Website owners and users - San Francisco AIDS Foundation

>>> How can public health, website owners and
website users come together to solve one of
the biggest challenges in gay, bi and trans
men’s health?
The following is a report from a national study conducted by
STOP AIDS Project, The California HIV/STD Prevention Training
Center and the San Francisco Department of Public Health. It
was funded through a grant from amfAR.
Please don’t hesitate to contact us if you have any questions
or feedback: [email protected].
This report was authored by Dan Wohlfeiler, Jennifer Hecht,
H. Fisher Raymond, Tom Kennedy, and Willi McFarland
02
Why we did this survey
Our primary goal for this survey was to help reduce the spread
of HIV and STDs among men looking for male sex partners
online. Our San Francisco-based team wondered if making
minor changes to websites could improve the sexual and
social health of gay, bisexual, and transgender men. We
wanted to identify HIV and STD prevention strategies that are:
4Feasible from the viewpoint of website owners,
4Effective from the perspective of public health experts, and
4Attractive to users.
Here are some of the most common sexual health risks for
gay and bi men in the United States:
4Nationally, 20% of gay and bisexual men are estimated to
be living with HIV.
4Of gay and bi men who visit STD clinics, 15% have
gonorrhea and 11% have chlamydia.
03
We also wanted to improve communication between HIV/
STD directors and website owners. While HIV/STD directors
and website owners have collaborated before, including
developing guidelines for online partner notification,
owners continue to receive many requests from local health
jurisdictions around the country. The lack of a coordinated
approach toward online HIV and STD prevention works
against all of us.
We were also eager to learn which new and existing features
web users wanted to see incorporated into their favorite
sites. HIV/STD directors and website owners are more likely
to be successful in efforts to promote health if they know the
opinions of the end users.
The lack of a
coordinated approac
toward online HIV/
STD prevention work
>>> The lack of a coordinated approach toward online
HIV/STD prevention works against all of us.
04
The Three Stakeholders
To meet our goals, we collected the opinions of three
stakeholder groups: website owners, HIV/STD directors, and
website users. Some of the questions we tried to answer
were:
4 Which ideas do website owners and users both like?
4 Which ideas don’t they like?
4 Which strategies do HIV/STD directors think would
be effective at preventing HIV/STD infection?
4 Do men of different ages or ethnicities prefer
different strategies?
4 Do men from rural and urban areas prefer
We defined this as people having two or more unprotected
different strategies?
partners in the previous six months, where the partners
4 Which strategies do men who take
are of different or unknown HIV status.
> THE MOST SEXUAL RISKS < prefer?
4 How willing are website owners to make
specific changes?
For a strategy to be considered “supported”,
more than 50% of that group needed to have
rated it as a 4 or 5, on a scale from 1 to 5.
After learning how these groups reacted to various
strategies, we then looked for areas of agreement
and disagreement. If the majority of all three groups
> SUPPORTED < a strategy, it would obviously be an
important finding. We also wanted to find those
strategies that no one supported.
05
We anticipated that the groups might disagree about some
strategies. Here are some scenarios we imagined:
4 Owners think a strategy would make a difference and are
willing to do it. HIV/STD directors love the idea too. But
only a small percentage of users would ever use it.
4 Owners and users love an idea but HIV/STD directors believe
it would do little to stop the spread of HIV and STDs.
4 Users and HIV/STD directors want features that may be
too costly or that aren’t in line with an owner’s vision for
their business.
Here’s How We Gathered The Data
We designed three surveys, each with the same set of
intervention strategies for the three stakeholder groups. For
each idea, we asked:
4Owners >> What is your willingness to participate or host
it on your site?
4HIV/STD Directors >> Do you think this strategy could
reduce HIV/STD transmission? By how much?
4Users >> How likely would you be to use it?
