HIV-related posts from a Chinese internet discussion forum: An exploratory study

Background In China, the introduction of antiretroviral treatment has increased the number of people living with HIV/AIDS (PLWHA). New technologies, such as social media, might be useful for enhancing HIV surveillance, especially given the lack of Chinese research, which is related to stigma and discrimination. Thus, the relative anonymity of social media may make it useful for evaluating "hard to reach" PLWHA. Setting This study used social media data to assess whether it reflected the prevalence of HIV and to explore PLWHA' needs and online habits. Methods In 2017, the Baidu Tieba platform was searched to obtain 2,500 HIV-related postings and 2,500 tuberculosis-related postings as a comparative sample. Word clouds and coding schemes were used to analyze the contents and review the users' needs and online habits. Negative binomial regression was used to evaluate the relationships between word cloud geolocations and provincial numbers of men who have sex with men (MSM) PLWHA cases, after controlling for socioeconomic status. Results Word cloud geolocations were associated with reported MSM-PLWHA cases (p<0.001). Over one-third of the HIV-related posts were seeking advice, with 40.12% being related to medical topics, although these posts received the fewest replies. The number of HIV-related social support requests was approximately 3-fold higher than the number of posts providing social support, although relatively similar proportions of support requests and support provision were observed in the tuberculosis-related postings. Conclusion Social media may help enhance HIV surveillance. Our findings also indicate that the Chinese government, non-government organizations, and healthcare professionals should offer more online support to PLWHA.