Restricted accessResearch articleFirst published online 2026
Engagement with Social Media Sexual Health Communities: Motivations and Outcomes of Community Engagement by Consumers with Different Sexual Preferences
As concerns about sexually transmitted infections rise, individuals increasingly rely on social media–based communities for peer-driven information and support due to persistent barriers to appropriate medical care. Using a qualitative, multimethod approach that combines in-depth interviews with netnographic observation of a large online sexual health community (OSHC), this study explores consumers’ motivations for engagement with OSHC. Findings contribute to the development of a new theoretical framework that reveals two main motivational patterns for consumer engagement with OSHCs: proactive motivations, such as community homophily, information diversity, language barriers, convenience, community moderation, inclusive language, and collaborative knowledge building; and reactive motivations, triggered by emotional distress, loneliness, perceived stigma and discrimination, confidentiality assurance, information gatekeeper, and need for social support. The cultural context moderates these motivations. Engagement outcomes include health empowerment, perceived value, sexual health confidence and well-being, and relief and reduction in emotional distress, moderated by the perceived severity of users’ health conditions. The study advances understanding of digital consumer engagement in stigmatized health contexts and offers a theoretical framework for how individuals cocreate knowledge, manage risk, and achieve empowerment through online peer interaction. The study offers implications for policymakers, health communities, and medical organizations.
AgnihotriArpitaBhattacharyaSaurabhYannopoulouNataliaLiuMartin J. (2022), “Examining Social Media Engagement Through Health-Related Message Framing in Different Cultures,” Journal of Business Research, 152, 349–60.
2.
AirhihenbuwaCollins O.FordChandra L.IwelunmorJuliet I. (2014), “Why Culture Matters in Health Interventions: Lessons from HIV/AIDS Stigma and NCDs,” Health Education & Behavior, 41 (1), 78–84.
3.
AlbrechtTerrance L.AdelmanMara B. (1987), Communicating Social Support. Sage.
4.
AtanasovaSaraKaminTanjaPetričGregor (2018), “The Benefits and Challenges of Online Professional-Patient Interaction: Comparing Views Between Users and Health Professional Moderators in an Online Health Community,” Computers in Human Behavior, 83, 106–18.
5.
AtkinsonRowlandFlintJohn (2001), “Accessing Hidden and Hard-to-Reach Populations: Snowball Research Strategies,” Social Research Update, 33 (1), 1–4.
6.
Babić RosarioAnaRussellCristel AntoniaShanahanDoreen Ellen (2022), “Paradoxes of Social Support in Virtual Support Communities: A Mixed-Method Inquiry of the Social Dynamics in Health and Wellness Facebook Groups,” Journal of Interactive Marketing, 57 (1), 54–89.
7.
BansalGauravGefenDavid (2010), “The Impact of Personal Dispositions on Information Sensitivity, Privacy Concern and Trust in Disclosing Health Information Online,” Decision Support Systems, 49 (2), 138–50.
8.
BaziSalehFilieriRaffaeleGortonMatthew (2020), “Customers’ Motivation to Engage with Luxury Brands on Social Media,” Journal of Business Research, 112, 223–35.
9.
BeardenWilliam O.HardestyDavid M.RoseRandall L. (2001), “Consumer Self-Confidence: Refinements in Conceptualization and Measurement,” Journal of Consumer Research, 28 (1), 121–34.
10.
BergerMatthew N.TabaMelodyMarinoJennifer L.LimMegan SCRachel SkinnerS. (2022), “Social Media Use and Health and Well-Being of Lesbian, Gay, Bisexual, Transgender, and Queer Youth: Systematic Review,” Journal of Medical Internet Research, 24 (9), e38449.
11.
BernardiRobertaWuPhilip F. (2022), “Online Health Communities and the Patient-Doctor Relationship: An Institutional Logics Perspective,” Social Science & Medicine, 314, 115494.
12.
BradfordTonya WilliamsGrierSonya A.HendersonGeraldine Rosa (2017), “Weight Loss Through Virtual Support Communities: A Role for Identity-Based Motivation in Public Commitment,” Journal of Interactive Marketing, 40 (1), 9–23.
13.
BraunVirginiaClarkeVictoria (2006), “Using Thematic Analysis in Psychology,” Qualitative Research in Psychology, 3 (2), 77–101.
14.
BrodieRoderick J.IlicAnaJuricBiljanaHollebeekLinda (2013), “Consumer Engagement in a Virtual Brand Community: An Exploratory Analysis,” Journal of Business Research, 66 (1), 105–14.
15.