06
To develop the list of strategies, we reviewed 1) the content
of many websites for existing practices, 2) ideas from other
research studies, and 3) ideas that were brainstormed
through our pilot research but were never implemented. We
also consulted with numerous health and website experts
to learn what they thought should be added to our list.
We held focus groups in San Francisco to pre-test the ideas
on our list, learning ways to improve the items we were
considering. We then launched the owners’ survey and the HIV/
STD directors’ survey. This also allowed us to ask owners and
directors for suggestions of more strategies, which we asked
users about. To promote the survey to users, we developed a
series of > BANNER ADS < which we then placed on 11 websites.
Our ads appeared on the
following sites: BarebackRT,
BearCiti, Big Muscle,
Big Muscle Bears, Black
Gay Chat, DaddyHunt,
DudesNude, Facebook,
Fridae, Gay.com, Men4Now,
Poz.com and Rentboy.
07
Who Participated
We were able to find contact information for 31 owners of
popular websites, and invited them to participate in our
survey. Eighteen of them completed it (58%). We heard from
many types of sites: large and small; some only serving gay
men, others serving everyone; some catering to men seeking
unprotected sex; others targeting specific demographic
groups; and sites that promote dating, hookups, male
escorts and masseurs.
We also invited members of the > NATIONAL COALITION OF STD DIRECTORS <
and the > NATIONAL ALLIANCE OF STATE AND TERRITORIAL AIDS DIRECTORS <
to participate. A total of 82 members (76% of the membership)
completed the survey.
www.ncsddc.org
www.nastad.org
6,896 web users accepted our invitation to participate in
the survey and 3050 completed it. Only people who met the
> ELIGIBILITY CRITERIA < could participate. The demographics of
web users who completed the survey follow:
Eligibility criteria for participation included: being over
18 years of age, living in the United States, identifying
as male or transmale, and having looked for a male sex
partner online in the previous six months.
08
risk
level
location
high 10%
WEBSITE USER
RESPONDENT
DEMOGRAPHICS:
low
90%
declined
to state
1.3%
urban
* we defined rural
areas
as the 10 states
92.4%
with the fewest
lgbt couples
hiv76%
don’t
know
7.1%
hiv+
14.5%
declined
to state
2.3%
55-64 5%
65+ 1%
age
hiv status
rural areas *
1.3%
35-54
36.7%
25-34
30.4%
race
18-24
latino
8%
white
69%
native american 3%
asian / pacific islander 3%
multi-racial 3%
26.8%
other 1%
black
13%
09
“IN A TYPICAL WEEK, HOW
MANY HOURS DO YOU SPEND
ONLINE LOOKING FOR GUYS?”
% of users >>
light use / < 3 hrs
22.9%
moderate use / 3-5 hrs
frequent use / 6-13 hrs
heavy use / > 13 hrs
0.7%
“HOW OFTEN DO YOU GET
WHAT YOU’RE LOOKING
FOR ONLINE?”
29.6%
26.0%
20.8%
no response
% of users >>
rarely
sometimes
often
45.4%
39.2%
9.9%
5.4%
no response
10
What Users Told Us About Themselves
We asked participants to identify sites they visited in the
last six months, providing them with a list of 49 of the most
popular dating and hook-up sites. We also left a space for
them to list other sites.
PERCENT OF RESPONDENTS
WHO VISITED EACH SITE
(TOP FIFTEEN):
11
PERCENT OF RESPONDENTS WHO
NAMED THE FOLLOWING SITES AS
THEIR FAVORITE (TOP FIFTEEN):
12
> RESULTS >
Here are the results of how each group responded to
questions about the different strategies. We looked at
how each group rated the various strategies on a scale from
1 to 5. If more than 50% of the group rated the strategy as
either a 4 or 5, we considered the strategy to be ‘supported.’
Then we looked to see which strategies were supported by
all three groups.
www.stopaids.org/online.pdf
You can > DOWNLOAD < a longer narrative of this report,
which we wrote for a public health audience.
