J. Med. Internet Res. - An AIDS-denialist online community on a Russian social networking service: patterns of interactions with newcomers and rhetorical strategies of persuasion.


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CKGROUND: The rise of social media proved to be a fertile ground for the expansion of the acquired immune deficiency syndrome (AIDS)-denialist movement (in the form of online communities). While there is substantial literature devoted to disproving AIDS-denialist views, there is a lack of studies exploring AIDS-denialists online communities that interact with an external environment.OBJECTIVE: We explored three research areas: (1) reasons for newcomers to come to an AIDS-denialist community, (2) the patterns of interactions of the community with the newcomers, and (3) rhetorical strategies that denialists use for persuasion in the veracity of their views.METHODS: We studied the largest AIDS-denialist community on one of the most popular social networking services in Russia. We used netnography as a method for collecting data for qualitative analysis and observed the community for 9 months (at least 2-3 times a week). While doing netnography, we periodically downloaded community discussions. In total, we downloaded 4821 posts and comments for analysis. Grounded theory approach was used for data analysis.RESULTS: Most users came to the community for the following reasons: their stories did not fit the unitary picture of AIDS disease progression translated by popular medical discourse, health problems, concern about HIV-positive tests, and desire to dissuade community members from false AIDS beliefs. On the basis of strength in AIDS-denialist beliefs, we constructed a typology of the newcomers consisting of three ideal-typical groups: (1) convinced: those who already had become denialists before coming to the group, (2) doubters: those who were undecided about the truth of either human immunodeficiency virus (HIV) science theory or AIDS-denialist theory, and (3) orthodox: those who openly held HIV science views. Reception of a newcomer mainly depended on the newcomer's belief status. Reception was very warm for the convinced, cold or slightly hostile for the doubters, and extremely hostile or derisive for the orthodox. We identified seven main rhetorical strategies of persuasion used by the denialists on the "undecided".CONCLUSIONS: Contrary to the widespread public health depiction of AIDS denialists as totally irrational, our study suggests that some of those who become AIDS denialists have sufficiently reasonable grounds to suspect that "something is wrong" with scientific theory, because their personal experience contradicts the unitary picture of AIDS disease progression. Odd and inexplicable practices of some AIDS centers only fuel these people's suspicions. We can conclude that public health practitioners' practices may play a role in generating AIDS-denialist sentiments. In interactions with the newcomers, the experienced community members highlighted the importance of personal autonomy and freedom of choice in decision making consistent with the consumerist ideology of health care. The study findings suggest that health care workers should change a one-size-fits-all mode of counseling for a more complex and patient-tailored approach, allowing for diversity of disease progression scenarios and scientific uncertainty.

Resumo Limpo

ckground rise social media prove fertil ground expans acquir immun defici syndrom aidsdenialist movement form onlin communiti substanti literatur devot disprov aidsdenialist view lack studi explor aidsdenialist onlin communiti interact extern environmentobject explor three research area reason newcom come aidsdenialist communiti pattern interact communiti newcom rhetor strategi denialist use persuas verac viewsmethod studi largest aidsdenialist communiti one popular social network servic russia use netnographi method collect data qualit analysi observ communiti month least time week netnographi period download communiti discuss total download post comment analysi ground theori approach use data analysisresult user came communiti follow reason stori fit unitari pictur aid diseas progress translat popular medic discours health problem concern hivposit test desir dissuad communiti member fals aid belief basi strength aidsdenialist belief construct typolog newcom consist three idealtyp group convinc alreadi becom denialist come group doubter undecid truth either human immunodefici virus hiv scienc theori aidsdenialist theori orthodox open held hiv scienc view recept newcom main depend newcom belief status recept warm convinc cold slight hostil doubter extrem hostil deris orthodox identifi seven main rhetor strategi persuas use denialist undecidedconclus contrari widespread public health depict aid denialist total irrat studi suggest becom aid denialist suffici reason ground suspect someth wrong scientif theori person experi contradict unitari pictur aid diseas progress odd inexplic practic aid center fuel peopl suspicion can conclud public health practition practic may play role generat aidsdenialist sentiment interact newcom experienc communiti member highlight import person autonomi freedom choic decis make consist consumerist ideolog health care studi find suggest health care worker chang onesizefitsal mode counsel complex patienttailor approach allow divers diseas progress scenario scientif uncertainti

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