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. 2017 Nov 3;18(1):59.
doi: 10.1186/s12910-017-0216-7.

The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers

Sophia Fantus  1 , Rusty Souleymanov  2 , Nathan J Lachowsky  2   3 , David J Brennan  2   4
Affiliations

The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers

Sophia Fantus et al. BMC Med Ethics. .

Abstract

Background: Mobile applications and socio-sexual networking websites are used by outreach workers to respond synchronously to questions and provide information, resources, and referrals on sexual health and STI/HIV prevention, testing, and care to gay, bisexual and other men who have sex with men (GB2M). This exploratory study examined ethical issues identified by online outreach workers who conduct online sexual health outreach for GB2M.

Methods: Semi-structured individual interviews were conducted between November 2013 and April 2014 with online providers and managers (n = 22) to explore the benefits, challenges, and ethical implications of delivering online outreach services in Ontario, Canada. Interviews were digitally recorded and transcribed verbatim. Thematic analyses were conducted, and member-checking, analyses by multiple coders, and peer debriefing supported validity and reliability.

Results: Four themes emerged on the ethical queries of providing online sexual health outreach for GB2M: (a) managing personal and professional boundaries with clients; (b) disclosing personal or identifiable information to clients; (c) maintaining client confidentiality and anonymity; and (d) security and data storage measures of online information. Participants illustrated familiarity with potential ethical challenges, and discussed ways in which they seek to mitigate and prevent ethical conflict.

Conclusions: Implications of this analysis for outreach workers, researchers, bioethicists, and policy-makers are to: (1) understand ethical complexities associated with online HIV prevention and outreach for GB2M; (2) foster dialogue to recognize and address potential ethical conflict; and (3) identify competencies and skills to mitigate risk and promote responsive and accessible online HIV outreach.

Keywords: Boundaries; Confidentiality; Ethics; GB2M; HIV prevention; Online sexual health outreach; Outreach workers.

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Conflict of interest statement

Authors’ information

SF is a doctoral candidate in a collaborative social work and bioethics PhD program.

Ethics approval and consent to participate

The study was approved by the University of Toronto and University of Guelph Research Ethics Boards. All participants granted written consent prior to their interview. As noted by the University of Toronto Research Ethics Board, HHS regulations (Common Rule) applies only to research funded by US government agencies and is not related to where the participants reside. As the study was not funded through a US government agency, HHS regulations did not have to be met. The U of T REB holds a Federal-Wide Assurance and is registered as a recognized Institutional Review Board. All participant data were stored on password-protected, encrypted and secure servers located in Canada.

Consent for publication

The authors have received the consent to publish the aggregated findings and anonymized quotations from participants. Written informed consent was obtained from all participants.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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