Facebook, gay men and HIV prevention: the new ménage a trois?

Facebook, gay men and HIV prevention: the new ménage a trois?

HIV Australia | Vol. 10 No. 1 | June 2012

Yves Calmette looks at the emergent power of Facebook to reach and (re)engage with gay men.

Social media is currently the most popular online activity worldwide; social networking sites now reach 82% of the online population, representing 1.2 billion users around the world.1

The popularity of social media is even more evident when examining the amount of time people spend engaging with it.

Research from ComScore indicates that social media use has more than tripled in the last few years, with users now devoting nearly one in every five minutes of the time they spend online with social networking activities.2

This is a huge increase from March 2007 when social networking accounted for only 6% of the total time spent online; over the past year alone, the total time individuals spent using social media grew by 35%.3

This rapid growth of social media’s popularity has been further accelerated by the growth in mobile social media use, driven largely by the increasing popularity of smartphones.

Australia has the second highest smartphone penetration by population density in the world.4 In 2011, the percentage of Australians who owned a smartphone grew from 37 to 50% and this figure is projected to increase further in 2013; little wonder that Australia ranks as the #1 online population using social media.5

Nevertheless, organisational uptake of social media has been relatively slow. For example, according to a 2010 study conducted by the Harvard Business Review in the US, only 12% of companies and organisations surveyed indicated that they were effective users of social media and just 7% said they were able to integrate social media into their marketing activities.6

At the same time, research clearly demonstrates that much of gay men’s connection and engagement is via online environments.

30 years into the HIV epidemic, engaging gay men with health promotion messages through traditional channels is becoming extremely challenging. They pay less and less attention to these messages – and a large majority no longer engages regularly with gay print media.7, 8

Health promoters are therefore urged to adapt accordingly and quickly master all the possibilities the digital world and social media have to offer.

Facebook’s viral reach

To fully understand the state of social media today, we must appreciate the immense influence Facebook has on the entire social media category; it is the largest social media player by any metric and the third largest website in the world, following only Google and Microsoft.9

In October 2011, Facebook was accessed by more than the half of the world’s internet users, accounting for up to 90% of time people spent on social media sites and one in every seven minutes spent online overall.10

Research shows that gay men have enthusiastically embraced Facebook, with approximately 75% of gay men in the US reporting that they had a Facebook profile in 2010.11

Two surveys confirmed that 75% of Australian gay men use Facebook every day while only 21–28% reported reading the weekly gay press every week.12, 13

‘Fans’ and friends of fans

Facebook’s reach is much greater than the number of ‘fans’ of a particular page; the site enables innovative ways of sharing amongst friends that accelerates the viral reach of content. Many organisations tend to focus only on the number of ‘fans’ they attract (i.e. people who have directly ‘liked’ their Facebook page); however, the friends of these fans constitute a second potential audience.

This group is much larger than a pages’ primary fan base (34 times on average, for the top 100 brands on Facebook14) and receives social media content via their friends.

In addition, the potential level of interest friends of fans have in the content might be as high as the fans themselves. Although they might not be willing to explicitly ‘like’ a page themselves, they are still likely to be interested in what their friends ‘like’ or engage with.

Therefore, an organisation working on acquiring and engaging fans can benefit from a significant secondary effect that provides additional exposure often surpassing the reach among fans.

Case study: The Big Picture campaign

For its The Big Picture social marketing campaign, ACON sourced the specific benefits Facebook offers for updating gay men’s knowledge about the current state of the HIV epidemic in New South Wales, Australia.

ACON set up a dedicated Facebook page linked to a website containing the most up-to-date epidemiological and behavioural research into HIV and gay men in Australia.

Daily updates were posted under four topic headings: HIV (notification/risk behaviour) rates; Who is most at risk; Living with HIV; and Stepping up to drive infections down.

The relevance and impact of posts was enhanced via an optimised online experience mix of open and poll questions, graphs, text-only posts, targeted ads and sponsored stories. ACON monitored social media activity in order to maintain an authentic ‘Facebook grade’ responsiveness to fan feedback.

A Facebook advertising campaign was also created to direct people to the Facebook page and to increase the number of fans. Fourteen different ads were developed, using different design, copy, and targeting techniques.

These were shown over 8 million times and were directly attributed to the recruitment of up to 75% of new fans at a very low cost: $2,500.

Interestingly, targeting men according to their interests related to gay clichés such as ‘fans of Lady Gaga’ or ‘George Michael’ proved to be more effective and sustainable than targeting men who specified in their profiles that they were, ‘interested in men’. Ad copy that included the words ‘gay’ and ‘HIV’ were also more successful. And – surprise, surprise! – designs featuring photos of men also generated more clicks.