BrownLew G.McEnallyMartha R. (1992), “Convenience: Definition, Structure, and Application,” Journal of Marketing Management, 2 (2), 47–56.
16.
ChenJunhanWangYuan (2021), “Social Media Use for Health Purposes: Systematic Review,” Journal of Medical Internet Research, 23 (5), e17917.
17.
ChenLangtaoBairdAaronStraubDetmar (2019), “Fostering Participant Health Knowledge and Attitudes: An Econometric Study of a Chronic Disease-Focused Online Health Community,” Journal of Management Information Systems, 36 (1), 194–229.
18.
CorbinJulietStraussAnselm (2014), Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Sage.
19.
CostelloLeesaMcDermottMarie-LouiseWallaceRuth (2017), “Netnography: Range of Practices, Misperceptions, and Missed Opportunities,” International Journal of Qualitative Methods, 16 (1).
20.
CummingsJonathon N. (2004), “Work Groups, Structural Diversity, and Knowledge Sharing in a Global Organization,” Management Science, 50 (3), 352–64.
21.
De AlmeidaStefânia OrdovásDholakiaUtpal M.HernandezJosé Mauro C.MazzonJosé Afonso (2014), “The Mixed Effects of Participant Diversity and Expressive Freedom in Online Peer-to-Peer Problem Solving Communities,” Journal of Interactive Marketing, 28 (3), 196–209.
22.
De KervilerGwarlannDemoulinNathalie T.M.ZiddaPietro (2016), “Adoption of In-Store Mobile Payment: Are Perceived Risk and Convenience the Only Drivers?” Journal of Retailing and Consumer Services, 31, 334–44.
23.
De MooijMariekeHofstedeGeert (2002), “Convergence and Divergence in Consumer Behavior: Implications for International Retailing,” Journal of Retailing, 78 (1), 61–69.
24.
DenzinNorman K. (2012), “Triangulation 2.0,” Journal of Mixed Methods Research, 6 (2), 80–88.
De ValckKristineVan BruggenGerrit H.WierengaBerend (2009), “Virtual Communities: A Marketing Perspective,” Decision Support Systems, 47 (3), 185–203.
27.
EisendMartinHermannErik (2020), “Sexual Orientation and Consumption: Why and When Do Homosexuals and Heterosexuals Consume Differently?” International Journal of Research in Marketing, 37 (4), 678–96.
28.
FeredayJenniferMuir-CochraneEimear (2006), “Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development,” International Journal of Qualitative Methods, 5 (1), 80–92.
29.
FlickUwe (2018), Managing Quality in Qualitative Research. Sage.
30.
FordJessie V.VargasEsther CoronaFinotelliItorJr.Dennis FortenberryJ.KismödiEszterPhilpottAnneRubio-AuriolesEusebioColemanEli (2019), “Why Pleasure Matters: Its Global Relevance for Sexual Health, Sexual Rights and Wellbeing,” International Journal of Sexual Health, 31 (3), 217–30.
31.
FosterDrew (2016), “‘Keep Complaining til Someone Listens’: Exchanges of Tacit Healthcare Knowledge in Online Illness Communities,” Social Science & Medicine, 166, 25–32.
32.
FraserSuzanneMooreDavidWalingAndreaFarrugiaAdrian (2021), “Making Epistemic Citizens: Young People and the Search for Reliable and Credible Sexual Health Information,” Social Science & Medicine, 276, 113817.
33.
FugateDouglas L. (1993), “Evaluating the US Male Homosexual and Lesbian Population as Viable Target Market Segment: Review with Implications,” Journal of Consumer Marketing, 10 (4), 46–57.
34.
GarbóczySzabolcsSzemán-NagyAnitaAhmadMohamed S.HarsányiSzilviaOcsenásDorottyaRekenyiViktorAl-TammemiAla’A. B.KolozsváriLászló Róbert (2021), “Health Anxiety, Perceived Stress, and Coping Styles in the Shadow of the COVID-19,” BMC Psychology, 9 (1), 1–13.
35.
GehrtKenneth C.YaleLaura J. (1993), “The Dimensionality of the Convenience Phenomenon: A Qualitative Reexamination,” Journal of Business and Psychology, 8 (2), 163–80.
36.
GinderWhitneyByunSang-Eun (2015), “Past, Present, and Future of Gay and Lesbian Consumer Research: Critical Review of the Quest for the Queer Dollar,” Psychology & Marketing, 32 (8), 821–41.
37.
GohJie MeinGaoGuodongAgarwalRitu (2016), “The Creation of Social Value,” MIS Quarterly, 40 (1), 247–64.
