1. © 2009 Adelson Consulting Services

2. Why a Supplemental Incomplete understanding of gay men, MSM, and web-based communities – Increase general cultural competency – Increase awareness of gay culture – Increase understanding of MSM Confusion regarding the features and functions within social websites Assist in the normalization of IPS Help to ensure the longevity of IPS © 2009 Adelson Consulting Services

3. Intended Audience These guidelines are intended for state, county, local, or federal Disease Intervention Specialists, STD Control managers, relevant Local Health Department staff, or those approved, designated, and trained by the appropriate authority, to conduct partner elicitation and notification. © 2009 Adelson Consulting Services Portions of this guidance are appropriate for use in conjunction with other tools that are used to conduct Online Outreach and other Internet interventions

4. Table of Contents Introduction Acknowledgements Objectives Background Understanding Gay Culture Understanding MSM Working Within MSM Communities Before You Begin Getting Started Out Of Jurisdiction Concerns Browsing the Internet Community-based Websites Defined DIS Staffing for IPS Interviewing the OP Profile Basics Common Website Features Conclusions © 2009 Adelson Consulting Services

5. Understanding Gay Culture Freedom of sexual expression is generally a freedom that gay men value, treasure, and protect vehemently. Before any DIS is instructed to perform IPS within an MSM community their perceptions and assumptions regarding the sexual practices of gay men must be uncovered and addresses appropriately. Prior to the Stonewall riots of 1969 and changes in several laws and individual perceptions, gay men were forced to conceal their sexual orientation in order to achieve any semblance of assimilation into main-stream society. © 2009 Adelson Consulting Services

6. Understanding MSM Simply because a man falls within the category of MSM does not mean that he defines himself as gay. It is extremely important to remember that significant segments of the MSM population do not identify as gay or can be defined as being gay and closeted. Although the term MSM has been widely accepted in public health, the term is generally meaningless to those that have engaged in the behavior. It is important to remember that the term men who have sex with men is a behavioral term describing what someone does or has done, voluntarily or not. The term does not describe ones identity in any way. © 2009 Adelson Consulting Services

7. Working Within MSM Communities A profile is a glimpse into one or more aspects of a personality, created by an individual to be used as a marketing tool with a specific purpose in mind (e.g. to engage in offline sexual activity, to seek a long term partner, or simply to expand their social circle). IPS programs must use a variety of sites not only for partner notification but to obtain background information on an Original Patient or partners. Sites like Facebook and MySpace can provide a wealth of background information even if the sites are not used for the actual partner notification. © 2009 Adelson Consulting Services

8. About the Members It is a fallacy to assume that simply because a person is a member of an adult community that they are online for the sole purpose of arranging a sexual encounter. Online communities are much more complex than it appears on the surface. Social sites are often used as a way to affirm ones identity. A gay man in an oppressive area or situation may find great solace and joy in finding other gay men, even if they can only meet virtually. © 2009 Adelson Consulting Services

9. Getting Started: Questions to Consider Are MSM naming websites as venues of transmission? Does this staff person have the technical knowledge to effectively use the Internet as a disease intervention tool? Is this staff person culturally competent and able to serve online communities in an effective, non-judgmental way? Is the technology that will be needed in available and in place? Do computers to be used by DIS have access to sexually explicit websites? Has the legal department been consulted? Will there need to be any changes to existing policies that govern computer usage? Have I engaged and do I have the support of key stakeholders, policy, and the administrative community? © 2009 Adelson Consulting Services

10. Community-based Websites Defined Social Networking Sites A Social Networking Site (SNS) is web-based services that allow individuals to construct a public or semi-public profile within a bounded system that lists other users with whom they share a connection and can view and traverse this list of connections and the connections made by others within the system. In other words, a Social Networking Site is different from other online communities in that members on an SNS may publically collect friends and these friends then become links to others (one persons page can easily lead to another persons page). Niche Websites Some refer to all dating websites with adult content created to facilitate sexual hookups as; Niche Internet Dating sites. Dating Websites Dating Websites are a web-based service that allow individuals, couples and groups to create a public or semi-public profile with the objective of developing a personal romantic or sexual relationship. © 2009 Adelson Consulting Services

11. Staffing for IPS It is hoped that any DIS chosen for IPS is dedicated to reducing the rates of infection and passionately dedicated to their work. As stated in the California Department of Public Health IPS Standards: Every time a Disease Intervention Specialist (DIS) takes the time to assist a person diagnosed with an infection, the likelihood of that person becoming re-infected or infecting someone else drops. The willingness of DIS to assist in outbreak situations, and work with people from all walks of life tells of their dedication and commitment to improving the lives of all people and public health. © 2009 Adelson Consulting Services

12. Common Website Features Friends / Buddies – Some sites offer the option to collect buddies, others offer the option to collect friends. There are important differences between buddies and friends. You must use great care when adding any member as a friend or a buddy. In most cases, especially on Social Networking Sites, a Friend will be publically displayed on your profile or page. Buddies are generally a private list of other members and cannot be seen or viewed by the public. It is recommended that DIS avoid using a buddy list or friends all together. © 2009 Adelson Consulting Services

13. Get Involved! Include your thoughts! What do you wish you had when starting your IPS program? What questions do you have as you start your program? What are the most asked questions by your DIS that currently conduct IPS? What questions do you have about gay men, or MSM? What features on websites are the most confusing? © 2009 Adelson Consulting Services

14. What are the most common misconceptions in your department about IPS? What topics should be covered in IPS training? What are the factors that have made your IPS program a success? What are the persistent challenges you face in your program? Do you believe that IPS and the use of other technologies for DIS work can eventually replace field work? © 2009 Adelson Consulting Services

15. Contact info Stephan Adelson 617-953-9366 sadelson@sadelson.com © 2009 Adelson Consulting Services