After eight weeks the Facebook page had gained more than 1,500 fans, offering viral onflow to a potential 535,000 friends. Every week, the page was seen between 50,000 and 100,000 times by fans and friends of fans on Facebook, extending target demographic impact potential far beyond traditional campaign engagement parameters.

We know that Facebook is particularly effective in reaching younger demographics. Research shows that men in the 35–54 age group spend half the amount of time on social media than the 20–24 age group.15 However, people aged 55 and older are in fact the fastest growing group of social media users worldwide, exceeding 90% of users in some regions.16

User engagement with The Big Picture campaign also indicates that Facebook is not only for young people: 30% of our fans were under 24, while 37% were in the 25–44 age group and 13% were over 45. It is interesting to note that for the first two weeks, 50% of our fans were under 25 but the targeting techniques we used ultimately also allowed us to reach older men.

Facebook also proved to be crucial in expanding the campaign reach and profile in the online space and was a primary driver of traffic to the website.

The website attracted three times more traffic than previous campaigns with similar budgets and themes, but no activities on Facebook.

Interestingly, the level of interaction between the Facebook page and the fans was relatively limited. An average of 100 to 200 people ‘talked’ about the posts on a single week: they mostly ‘liked’ them and a few shared them or posted a comment, with a maximum of 2,300 people participating in or observing these interactions. 60% of people were exposed to the messages up to three times.


Barriers to interaction

It’s not clear what the main barriers to interaction were but research on other Facebook campaigns suggests that:

  • Facebook users are typically more engaged by content that relates to them and with which they can personally identify, as opposed to factual content (such as the Big Picture campaign).
  • Facebook users also preference the simple and clear over the unfamiliar, lengthy and complex.

The external campaign qualitative evaluation17 gives very valuable insights about the relatively low level of interaction:

  • Many gay men – in particular older men – have concerns about Facebook privacy and security.
  • Those who aren’t openly gay don’t want to be outed on Facebook.
  • Others, even if they are totally comfortable with their sexuality, aren’t entirely open to talking about HIV-related topics in a public space such as Facebook. They don’t want their work colleagues, potential recruiters or families, to make assumptions about their sexuality or their HIV status.
  • Many men will never consider adding to the conversation, preferring to read posts rather than contributing their own.


As social media continues to redefine the digital media landscape, health promoters have an ever increasing range of prevention message dissemination options.

The Big Picture experience demonstrates the power of the largely untapped prevention message reach potential within the Facebook Fans/Friends viral flow. Creative use of rapidly evolving online communication methodologies offers as yet largely unexplored potential for engaging, listening and responding to online priority populations at risk of HIV.

Facebook is an invaluable tool for reaching mass audiences at low cost and offers a much more engaging next generation alternative to gay print media, which – like print media everywhere – is facing declining readership and relevance.

The great conundrum is that while Facebook is particularly effective in driving traffic to gay men’s health promotion websites, it can’t make gay men more interested in – or engaged with – the information they find on arrival. If we find the key to that, we could take the power of Facebook to the next level and make it one of the most effective (re)engagement options for gay men.

See also

Yves’ slides on this topic from the AFAO/NAPWA Gay Men’s HIV Health Promotion Conference (May 2012)


1 ComScore. (2011A). It’s a Social World: Top 10 Need-to-Knows About Social Networking and Where It’s Headed. Retrieved from: www.comscore.com/it_is_a_social_world

2 ibid.

3 ibid.

4 IPSOS/Google research quoted by Nett.com.au (2011). Australia has second highest global smartphone usage, study shows. Retrieved from: http://nett.com.au

5ComScore. (2011A), op. cit.

6 Harvard Business Review Analytics Services. (2010). The New Conversation: Taking Social Media from Talk to Action. Retrieved from: http://www.sas.com/

7 Spina, A. (2010A). Whytest Evaluation Report. ACON, Sydney.

8 Spina, A. (2010B). Drama Down Under Phase 2 Evaluation Report. Australian Federation of AIDS Organisations, Sydney.

9 ComScore. (2011A), op. cit.

10 ibid.

11 Harris Interactive. (2011). Social Networks, Blog Popularity Remain High for Gay Americans over Past Three Years. Retrieved from www.prnewswire.com/newsreleases/

12 Spina, A. (2010A), op. cit.

13 Spina, A. (2010B), op. cit.

14 ComScore.(2011B). The Power of Like. How Brands Reach and Influence Fans Through Social Media Marketing. p. 2. Retrieved from: www.comscore.com/like

15 ComScore. (2011A), op. cit.

16 ibid.

17 Stokes Mischewski Market Research Sydney. (2012). The Big Picture Evaluation Report. ACON, Sydney.

Yves Calmette is Principal Program Planner at ACON.