38.
GoodwinCathy (1991), “Privacy: Recognition of a Consumer Right,” Journal of Public Policy & Marketing, 10 (1), 149–66.
39.
HawnCarleen (2009), “Take Two Aspirin and Tweet Me in the Morning: How Twitter, Facebook, and Other Social Media Are Reshaping Health Care,” Health Affairs, 28 (2), 361–68.
40.
HollebeekLinda (2011), “Exploring Customer Brand Engagement: Definition and Themes,” Journal of Strategic Marketing, 19 (7), 555–73.
41.
Hollebeek, Linda D., Biljana Juric, and Wenyan Tang (2017), “Virtual Brand Community Engagement Practices: A Refined Typology and Model,” Journal of Services Marketing, 31 (3), 204–17.
42.
HoodJulia E.FriedmanAllison L. (2011), “Unveiling the Hidden Epidemic: A Review of Stigma Associated with Sexually Transmissible Infections,” Sexual Health, 8 (2), 159–70.
43.
HorvathKeith J.BauermeisterJosé A. (2017), “eHealth Literacy and Intervention Tailoring Impacts the Acceptability of a HIV/STI Testing Intervention and Sexual Decision Making Among Young Gay and Bisexual Men,” AIDS Education and Prevention, 29 (1), 14–23.
44.
HouseJames S.UmbersonDebraLandisKarl R. (1988), “Structures and Processes of Social Support,” Annual Review of Sociology, 14 (1), 293–318.
45.
HurInkyoungCousinsKarlene C.StahlBernd Carsten (2019), “A Critical Perspective of Engagement in Online Health Communities,” European Journal of Information Systems, 28 (5), 523–48.
46.
HwangKevin O.OttenbacherAllison J.GreenAngela P.Roseann Cannon-DiehlM.RichardsonOnekaBernstamElmer V.ThomasEric J. (2010), “Social Support in an Internet Weight Loss Community,” International Journal of Medical Informatics, 79 (1), 5–13.
47.
JaegerFabienne N.PellaudNicoleLavilleBénédicteKlauserPierre (2019), “The Migration-Related Language Barrier and Professional Interpreter Use in Primary Health Care in Switzerland,” BMC Health Services Research, 19 (1), 1–10.
48.
JohnstonAllen C.WorrellJames L.Di GangiPaul M.WaskoMolly (2013), “Online Health Communities: An Assessment of the Influence of Participation on Patient Empowerment Outcomes,” Information Technology & People, 26 (2), 213–35.
49.
KatesSteven M. (2000), “Out of the Closet and Out on the Street! Gay Men and Their Brand Relationships,” Psychology & Marketing, 17 (6), 493–513.
50.
KoHsiu-ChiaWangLi-LingXuYi-Ting (2013), “Understanding the Different Types of Social Support Offered by Audience to A-List Diary-Like and Informative Bloggers,” Cyberpsychology, Behavior, and Social Networking, 16 (3), 194–99.
51.
KozinetsRobert V. (2002), “The Field Behind the Screen: Using Netnography for Marketing Research in Online Communities,” Journal of Marketing Research, 39 (1), 61–72.
52.
KozinetsRobert V. (2015), Netnography: Redefined. Sage.
53.
LangerRoyBeckmanSuzanne C. (2005), “Sensitive Research Topics: Netnography Revisited,” Qualitative Market Research: An International Journal, 8 (2), 189–203.
54.
LiuShanXiaoWenyiFangChaoZhangXingLinJiabao (2020), “Social Support, Belongingness, and Value Co-Creation Behaviors in Online Health Communities,” Telematics and Informatics, 50, 101398.
55.
MageeJoshua C.BigelowLouisaDeHaanSamanthaMustanskiBrian S. (2012), “Sexual Health Information Seeking Online: A Mixed-Methods Study Among Lesbian, Gay, Bisexual, and Transgender Young People,” Health Education & Behavior, 39 (3), 276–89.
56.
MalikSumaira H.CoulsonNeil S. (2010), “Coping with Infertility Online: An Examination of Self-Help Mechanisms in an Online Infertility Support Group,” Patient Education and Counseling, 81 (2), 315–18.
57.
ManoRita S. (2014), “Social Media and Online Health Services: A Health Empowerment Perspective to Online Health Information,” Computers in Human Behavior, 39, 404–12.
58.
MarkosEreniMilneGeorge R.PeltierJames W. (2017), “Information Sensitivity and Willingness to Provide Continua: A Comparative Privacy Study of the United States and Brazil,” Journal of Public Policy & Marketing, 36 (1), 79–96.
