HIV researchers were among the first professionals to create health solutions using consumer technology. Since the HIV epidemic began in the early 80s, gay men have been among the highest risk groups for HIV infection. And because gay men are also early technology adopters, researchers were able to bring their studies online to meet the population at highest risk for HIV. By the mid-2000s, researchers followed gay men from gay bars and clubs to Craigslist and Gay.com - and then on to hookup apps like Grindr. HIV prevention and treatment professionals used researcher’s findings. They created tools using emerging technology to understand health issues and improve outcomes.
Now, the broader population is online and are using services that were once considered fringe. Since HIV researchers first started following gay men online, Amazon's revenue has grown by more than 10 times. When HIV researchers first started using Facebook in 2007 to engage men at risk of HIV, Facebook had 20 million users. Today there are 1.6 billion. Lessons from the early digital fight against HIV/AIDS can now be applied to issues facing our entire society like reducing obesity, preventing diabetes, and curing cancer.
The opportunity to improve health with technology has created a gold rush. In 2011, $1 billion was invested in digital health companies. By 2015, venture capital firms and angels invested $4.5 billion (nearly 7% of all venture capital funding) into digital health startups.
But the digital health space is not without controversy. The American Medical Association CEO, James L. Madara, MD described emerging digital technologies as "modern snake-oil." The Wall Street Journal exposed Theranos, a startup valued at one point as much as $9 billion as a near fraud. And there are thousands of ideas, apps, and websites that languish in app stores and on search engines with little use.
So what early lessons in the fight against HIV/AIDS should digital health providers learn from to improve the odds these tech health tools make an impact?
First, the tools need to work. Not just from a technical perspective, but there needs to be long-term evidence that the technology makes a difference. The National Institutes of Health and multiple other healthcare funders supported randomized controlled trials and evaluations to establish whether the HIV interventions actually reduced transmission. Unfortunately, evaluations of digital health apps in other sectors have been far fewer. This makes it hard for apps to gain credibility and traction within the medical establishment. Do users lose weight when they use a specific diet app? Does that sleep app improve sleep and help people feel more rested? Right now the evidence is lacking.
Secondly, HIV researchers learned that just applying technology to a problem isn't enough. The technology has to be easy to use and maybe even fun. The tech needs to speak to the user's unique perspectives on an emotional level. Today, digital health tools have a poor reputation when it comes to design and ease of use. Just look at online electronic medical records. Traditional and more innovative healthcare brands are still awash in bland blues and whites that denote safety and credibility. HIV technology programs included bold, culturally diverse and relevant imagery that didn't shy away from sexiness. The applications didn't just provide step count and heart-rate but turned this data into games and relevant recommendations.
Finally, and most importantly, an ounce of prevention is worth a pound of cure. We know exactly what behaviors cause HIV, and changes in behavior can prevent it. HIV researcher not only focused on treatments and cures, they focused on creating digital assets that changed opinions and behaviors to prevent HIV infection in the first place. Heart disease, lung cancer, diabetes, asthma and many other diseases have strong behavioral and environmental components. While pharmaceutical drug research should continue, we should take a queue from the HIV world and focus on prevention as well.
There is still a lot of work to be done to combat HIV. Cities like Baltimore, Jackson, and Miami have alarmingly high new infection rates. The epidemic in sub-Saharan Africa remains.
But there are successes - and those successes are ones the entire healthcare sector should learn from. The lessons have application far beyond sexual health and HIV.
Matthew Amsden is CEO of ProofPilot, a venture-backed online platform that makes it easy to design, launch and participate in research studies that determine what works to improve human health. The idea for ProofPilot came while working on HIV prevention research studies. The lessons can now be applied by anyone on studies in healthcare, wellness, fitness, education and social-services. www.proofpilot.com.