Abstract
Although accounting for 13 percent of the American population, in 2017, African-Americans made up over 42 percent of people living with HIV or AIDS (PLWHA) in the United States. In addition to the highest prevalence, African-Americans face the highest rates of new diagnoses, diagnoses that occur at the stage of AIDS, and HIV/AIDS-related deaths in comparison to other races of the United States. The described African-American HIV/AIDS crisis developed throughout a complex history of marginalization, and largely persists because of various deep-rooted sociocultural barriers that act as an impediment to people of color being linked to and progression through the Prevention and Care Continuum. To this end, the Internet and World Wide Web are being increasingly integrated into prevention, treatment, support, and health communication initiatives tailored to reach populations most at risk and affected by HIV/AIDS. Considering the popularity of Twitter among African-American Internet users and its adoption by leading organizations of the fight to end HIV/AIDS in Black communities, this particular social media platform shows the potential to foster connection, communication, and activism/advocacy around the African-American HIV/AIDS crisis – a dynamic that has yet to be explored.
This thesis endeavored to explore a collective representation of the African-American HIV/AIDS Movement on Twitter through mixed-methods. Virtual snowball sampling was used to identify a network of tweeters (i.e., Twitter users) with a shared interest in or affiliation to HIV/AIDS and the Black community. Profile biography texts of the identified African-American HIV/AIDS Twitter Network were categorized to determine the diversity of healthcare stakeholders represented. Social Network Analysis (SNA) was performed in Gephi and used to map comradery (i.e., who follows who) and communication (i.e., who tweets who) between tweeters and healthcare stakeholder categories of the network. Additionally, the tweets, replies, and retweets of the network were collected over a 6-month period with TweetArchiver and a content analysis was performed in Leximancer to provide insight on the salient themes and contexts of network tweets overtime.
Composed of 237 tweeters who share 1389 following relations between them, the identified African-American HIV/AIDS Twitter Network was cohesive, reflecting that of a small world. A variety of healthcare stakeholders were represented including providers (e.g., HIV/AIDS organizations), activism/advocacy, consumers (e.g., PLWHA), media, events, and government in descending order of their frequency. The first SNA of the thesis revealed the Black AIDS Institute, National Minority AIDS Council (NMAC), Sister Love Inc., and the National Black Leadership Commission on AIDS (NBLCA) as tweeters with particular positions of influence based on the internal following behavior of the African-American HIV/AIDS Twitter Network. Comradery mapping also revealed providers and activism/advocacy as the most followed and central healthcare stakeholders who had the strongest following relationship of the entire network between them.
During the six-month collection period, 103 tweeters of the African-American HIV/AIDS Twitter Network tweeted, producing a combined total of 55662 tweets. Content analysis revealed marginalization, HIV, reflection, current affairs, individual16 (an alias used to preserve anonymity), and via as the salient themes of network tweets. Of the 103 total who tweeted during the collection period, 68 tweeters of the African-American HIV/AIDS Twitter Network tweeted internally, sharing a total of 2280 internal tweeting relations between them. The second SNA of the thesis distinguished the Black AIDS Institute, individual15, Sister Love Incorporated, NBLCA, and individual19 as tweeters with particular positions of influence based on internal tweeting behavior of the network. Communication mapping also revealed activism/advocacy as the most tweeted and central healthcare stakeholder of the network.
The findings of the thesis provide the first known collective snapshot of the African-American HIV/AIDS Movement on Twitter. From the analyses, characteristics of the African-American HIV/AIDS Twitter Network appear to mirror the wider story of the African-American HIV/AIDS crisis. On Twitter, the African-American HIV/AIDS Movement leads a comprehensive approach drawing attention to the myriad of sociocultural barriers (e.g., racism, stigma). It also mobilizes African-American populations around prevention, treatment, and support through the power of tweeting and following. The thesis provides practical recommendations for stakeholders invested in the online fight to end HIV/AIDS in the Black community and a methodological framework for future studies of other minority health networks that are likely to exist on Twitter.