59.
MartinPhilippeCousinLorraineGottotSergeBourmaudAureliede La RochebrochardEliseAlbertiCorinne (2020), “Participatory Interventions for Sexual Health Promotion for Adolescents and Young Adults on the Internet: Systematic Review,” Journal of Medical Internet Research, 22 (7), e15378.
60.
MathwickCharlaWiertzCarolineDe RuyterKo (2008), “Social Capital Production in a Virtual P3 Community,” Journal of Consumer Research, 34 (6), 832–49.
61.
McPhersonMillerSmith-LovinLynnCookJames M. (2001), “Birds of a Feather: Homophily in Social Networks,” Annual Review of Sociology, 27 (1), 415–44.
62.
MereishEthan H.PoteatV. Paul (2015), “A Relational Model of Sexual Minority Mental and Physical Health: The Negative Effects of Shame on Relationships, Loneliness, and Health,” Journal of Counseling Psychology, 62 (3), 425–37.
63.
MeyerIlan H. (2003), “Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence,” Psychological Bulletin, 129 (5), 674–97.
64.
MeyerIlan H.FrostDavid M. (2013), “Minority Stress and the Health of Sexual Minorities,” in Handbook of Psychology and Sexual Orientation, PattersonCharlotte J.D’AugelliAnthony R., eds. Oxford University Press, 252–66.
65.
MirzaeiTalaEsmaeilzadehPouyan (2021), “Engagement in Online Health Communities: Channel Expansion and Social Exchanges,” Information & Management, 58 (1), 103404.
66.
MorrisDaniel D.A.FernandesVanessaRimesKatharine A. (2022), “Sexual Minority Service User Perspectives on Mental Health Treatment Barriers to Care and Service Improvements,” International Review of Psychiatry, 34 (3–4), 230–39.
67.
MunizAlbertJr.,O’GuinnThomas C. (2001), “Brand Community,” Journal of Consumer Research, 27 (4), 412–32.
68.
NambisanPriya (2011), “Information Seeking and Social Support in Online Health Communities: Impact on Patients’ Perceived Empathy,” Journal of the American Medical Informatics Association, 18 (3), 298–304.
69.
NelsonKimberly M.CareyMichael P.FisherCelia B. (2019), “Is Guardian Permission a Barrier to Online Sexual Health Research Among Adolescent Males Interested in Sex with Males?” Journal of Sex Research, 56 (4–5), 593–603.
70.
OliverRichard L.DeSarboWayne S. (1988), “Response Determinants in Satisfaction Judgments,” Journal of Consumer Research, 14 (4), 495–507.
71.
ÖzmeteEminePakMelike (2020), “The Relationship Between Anxiety Levels and Perceived Social Support During the Pandemic of COVID-19 in Turkey,” Social Work in Public Health, 35 (7), 603–16.
72.
ParkAlbertConwayMike (2017), “Longitudinal Changes in Psychological States in Online Health Community Members: Understanding the Long-Term Effects of Participating in an Online Depression Community,” Journal of Medical Internet Research, 19 (3), e71.
73.
PatelPankaj C.FengCong (2021), “LGBT Workplace Equality Policy and Customer Satisfaction: The Roles of Marketing Capability and Demand Instability,” Journal of Public Policy & Marketing, 40 (1), 7–26.
74.
PattonMichael Quinn (2014), Qualitative Research & Evaluation Methods: Integrating Theory and Practice. Sage.
75.
PechmannCorneliaMooreElizabeth S.AndreasenAlan R.ConnellPaul M.FreemanDanGardnerMeryl P.HeisleyDeborahLefebvreR. CraigPirouzDante M.SosterRobin L. (2011), “Navigating the Central Tensions in Research on At-Risk Consumers: Challenges and Opportunities,” Journal of Public Policy & Marketing, 30 (1), 23–30.
76.
PeñalozaLisa (1994), “Crossing Boundaries/Drawing Lines: A Look at the Nature of Gender Boundaries and Their Impact on Marketing Research,” International Journal of Research in Marketing, 11 (4), 359–79.
77.
PorcelliPiero (2020), “Fear, Anxiety and Health-Related Consequences After the COVID-19 Epidemic,” Clinical Neuropsychiatry, 17 (2), 103.
78.
RheingoldHoward (1993), Global Networks: Computers and International Communication. MIT Press.
79.
RosenstockIrwin M. (2005), “Why People Use Health Services,” Milbank Quarterly, 83 (4).
