A culturally sensitive online communication campaign to reach hidden men who have sex with men for HIV/STI prevention and testing in Indonesia: TemanTeman.org

A culturally sensitive online communication campaign to reach hidden men who have sex with men for HIV/STI prevention and testing in Indonesia: TemanTeman.org
T. Anand, J. Ananworanich1,2,3, T. Parwati Merati4, E. Yunihastuti5, D. Imran5, C. Nitpolprasert1, A.H. Sohn6, N. Phanuphak1,3
1The Thai Red Cross AIDS Research Centre, Bangkok, Thailand, 2The HIV Netherlands Australia Thailand Research Collaboration, Bangkok, Thailand, 3South East Asia Research Collaboration with Hawaii (SEARCH), Bangkok, Thailand, 4Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Udayana University and Sanglah Hospital, Bali, Indonesia, 5Working Group on AIDS, Cipto Mangunkusumo Hospital - Faculty of Medicine, University of Indonesia, Jakarta, Indonesia, 6TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
Background: Societal and cultural conventions are barriers to advocating for HIV/AIDS awareness and outreaching to hidden men who have sex with men (MSM) in Indonesia, a population faced with a rising HIV prevalence (~8.1% in Jakarta and 13- 19% in Bali). Although Indonesia is the third largest Facebook user in the world, the Internet has not been optimally used for promoting HIV prevention. We designed and launched an online platform to offer a multi-faceted HIV/sexually transmitted infection (STI), healthcare and support information to Indonesian MSM.
Methods: A qualitative research project was conducted from November-December 2011 in Jakarta, Bandung, Yogyakarta, Surabaya and Bali to gather input from local MSM and to understand cultural sensitivities surrounding the establishment of an online MSM health campaign. The study involved meetings with 60 HIV/AIDS organizations and structured interviews of 177 MSM randomly selected from shopping malls, fitness centers, clubs and beaches. 
Results: Being gay is a taboo in Indonesia. Of 177 MSM (mean age 26.4 years) 79% hid their sexual identity. Although 95% were active internet users, 81% were not aware of any HIV/AIDS website and 75% did not know locations of testing centers. 88% expressed interest in seeking MSM sexual health information through an edutainment website. HIV/AIDS organizations universally reported outreach to hidden MSM as a major challenge. Therefore, TemanTeman.org, an integrated online communication strategy, was developed and launched by The Thai Red Cross AIDS Research Centre in December 2012 based on an MSM edutainment website in Thailand (www.AdamsLove.org). TemanTeman.org utilizes similar platform and social media channels to offer information on MSM-friendly healthcare and support services in Indonesia. The website features > 40 expert advice videos on sexual health. Male fashion photography is linked to HIV/STI information to promote safer sexual practices. The campaign is affiliated with Pokdisus AIDS Clinic at Cipto Mangunkusumo Hospital in Jakarta and Nusa Indah Clinic at Sanglah Hospital in Bali, where HIV/STI testing is available.
Conclusion: TemanTeman.org is a new approach to access the hidden MSM community in Indonesia, and could help increase HIV/AIDS awareness and testing while respecting cultural limitations.