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Article

An AIDS-denialist Online Community in a Russian Social Networking Service: Patterns of Interactions with the Newcomers and Rhetorical Strategies of Persuasion

Journal of Medical Internet Research. 2014. Vol. 16. No. 11. P. e261.

Background: The rise of social media proved to be a fertile ground for the expansion of AIDS-denialist movement (in the form of online communities). While there is substantial literature devoted to disproving AIDS-denialist views there is dearth of studies exploring AIDS-denialists as online communities that interact with external environment.

Objective: We explored three research questions: why newcomers come to an AIDS-denialist community; what are patterns of interactions of the community with the newcomers; what are rhetorical strategies that denialists employ for persuasion in the veracity of their views.

Methods: We studied the largest AIDS-denialist community in one of the most popular social networking services in Russia. We used netnography as a method for collecting data for qualitative analysis. We observed the community during 9 months (at least 2-3 times a week). While doing netnography we periodically downloaded the community discussions. In total we have downloaded 4821 posts and comments for analysis. Grounded theory approach was used for data analysis.

Results: Most come to the community for the following reasons: their stories do not fit the unitary picture of AIDS disease progression translated by popular and popular medical discourses; health problems; concern about HIV-positive tests; desire to dissuade the community members from false AIDS-beliefs. On the basis of strength in AIDS-denialist beliefs we constructed a typology of the newcomers that consists of the three idealtypical groups: ‘convinced’ (who already had become denialists  before coming to the group); ‘doubters’ – who are undecided as to the truth of either HIV science theory or AIDS-denialist theory; ‘orthodox’ – who openly hold HIV science views. Reception of a newcomer mainly depends on the newcomer’s belief status – it is very warm for ‘convinced’, cold or slightly hostile for ‘doubters’ and extremely hostile or derisive for ‘orthodox’. We identified sixth main rhetorical strategies of persuasion of the “undecided” on the issue used by denialists.

Conclusions: Contrary to the widespread public health depictions of AIDS-denialists as totally irrational, our study suggests that some of those who become AIDS-denialist have sufficiently reasonable grounds to suspect that 'something is wrong' with the scientific theory because their personal experience contradicts the unitary picture of AIDS disease progression they have in mind. 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-denialists 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 healthcare. The study findings suggest that healthcare 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.