>>> “Some of these ideas are good, it’s just finding a way
to integrate them into the sites.” –WEB OWNER
13
OF THE 41 STRATEGIES INCLUDED IN THE SURVEY, THE FOLLOWING
EIGHT WERE SUPPORTED BY ALL THREE GROUPS:
1.
Allow users to filter partners
by their profile information
3.
4.
6.
Include a specific sub-section or chat-room of a
website for men with specific sexual interests (“safe
sex only”, “barebacking”, “HIV positive”, etc.)
Include safe sex preference
as a profile option
5.
Access to sexual
health experts
Access to sex-positive videos,
showing men dealing with issues
like safer sex, telling someone
their HIV status, or related issues
7.
8.
2.
Online STD testing
directory by zip code
Automatic reminders from sites
to get an HIV and/or STD test at
an interval of the user’s choice
E-cards to notify partners of a
potential exposure to an STD
14
THREE STRATEGIES WERE SUPPORTED BY A MAJORITY OF
USERS AND OWNERS, AND CLOSE TO A MAJORITY OF HIV/STD
DIRECTORS:
4 Having specific sexual behaviors listed in profile options
4 Having an online HIV testing directory by zip code
4 Providing information about HIV/STDs
(Due to the way we asked HIV/STD directors to rate some
of the items on the survey, it’s likely that they expressed
support for fewer strategies than if we had asked them in
the exact same way as users and owners)
aving HIV status includ
s a profile option was
upported by more than
>>> Having HIV status included as a profile option was supported by more
than three-quarters of HIV/STD directors and website users, but only
44% of website owners.
15
FOLLOWING ARE MORE DETAILED RESULTS FOR STRATEGIES,
GROUPED BY TYPE:
4 Ways to search for partners
4 Profile options
4 Information about sites
4 Health information
4 Information about meeting partners and socializing
4 Education and outreach activities
4 HIV/STD testing options
4 Partner notification options
16
Ways To Search For Partners
These two strategies allow users to find partners with
specific characteristics.
4 Using profiles to search for partners: users filter the
members of a site based on the profile options available.
4 Specific chat-rooms and lists: Users have the
opportunity to access a specific, targeted area of a
site, which would only include members with specific
characteristics, such as HIV status or safer sex
preference.
Both of these strategies were supported by more than 50%
of all three stakeholders:
website
owners
website
users
hiv / std
directors
filtering for partners by profiles
61%
86%
75%
subsites, chat rooms, lists or areas
by specific profile options
56%
73%
63%
SEARCHING FOR PARTNERS:
indicates a minimum approval rate
of 50% among all three groups
17
Profile Options
We asked stakeholders which > PROFILE OPTIONS <
they want included in a profile screen.
Of all the profile options, only > SAFE SEX PREFERENCE <
scored above 50% in all three stakeholder groups.
Two others rated close to 50% by all three groups:
> SEXUAL BEHAVIORS < and HIV status.
E.g. Top, bottom or versatile;
oral, jacking off
E.g. Always, sometimes,
needs more discussion
• safe sex preference
(always; sometimes; needs more discussion)
• specific sexual behaviors (top; bottom; oral; jacking off; etc)
• HIV status
• date of last HIV test
• date of last STD test
• relationship status
(single, partnered, etc)
• looking to hookup (yes, no)
• looking to date (yes, no)
• hep B status
• hep C status
• PnP (party and play) preference
• drug use preference.
