Trojan Horse: An Analysis of Targeted Advertising to Reduce Sexually Transmitted Diseases Among YMSM

Background: Men who have sex with men (MSM) increasingly use internet-based websites and geospatial apps to seek sex. Though these platforms may be useful for public health intervention, evaluations of such interventions are rare. We sought to evaluate the online behavior of young MSM of color in Philadelphia and the effectiveness of using ads to link them to DoYouPhilly.org, where users can order free condoms, lubricant, and sexually transmitted infection test kits delivered via the U.S. postal service. Method: Data collection and analyses were conducted in two phases. First, we performed keyword research and analyzed web browser logs using a proprietary data set owned by Microsoft. Subsequently, we ran a Google Ads campaign using the keywords identified in the preliminary phase, and directed targeted users to the DoYouPhilly.org condom or test kit ordering pages. Results were analyzed using MATLAB 2018. Results: Test kit advertisements received 5,628 impressions, 157 clicks, and 18 unique conversions. The condom advertisements received 128,007 impressions, 2,583 clicks, and 303 unique conversions. Correlation between the click-through rate and the conversion rate per keyword was ρ = −.35 (P =.0096) and per advertisement was ρ =.40 (P =.14). Keywords that directly related to condoms were most effective for condom ordering (42% conversion rate vs. ≤2% for other classes), while keywords emphasizing the adverse effects of unprotected sex were most effective in test kit ordering (91% conversion rate vs. 13% and 12% for other classes). Conclusions: Online advertisements seemed to affect real-world sexual health behavior, as measured by orders of condoms and test kits, among a group of young MSM living in the same community.