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UMass Memorial Health Care

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Analytical, Diagnostic and Therapeutic Techniques and Equipment | Communication Sciences and Disorders | Community Health and Preventive Medicine | Health Communication | Health Services Administration | Health Services Research | Otorhinolaryngologic Diseases | Preventive Medicine | Social Media | Telemedicine | Virus Diseases


BACKGROUND: About 46% of US adults obtain recommended HIV screening at least once during their lifetime. There is little knowledge of screening rates among deaf and hard-of-hearing adults who primarily use American Sign Language (ASL), or of social media as a potentially efficacious route for HIV prevention outreach, despite lower HIV/AIDS-specific health literacy and potentially higher HIV seropositivity rates than hearing peers.

OBJECTIVE: We investigated both the likelihood of HIV screening uptake among deaf adults in the past year and over one year ago, and the relationship between social media use and HIV screening uptake among deaf adult ASL users.

METHODS: The Health Information National Trends Survey in ASL was administered to 1340 deaf US adults between 2015-2018. Modified Poisson with robust standard errors was used to assess the relationship between social media usage as a predictor and HIV screening as an outcome (screened more than one year ago, screened within the past year, and never been screened), after adjusting for sociodemographics and sexually transmitted disease (STD) covariates.

RESULTS: The estimated lifetime prevalence of HIV screening uptake among our sample was 54% (719/1340), with 32% (429/1340) in the past year. Being of younger age, male gender, black, lesbian, gay, bisexual, or queer, or having some college education or a prior STD were associated with HIV screening uptake. Adjusting for correlates, social media use was significantly associated with HIV screening in the past year, compared to either lifetime or never.

CONCLUSIONS: Screening falls well short of universal screening targets, with gaps among heterosexual, female, Caucasian, or older deaf adults. HIV screening outreach may not be effective because of technological or linguistic inaccessibility, rendering ASL users an underrecognized minority group. However, social media is still a powerful tool, particularly among younger deaf adults at risk for HIV.


deaf, internet, sexually transmitted disease, sexually transmitted infection, sign language, social media, HIV

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Copyright © Michael Argenyi, Poorna Kushalnagar. Originally published in JMIR Public Health and Surveillance (, 02.10.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

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JMIR Public Health Surveill. 2019 Oct 2;5(4):e13658. doi: 10.2196/13658. Link to article on publisher's site

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JMIR public health and surveillance

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.