After web owners and HIV/STD directors shared
their input, we added nine additional profile
options to the user survey:
•
•
•
•
•
•
•
•
•
herpes status
SM/kink/bondage
“I used a condom the last time I hooked up” “I plan to use a condom the next time I hook up”
race
poz-friendly (open to sex with HIV positive guys)
educational background
income
age
like helping HIV+ people
d other HIV+ people on
ular hook up sites. I
>>> “I like helping HIV+ people find other HIV+ people on regular hook
up sites. I don’t want to have to go to a separate hook up site
for HIV+ people.” –WEB USER
18
label 50
make 50
STAKEHOLDERS’ SUPPORT
OF PROFILE OPTIONS
d
Dots closest to the center
indicate the most support
o
d
u
separat
o
key: AD
u
d
u
o
o
d
d
u
o
o
u d
u
u
d
o
d u
u
u
o
d
o
o website owners
u website users
d hiv / std directors
indicates a minimum approval rate
of 50% among all three groups
o
u o
d
d
od u
19
Information About Sites
We asked participants for their opinions about having an
independent website that could list detailed information
about the membership characteristics of different dating
and hookup sites; for example, how many profiles on a given
site had ‘safe sex only’ or ‘no PNP’ in them. We also asked
participants to rate having a third-party, independent site
where members rated dating and hookup sites, or could blog
about their experiences.
website
owners
website
users
links to user blogs about
cruising experiences
44%
43%
user reviews of websites
22%
56%
23%
aggregate statistics on site
user characteristics
33%
67%
63%
STD statistics on specific sites
33%
65%
63%
INFORMATION ABOUT SITES:
hiv / std
directors
10 %
20
There were four items in this section:
1. Links to blogs for users to review sites. These would
provide users an opportunity to create their own “yelp”like reviews.
2. Having independent sites which publicize STD statistics,
collected by health departments, about the number of
people who had recently received an STD diagnosis and
reported meeting partners on specific websites.
3. A third-party site where users could write reviews of the
top cruising websites.
4. A website that would provide aggregate statistics on
site user characteristics (e.g., percent of men who say
they are looking for safe sex only, percent looking for
barebacking, etc.) This information would be provided
by website owners and hosted on a site that would be
updated several times a year.
Free HIV tests seem eas
find, but I’m unsure ab
ee STD tests.”
>>> “Free HIV tests seem easy to find, but I’m unsure
about free STD tests.” –WEB USER
21
Health Information
We asked stakeholders about seven items:
4 information about HIV/STDs
4 access to a sexual health expert
4 live chat with an outreach worker
4 tailored user-specific health information
4 drug information
4 local health education events listing
4 tips on having healthy hot sex.
All three stakeholder groups supported having access to a
sexual health expert. Users preferred having access to sexual
health experts than to outreach workers.
While a majority of HIV/STD directors and users supported
entry screens in which individuals enter personal information
to receive tailored health advice, only 22% of owners did.
22
HEALTH INFORMATION:
website
owners
website
users
hiv / std
directors
info about HIV/STDs
94%
65%
42%
access to a sexual health expert
78 %
58%
64%
live chat with outreach worker
72 %
41%
57%
59%
64%
tailored user-specific health info
22 %
drug information
83 %
local health education events listing
71 %
46 %
tips for having hot, healthy sex
78 %
65%
28 %
10 %
7%
41%
indicates a minimum approval rate
of 50% among all three groups
23
Information About Meeting
Partners and Socializing
None of the following strategies were supported by a
majority of all three stakeholder groups:
website
owners
website
users
61%
75%
safer cruising advice
94%
64%
advice on writing profiles
72 %
56%
links to local social events
links to social network profiles like Facebook
“black book” to keep track of sexual partners
28 %
39 %
26 %
65%
hiv / std
directors
7%
41%
14 %
11 %
59%
’d like a way to let guys
down easy, when you’re
nterested, without hav
>>> “[I’d like] a way to let guys down easy, when you’re not interested, without
having to ignore them or write an awkward message.” –WEB USER
24
Education and Outreach Activities
We asked participants to rate three types of online education:
individual educational sessions, group educational sessions,
and videos that show men dealing with issues like safer sex,
telling someone their HIV status, or related issues in a sexpositive way.
