Sexual health promoters who wish to harness the power of Facebook and other social media need to consider the role such websites play in young people’s presentations of themselves to others and the stigma of sexual health issues, according to a small qualitative study published in the May issue of Reproductive Health Matters.
Social media has particular potential for sexual health because it uses networks of peers. Young people’s friends are an important source of sexual information; learning sexual information from peers is often argued to be more effective than learning from adults.
In order to better understand this potential, investigators conducted focus groups with 22 young people, aged 16 to 22, in New South Wales, Australia. While some of the findings may be specific to this age group, the conclusions are suggestive for health educators using social media to reach other populations.
The researchers say that health promotion designed for social media needs to engage with the constantly evolving ways in which young people manage their identity in this semi-public space. Social media interactions have an impact on friendships and relationships in the 'real world'. Decisions about information shared, comments made, and photos uploaded are not made lightly, but often carefully considered in relation to an imagined audience.
“With health information, I think it’s better if it’s anonymous because I don’t think everyone’s really comfortable about talking about that kind of stuff with random [people]... It’s something they want to keep to themselves.”
Several participants suggested that it would be “weird” to post sexual health information on Facebook.
“It’s, like, you don’t really want that on your wall.”
Sexual health issues were much more likely to be discussed via personal messaging or conversations among close friends.
The researchers say that the agendas of health educators and social media users are, in many ways, conflicting. Professionals want to use social media to reach large numbers of young people with a single take-home message.
In contrast, users do not only ‘receive’ information in social media, but participate in its creation. People are most likely to share and disseminate information that is self-created, adapted or subverted (for example, through parodies) to suit different relationships and networks.
The young people said that sexual health information that is serious – i.e. didactic and risk-focused – is unlikely to have traction in social media spaces.
“No one wants to get a lecture while they are online and trying to do their social thing.”
Information which could be read as disclosing something about a young person’s sexual activities or suggest that he or she had a sexually transmitted infection was seen as particularly problematic. Some participants expressed fears of bullying, gossip and ‘drama’, which could occur either online or in the ‘real world’, for example at school.
However the researchers found that this apparent preference for generic, impersonal information does not actually fit into everyday social media practices. Young people tended to engage with information that connects with personal activities or concerns.
One way this paradox could be resolved, the participants said, was by using humour. Funny videos were commonly discussed as having the potential to not implicate the sender or the viewer, who are simply enjoying the humour. Using humour would increase the likelihood of material being disseminated amongst young people’s peer networks. The participants also felt that such messages were more likely to be remembered.
“Well I think you need to have a funny element because if it’s just serious it’s going to scare people off. So I think you need to draw people in using funny and then maybe have like a serious kind of punch line at the end or something.”
However, the authors caution that humour is personal and subjective; it needs to be handled carefully so as not to encourage stigma or shaming.
They conclude: “The young people in our study were interested in sexual health information, but did not want to access it at the cost of their own sense of comfort and belonging in their social networks. Any sexual health promotion within these sites must be understood as a site-specific intervention.”
Byron P et al. “It would be weird to have that on Facebook”: young people's use of social media and the risk of sharing sexual health information. Reproductive Health Matters 21: 35-44, 2013. (Full text available here.)
