Can twitter be a force against HIV discrimination?
Advertisers have seen the potential of social media for informing their work for years, but public health is only just looking into the potential for improving the impact of campaigns.
As part of UNAids’ Protect the Goal campaign to raise awareness of HIV and Aids during the World Cup in Rio, we explored whether tweets could be used to measure HIV-related stigma. We wanted to find out whether discrimination makes people less likely to access health services such as condoms, HIV tests and antiretrovirals. We captured about 8,000 tweets in Portuguese filtering all the public messages, with a taxonomy of keywords covering discrimination, HIV prevention and testing topics.
A challenge for the project was to discover to what extent people tweet about personal issues. In this case we found that most of the tweets extracted were expressing discriminatory attitudes, some about HIV prevention, and very few were about testing: people do tweet about condoms, but few about getting an HIV test. We also compared tweets (positive and negative) in the cities where matches were taking place with the number of people who used extra health services that were put on for the World Cup (mobile testing stations and condom give-aways).
HIV tweets in Brazil during World Cup. Photograph: UN Global Pulse
While the analysis is still underway, the project has triggered thoughts about how we could deliver real-time follow up information on health services and correct misconceptions through social media opinion leaders, for example on the transmission of HIV and effectiveness of treatment.
This approach can be used in other areas of public health. In 2013, a Unicef study in eastern Europe found that social media can be used to influence opinions around immunisation. The report recommended that governments and international agencies need to counter the anti-vaccination sentiment identified on social media with strong messaging.
And social media analysis can be used for more than understanding opinions and attitudes. There is also potential for understanding people’s unhealthy habits. For instance, it is possible to predict whether a person smokes cigarettes or drinks alcohol using a person’s record of “likes” on Facebook. Mapping rapidly changing trends at population-level is a promising opportunity to keep track of risky behaviours, such as those associated to non-communicable diseases.
There are numerous challenges to make social media data helpful in public health. We need to learn how to work with massive incomplete and biased data: social media is not a statistically representative sample of a population; the demographics of users are frequently unknown; not all posts are geo-referenced when they are published. It is also critical to follow strict privacy principles and never access data containing private personal information or communication content.
Adapting our decision-making processes to consider information flows coming from big data sources is not business as usual. Yet, we strongly believe that social media, and the data derived from it, can serve as a powerful tool and indicator for human rights and health.
Taavi Erkkola is senior adviser at UNAids & Miguel Luengo-Oroz is chief scientist at UN Global Pulse. Follow @UNGlobalPulse and @UNAIDS on Twitter.
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