Only one of these strategies, sex-positive videos, received
positive ratings by more than 50% of all three stakeholders.
website
owners
website
users
hiv / std
directors
online individual education
about sexual health
61%
41 %
80 %
online group education
about sexual health
56%
38 %
75 %
sex-positive videos
61%
52%
82 %
indicates a minimum approval rate
of 50% among all three groups
25
HIV/STD Testing Options
We asked participants to rate four strategies aimed at
increasing STD and HIV testing:
4 Links to online STD testing directories by zip code
4 Links to online HIV testing directories by zip code
4 Automatic reminders to get an HIV and/or STD test,
sent from dating and hook-up websites, at an interval
that the user chooses.
4 Printable lab slips to present to a commercial laboratory,
enabling users to get STD tests they want
think directories alrea
exist and information ca
be found, but making it
easier to find can’t hurt.
>>> “I think the directories already exist and information can be
found (but making it easier to find can’t hurt).” –HIV / STD DIRECTOR
26
ree HIV tests seem easy
o find, but I’m not sure
bout STD tests.
>>> “Free HIV tests seem easy to find, but I’m unsure
about free STD tests.” –WEB USER
website
owners
website
users
hiv / std
directors
STD test directory
89 %
71 %
62%
HIV test directory
89 %
70 %
48%
automatic testing reminders
67%
58%
70 %
online lab slips for STD testing
61%
58%
33 %
HIV/STD TESTING OPTIONS:
indicates a minimum approval rate
of 50% among all three groups
27
Partner Notification Options
We asked participants to rate three different ways to
implement partner notification.
1. Patients notifying partners on their own.
2. Patients notifying partners through sending an e-card,
such as the one inSPOT provides.
3. Health department professionals notify the partners of
patients with the patient’s permission. (We asked about
this strategy for both STDs and HIV.)
The majority of owners did not support health department
partner notification, although many of them have collaborated with health departments around the country to facilitate partner notification online. Owners preferred ‘on your
own’ or e-card solutions to health-department’s involvement in partner notification.
Of these four options,
the only one that was
supported by all three
stakeholder groups
>>> Of these four options, the only one that was
supported by all three stakeholder groups was
having users send e-cards to their partners.
28
Users were supportive of all partner notification strategies.
They were somewhat more supportive of notifying their
own partners.
HIV/STD directors supported health department-sponsored
partner notification.
website
owners
website
users
notify partners on your own
72 %
73 %
anonymous e-card by user
67%
63%
80 %
hiv / std
directors
28 %
health department initiated – HIV
33 %
62%
88 %
health department initiated – STD
33 %
59%
90 %
indicates a minimum approval rate
of 50% among all three groups
29
What Different Groups
of Users Told Us
When we looked at what different subcategories of users
said, we found some interesting results.
We defined this as people having two or
more unprotected partners in the previous
six months, where the partners are of
different HIV status.
> HIGH-RISK PARTICIPANTS < were somewhat less willing to use
nearly all strategies than lower-risk participants. The two
strategies they were more willing to use were:
4Providing specific sexual behaviors in their profile
4Stating an interest in SM kink/bondage in their profile
HIV positive participants were somewhat less willing to use
most strategies than HIV-negative participants: 84% of HIVnegative participants supported including their HIV status on
their profile, compared to 66% of HIV-positive participants.
Here were the seven strategies HIV+ participants were more
willing to use:
4Subsites, chat rooms, or lists with specific options
4List of nearby social events
4The following profile options:
> “pnp” preference option
> specific sexual behaviors > Looking to hook-up option
> SM kink/bondage
> Poz-friendly
30
Race >> African American participants were generally more
supportive of strategies than white participants. However,
while a majority of African American participants supported
“HIV status” and “safe sex preference” as profile options,
they did so at slightly lower levels than White participants.
Age >> Older men were somewhat less supportive of most
strategies. However, men over 65 did rate including “HIV
status” and “poz-friendly” as profile options higher than
younger men.