80.
RossCatherine E. (2017), Social Causes of Psychological Distress. Routledge.
81.
RothMartin S. (1994), “Enhancing Consumer Involvement in Health Care: The Dynamics of Control, Empowerment, and Trust,” Journal of Public Policy & Marketing, 13 (1), 115–32.
82.
RuegerJasminaDolfsmaWilfredAalbersRick (2021), “Perception of Peer Advice in Online Health Communities: Access to Lay Expertise,” Social Science & Medicine, 277, 113117.
83.
ScamblerGrahamHopkinsAnthony (1986), “Being Epileptic: Coming to Terms with Stigma,” Sociology of Health & Illness, 8 (1), 26–43.
84.
SeidersKathleenBerryLeonard L.GreshamLarry G. (2000), “Attention, Retailers! How Convenient Is Your Convenience Strategy?” MIT Sloan Management Review, 41 (3), 79–89.
85.
ShimMinsunJoHeui Sug (2020), “What Quality Factors Matter in Enhancing the Perceived Benefits of Online Health Information Sites? Application of the Updated DeLone and McLean Information Systems Success Model,” International Journal of Medical Informatics, 137, 104093.
86.
SillenceElizabethBriggsPamHarrisPeter RichardFishwickLesley (2007), “How Do Patients Evaluate and Make Use of Online Health Information?” Social Science & Medicine, 64 (9), 1853–62.
87.
SnyderDeirdre G.NewmanKevin P. (2019), “Reducing Consumer Loneliness Through Brand Communities,” Journal of Consumer Marketing, 36 (2), 337–47.
88.
SørensenKristineVan den BrouckeStephanFullamJohnDoyleGerardinePelikanJürgenSlonskaZsuzsannaBrandHelmut (2012), “Health Literacy and Public Health: A Systematic Review and Integration of Definitions and Models,” BMC Public Health, 12 (1), 80.
89.
SweeneyJillian C.DanaherTracey S.McColl-KennedyJanet R. (2015), “Customer Effort in Value Cocreation Activities: Improving Quality of Life and Behavioral Intentions of Health Care Customers,” Journal of Service Research, 18 (3), 318–35.
90.
TracySarah J. (2024), Qualitative Research Methods: Collecting Evidence, Crafting Analysis, Communicating Impact. John Wiley & Sons.
91.
TuncayLindaOtnesCele C. (2008), “The Use of Persuasion Management Strategies by Identity-Vulnerable Consumers: The Case of Urban Heterosexual Male Shoppers,” Journal of Retailing, 84 (4), 487–99.
92.
Van OerleSarahLievensAnnoukMahrDominik (2018), “Value Co-Creation in Online Healthcare Communities: The Impact of Patients’ Reference Frames on Cure and Care,” Psychology & Marketing, 35 (9), 629–39.
93.
VigilantLee GarthHeitkampAshleyHeitkampAmanda (2022), “If It Does Turn Out to Be Herpes, Try Not to Stress Too Much: The Contours of Emotional Support and Peer Diagnosis in an Online Sexual Health Community,” Sociological Inquiry, 92 (1), 200–224.
94.
WangXiZhaoKangStreetNick (2017), “Analyzing and Predicting User Participations in Online Health Communities: A Social Support Perspective,” Journal of Medical Internet Research, 19 (4), e6834.
95.
WeissRobert (1975), Loneliness: The Experience of Emotional and Social Isolation. MIT.
YanLuTanYong (2014), “Feeling Blue? Go Online: An Empirical Study of Social Support Among Patients,” Information Systems Research, 25 (4), 690–709.
98.
YaoTangZhengQiuyingFanXiucheng (2015), “The Impact of Online Social Support on Patients’ Quality of Life and the Moderating Role of Social Exclusion,” Journal of Service Research, 18 (3), 369–83.
99.
YoungLindsay E.SolizStephanieXuJackie JingyiYoungSean D. (2020), “A Review of Social Media Analytic Tools and Their Applications to Evaluate Activity and Engagement in Online Sexual Health Interventions,” Preventive Medicine Reports, 19, 101158.
100.
ZeithamlValarie A. (2000), “Service Quality, Profitability, and the Economic Worth of Customers: What We Know and What We Need to Learn,” Journal of the Academy of Marketing Science, 28, 67–85.
101.
ZigronShimritBronsteinJenny (2019), “‘Help Is Where You Find It’: The Role of Weak Ties Networks as Sources of Information and Support in Virtual Health Communities,” Journal of the Association for Information Science and Technology, 70 (2), 130–39.
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