New information and communication technologies (ICTs) have gained growing importance in shaping social relations and are increasingly used as a field of research and intervention in various areas of knowledge. The Internet has become both an important source of information on the health-disease-healthcare process and a technology that allows building new forms of subjectivity and social and affective interaction, thus meriting special attention by the Public Health field.
In this issue, the paper Cruising y e-citas: Un Nuevo Contexto para los Encuentros Sexuales entre Hombres Jóvenes que Tienen Sexo con Hombres by Grau-Muñoz et al. (p. 2303) report on a study in Spain on the use of ICTs (websites and smartphone apps) to mediate sexual relations among young men who have sex with men, and their importance for understanding new risk and protective practices in relation to STI/HIV/AIDS. ICTs are increasingly used for sexual encounters by way of Internet cruising. The authors used qualitative methodologies to hold offline discussion groups and content analysis of internet chat groups for sexual encounters. The study shows that ICTs contribute to a new organization of social practices, characterized by growing ease of access to sex partners; the widespread dissemination of such practices; immediate access to the encounters; anonymity; anticipation of offers during the face-to-face encounters; and openness to a wide range of users.
The research stems from concern over data pointing to “relaxation” in condom use and growing estimates of HIV/AIDS cases among young men who have sex with men in Spain, a trend that has also been observed in Brazil 11. Ministério da Saúde. Boletim Epidemiológico Aids/DST; 2014.. However, Grau-Muñoz et al. are careful to state that online cruising or Internet-mediated sexual encounters per se are not necessarily risk practices, although due to some of their characteristics they can produce a scenario of “relaxation” in safe sex. The authors conclude by stating that the cruising context is not characterized by a concern over HIV or STIs, but by the desire to accumulate and enhance experiences, or according to Silva 22. Silva LAV. Barebacking e a possibilidade de soroconversão. Cad Saúde Pública 2009; 25:1381-9. (p. 1388), quoted by the authors in relation to barebacking, “by the need to live the present intensely and completely”.
Beyond viewing the internet as a facilitator of risk practices, other aspects need to be considered, including its use to foster a feeling of security prior to the face-a-face encounter, resulting from the possibility of anticipating what is expected in such encounters (e.g., expectations as to condom use). In this sense, understanding the way new ICTs are used, redefined, and incorporated into social practices is crucially important for designing prevention and health promotion measures.
Cyberspace thus represents a rich field of possibilities for new studies and health interventions, transcending the mere diffusion or application of research instruments 33. Honorato EJS. A interface entre saúde pública e cibercultura. Ciênc Saúde Coletiva 2014; 19:481-5.. We thus propose to highlight some of its potentialities for producing new insights and theoretical and methodological tools for approaching some of the contemporary world’s complex objects.
In addition to advances in antiretroviral therapies, new communication technologies have helped reshape living with HIV/AIDS. Current developments of online support groups for persons living with HIV/AIDS include obtaining information, counselling, and social support. Participation in these groups allows developing greater optimism in relation to the disease and the future, besides a perception of less isolation 44. Mo PKH, Coulson NS. Online support group use and psychological health for individuals living with HIV/AIDS. Patient Educ Couns 2013; 93:426-32.. The Internet has also facilitated different risk/harm reduction strategies already used routinely by different people, such as serosorting, referring to sexual relations between persons with “concordant serology”, when the partners agree to waive condom use 55. Terto Jr. V. Diferentes prevenções geram diferentes escolhas? Reflexões para a prevenção de HIV/AIDS em homens que fazem sexo com homens e outras populações vulneráveis. Rev Bras Epidemiol 2015; 18 Suppl 1:156-68.. For example, some gay men living with HIV use the Internet to find other HIV-positive partners for unprotected anal sex. This online practice allows seropositive gay men to reduce the risk of HIV transmission, while avoiding sexual rejection and prejudice 66. Davis M, Hart G, Bolding G, Sherr L, Elford J. Sex and the internet: gay men, risk reduction and serostatus. Cult Health Sex 2006; 8:161-74..
The world is certainly witnessing new scenarios, scenes, and everyday meanings that have emerged through these new technologies. This opens a broad agenda for studies and questions to be elaborated (and naturally extending beyond the area of studies on sexuality and STI/HIV/AIDS prevention), the main focus of which is to analyze the relationship between humans and technologies. This also raises the need to rethink the place and importance of things and materials in the co-production of various phenomena. For example, when cellphones connected to mobile or Wi-Fi networks, they acquired new uses and interests, but also apparently engendered new forms of subjectification. Following some leads from the actor network theory, we can conceive of all natural and social things as effects generated continuously in the networks of relations in which they are situated 77. Law J. Actor network theory and material semiotics. In: Turner BS, editor. The new Blackwell companion to social theory. Chichester: Blackwell Publishing Ltd.; 2009. p. 141-58.. With new interactive possibilities and diverse connections, new “subjects” of collective health also emerge (professionals, researchers, communities, etc.). This emphasizes the need for a better understanding of these “actants” (persons and technologies) and a discussion and continuous revision of the limits and potentialities of our public policies.
Jorge Alberto Bernstein Iriart
Luís Augusto Vasconcelos da Silva
Instituto de Humanidades Artes e Ciências, Universidade Federal da Bahia, Salvador, Brasil.
- 1Ministério da Saúde. Boletim Epidemiológico Aids/DST; 2014.
- 2Silva LAV. Barebacking e a possibilidade de soroconversão. Cad Saúde Pública 2009; 25:1381-9.
- 3Honorato EJS. A interface entre saúde pública e cibercultura. Ciênc Saúde Coletiva 2014; 19:481-5.
- 4Mo PKH, Coulson NS. Online support group use and psychological health for individuals living with HIV/AIDS. Patient Educ Couns 2013; 93:426-32.
- 5Terto Jr. V. Diferentes prevenções geram diferentes escolhas? Reflexões para a prevenção de HIV/AIDS em homens que fazem sexo com homens e outras populações vulneráveis. Rev Bras Epidemiol 2015; 18 Suppl 1:156-68.
- 6Davis M, Hart G, Bolding G, Sherr L, Elford J. Sex and the internet: gay men, risk reduction and serostatus. Cult Health Sex 2006; 8:161-74.
- 7Law J. Actor network theory and material semiotics. In: Turner BS, editor. The new Blackwell companion to social theory. Chichester: Blackwell Publishing Ltd.; 2009. p. 141-58.
- Publication in this collection