While web users expres
low support for online o
reach, a majority of men
>>> While web users expressed low support for online outreach,
a majority of men under 25 did support it.
> RURAL MEN < >> Men from primarily rural and urban areas
gave similar ratings to most strategies. However, there
was one notable difference: rural participants were more
likely to support online individual and group education
sessions. While these strategies were still not overwhelmingly supported, it may suggest that they may be
more popular in states where in-person educational sessions may not be as easily accessible.
For this analysis, we were particularly interested in how interventions were considered by men
from the 10 states with the fewest same sex couples. These included: Alabama, Idaho, Iowa,
Louisiana, Mississippi, Montana, North Dakota, South Dakota, West Virginia and Wyoming.
31
Strategies that no group supported
There were several strategies that did not earn the support
of a majority of any of the three stakeholder groups. These
included:
4 Blogs about users’ experiences meeting partners online
4 Links from dating websites to social network sites, such
as Facebook
Additionally, five of the profile options that we presented
failed to gain the support of a majority of any of the three
stakeholders:
4 Hepatitis B and C status
4 Date of last STD test
4 Drug use preferences
4 “PnP” (“Party and Play”) preference
Due to the way we asked HIV/STD directors to rate some
of the items on the survey, it’s likely that they expressed
support for fewer strategies than if we had asked them in
the exact same way as users and owners.
32
Areas of Disagreement
There were several strategies which were rated lower by
one of the three stakeholders than by the other two.
Website owners >> low level of support
HIV/STD directors and users >> high level of support
4 Statistics on the number of STDs reported by users of
different websites posted on a neutral site
4 Statistics which would aggregate characteristics of
website users from different websites, posted on a
neutral site (i.e., number of individuals on the site
indicating they prefer safe sex)
4 Entry screens which would have an algorithm with health
information tailored to users according to their level of
risk or other characteristics
4 A “black book” which would allow users to keep track of
past sexual partners
4 Online partner notification initiated by Health
Departments for both HIV and STDs
4 HIV status on profile
hanges draw a lot of crit
sm from our user comunity. If they see benefi
ey usually go along. If i
ot obvious, they us
>>> Changes draw a lot of criticism from our user community.
If they see benefit, they usually go along. If it’s not obvious, they usually ignore it.” –WEB OWNER
33
HIV/STD directors >> low level of support
Website owners and users >> high level of support
4 The following options in profile screens:
> “Relationship status”
> “Looking to date” and “looking to hook-up”
> Specific sexual behaviors
4 Including links to local social events
4 Having infected individuals notify partners on their
own as a primary partner-notification strategy
4 Information about HIV/STDs
4 Tips for healthy, hot sex
4 Safer cruising advice
4 Advice on writing profiles
4 HIV test directory
4 Printable STD lab slips
Users >> low level of support
Website owners and HIV/STD directors >> high level of support
4
4
4
Individual education sessions
Group education sessions
Online chat with outreach worker
n the items that I didn’t
ve full support, I’d want
ome evidence that
>>> On the items that I didn’t give full support, I’d want some evidence that
these are what men want to see on these sites.” –HIV / STD DIRECTOR
34
What These Results Mean To Us
We found that all three stakeholder groups were willing to
participate in HIV and STD prevention activities, and in very
specific ways. For example, HIV/STD directors are willing to
create and maintain directories of STD test sites; website
owners are willing to send automatic reminders to their
users; and users are willing to sign up for the reminders (at
an interval of their choosing). Implementing this intervention
could well result in more people knowing their STD status and
getting the treatment they need in a timely manner.
There are, not surprisingly, important differences. We found
that only a minority of website owners supported providing
users with the number of individuals who have been diagnosed
with STDs who report meeting partners on their site. However,
opening dialogue with website owners about what additional
data they would be willing to share may advance dialogue
about development of future strategies.
