, respond to inbox queries and provide follow-up to referrals. The cyber-educators are constantly engaged in conversations with users. Typically, a cyber-educator will reach out to any user who has commented or ‘liked’ their post on Facebook and inquire if the user is interested in speaking with them or if they have any specific questions about HIV testing and prevention.

  1. In your opinion, what qualities make a good cyber-educator, and do you have a training mechanism for bringing new cyber-educators on board?

In my experience, the most successful cyber-educators combine passion about social media and customer service with health, and those who can integrate seamlessly into the community ideally as peers. This makes it easier for users to trust them, share sensitive information and ask questions they would be otherwise uncomfortable posing.

While a natural ability to communicate is ideal, we offer a robust cyber-education training program. Through in-depth orientation training, new hires are onboarded into the program, and are taught about PSI/PASMO’s focus areas, behavior change programming, interactive communication strategies, creating social media profiles for cyber-education and the program’s action plan. While the induction workshop is about a week long, in their first two months new cyber-educators can shadow others that have been involved in the program and get accustomed to the environment.  Our regional team also provides one-on-one support and follow-up on a weekly and bi-weekly basis.

  1. Tell us about a memorable experience you’ve had in the cyber-education program.

Among the many experiences I have had with cyber-education, one is most memorable to me.
Recently one of our cyber-educators had a conversation with a young man with very low self-esteem. He was embarrassed to tell anyone that he was gay. The cyber-educator provided him with information about HIV and encouraged him to get testing as he admitted to recently having unprotected sex. After encouragement and support, the young man agreed to get tested and discovered that he was HIV positive. To this day, the young man still regularly communicates with the cyber-educators and has become more confident in himself and his decisions because of it.

  1. Where do you see the cyber-educator program going in the future?

In 2016 and 2017, our cyber-education program expanded to other health areas in the region, including Zika prevention, and family planning services targeted to youth.  In the future, I have no doubt that we’ll continue to address other health areas such as mental health or others.  Social media is updating constantly as well, and although Facebook as a platform has been successful for for our online interventions, we are exploring new channels such as WhatsApp and dating apps such as Tinder and Grindr.  Social media for health interventions is the future.

For more details on the cyber-educator program, click here.