Recently in the San Francisco Bay Area some reports have shown a new development. The San Mateo County public health administration has been using a fake Grindr account as part of its outreach plan.
I take issue with this. While in theory one can explain it as just another use of social media for prevention. In practice it’s problematic at best.
The intersections of how we use our agency for sex, intimacy and everything are powerful. They are primal. They speak to how we live, what we value and deserve respect as such. Thus all interventions place a premium on assuring personal agency, dignity and consent occur. All doing this work (be clinicians, researchers, case managers, etc.) understand this intimately. And generally approach their strategies from that basis. This is the reason Human Subjects Protection training is mandatory for administrators and most in the field.
Yet as months turn into years (and then decades for some), one’s perspective can change. A support group can just look like qualitative data. A movie ticket stub can be just another part of a client’s monthly budget for their care plan. A condom can be just another line item consideration used to fulfill a grant deliverable. A black gay man can just look like a vector of disease. Names become ID numbers and people become only data.
It takes a toll to bring the personal into the professional. Looking at the example in San Mateo, it seems like this consideration may have been lost. Safeguarding personal agency and consent may have been low priority, because budget cuts tend to have that effect.
The work is taxing. Advocating for successful health outcomes in the midst of an ongoing epidemic is difficult. It calls on vast amounts of personal investment which most sane people would not be willing to offer. Yet, the vocation pivots from the notion that one is aiding the common good.
Though the individual point of views may now be more cynical or pessimistic. It goes without saying, that these men and women joined the work based on a deep seated personal motivation to drive change. This is especially true in the arena of HIV/AIDS and STD/STI prevention.
It creates a culture which normalizes lost sleep, “full time equivalent hours” and few benefits. Why? Because when you can see the hand you have in creating change in the lives of members of your community it’s worth it. The little victories chip away at the larger defeats and keep you in the fight.
In the public sector we’ve all had to do more with less since the economic downturn of 2008. People of color especially are still in the midst of trying to regain our footing and realize that we may have lost a lot of ground. Under this climate it’s always those with the least that loose the most.
One of those losses has been in services to our most vulnerable populations and the public health sector. Last year when Sequestration happened it appears that sector suffered another blow. Once again, HIV/AIDS programs are looking to find ways to combat an epidemic with dwindling resources.
As those hardest hit by the epidemic this, of course, has hit communities of color hardest.
In looking to be innovative, outreach plans have graduated from personal word-of-mouth networks. They have involved all aspects of social media since it became part of our everyday lives.
Community members and preventionists have continued to meet guys where they are most comfortable. This includes Adam4Adam, BGC, et al. These one-on-one interactions have been a successful tool.
As the shift happened from hook-up sites to dating apps; the outreach plans adjusted to meet that need. As a participant I noticed how certain prevention programs got my attention. Later, working at a not-for-profit clued me in on how to develop and market to the target population my demographic includes.
In my experience both Atlanta and San Francisco continue to be at the forefront of innovating outreach.
Still I wonder if this is a sign of things going too far. I wonder if this is another way that vulnerable communities are running into another form of exploitation. Exploitation from well-meaning agencies whose mission is to offer help is counterproductive. It’s one thing for an outreach worker to create a profile on a social media app and engage the community on a ‘virtual’ one-on-one basis. It’s a completely different matter to launch an initiative like the one in San Mateo. We have to value the personal agency of whomever we intend to help before we can ever imagine effectively counting on successful health outcomes.