Web owners’ participation in this survey, and their stated
willingness to continue to discuss these issues, represents
an important step in building partnerships between HIV/
STD directors and website owners which will support the
development of future online strategies.
35
A significant finding is the sheer number of strategies for
which there was agreement among all three stakeholders.
While some of the sites are already implementing these
strategies, this survey may help encourage other sites to
include them by providing data showing that their customers
react to them favorably and are willing to participate in them.
Next Steps
These data provide a starting point, which we hope will
be used for joint decision making. In order to help make
that happen, we recommend that a national task force be
formed, including representatives of the National Coalition
of STD Directors, the National Alliance of State and Territorial
AIDS Directors, and the Centers for Disease Control and
Prevention and website owners.
This group should meet to review these findings and prioritize
next steps. There are many strategies that all stakeholders
agreed upon, and we recommend that these be adopted by
as many websites and HIV/STD programs as possible. If HIV/
STD directors think these strategies will reduce HIV/STD
transmission, website owners are willing to support them,
and website users are likely to utilize them, what’s stopping
us from implementing them today?
36
The task force should also discuss how to make those
interventions which all stakeholders supported as easy to
access as possible. Website users may access information,
such as links to testing sites, more readily if they can find
them easily.
Additionally, in collaboration with the website owners and
users, we recommend modifying current strategies, or
developing new ones, to reach those men who gave many of
the interventions somewhat lower ratings, particularly HIVpositive and high-risk men.
In addition to directors’ perceptions of impact, the task
force should review published studies of the interventions
included in this survey, where available.
The task force should also discuss what should be done with
current strategies that were rated low by users (such as
online education sessions), perhaps reducing or eliminating
them to free up resources for other interventions.
This study revealed key strategies that can be put in place
now as well as areas for future dialogue between HIV/STD
directors and website owners. With HIV and STD rates on the
rise among MSM nationally, now is the time to act.
37
Thank You
We’d like to extend a thank you to all the study participants:
4 the thousands of website users whose feedback
will help assure us that whatever we do, it’ll be wellaccepted by the community;
4 STD and HIV program directors, who took time to assess
what would have the biggest impact on health;
4 and the website owners and managers who have taken
time from their work to help us understand how best
to leverage the internet’s many resources to promote
health for us all. Additionally, we’d like to thank Dana Cropper-Williams and
Kelly Mayor at the National Coalition of STD Directors and Dave
Kern and Julie Scofield at the National Association of State
and Territorial AIDS Directors for their assistance.
Ed Halteman provided consultation on the survey design
and preliminary analysis. Advertisements and banner ads
were designed by Michael Waddell and Eric Nielson. Kevin
O’Malley designed this report.
hank you so much for p
ing this survey out. I ca
>>> “Thank you so much for putting this survey out!
I can’t wait to see its results in action!” –WEB USER
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The following gave generous assistance before
and during the study
Stephan Adelson
Matthew Amsden
Coco Auerswald
Kyle Bernstein
Sheana Bull
Mary Ann Chiasson
Kevin Cranston
Alberto Curotto
Beau Gratzer
Paul Harterink
Sabina Hirshfield
Shana Krochmal
Deb Levine
Spencer Lieb
Julia Marcus
Jeffrey O’Malley
Jackson Peyton
John Peterson
Jim Pickett
Ron Stall
Frank Strona
Jo Ellen Stryker
Patrick Sullivan
Adam Vaughn
Edward White
Bill Woods
Staff at the STOP
AIDS Project >>
Staff at the California STD Control Branch and
California HIV/STD Prevention Training Center >>
Andy Connors
Terry Dyer
Greg Ford
Michael Hyde
Kyriell Noon
Jason Riggs
Jorge Vieto
Heidi Bauer
Gail Bolan
Jessica Frasure
Alice Gandelman
Tom Gray
Holly Howard
Greg Mehlhaff
Emily Quinn
Michael Samuel
Daniella Matthews-Trigg
39