EXPRESS: Engagement with Social Media Sexual Health Communities: Motivations and Outcomes of Consumers with Different Sexual Preferences

As concerns about sexually transmitted diseases 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, multi-method 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 wellbeing, 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 co-create knowledge, manage risk, and achieve empowerment through online peer interaction. The study has implications for policymakers, health communities, and medical organizations.