I must admit, mission accomplished, Genevieve Bell.
Bell’s CHI 2010 plenary most definitely delivered on its explicit intent to provoke. As an HCI researcher and practitioner, I was moved to finally get “REAL” in order to deal with the messiness that the future has to offer. Coupled with a charge to the CHI community to explore under-investigated areas such as sexuality and similarly alternative constructs, Bell’s rallying call for challenging the traditional assumptions and perspectives that often frame our communities’ efforts was especially intriguing.
However, I must admit that at the onset of her talk, I felt that for me, in particular, there would be nothing new offered. In the context of engaging design and technology in meeting societal challenges, the core thesis that a singular futureone that is clean, white, pristine, or simpledoes not exist was not a foreign notion, as it reflects my lived reality. In the HCI community, I feel I am about as diverse as they come. Moreover, I have often felt that with my diversity, alone, comes an innate sensitivity, awareness, and appreciationin essence, an understandingof considerations of difference. However, to my chagrin, as I reflected on Bell’s talk, specifically in the context of some of the work that I am doing in engaging interactive technologies in domestic HIV prevention among young men that have sex with men, this is truly not the case .
I questioned myself. Conceptually, how am I framing this design dilemma? How am I viewing my stakeholders (users)? What are the underlining assumptions that accompany such descriptions? Are these valid? Are there other means by which to characterize aspects of this dilemma that could underpin the innovation so desperately needed in responding to this crisis?
With my toolbox of traditional usability engineering oriented approaches, I felt ill-equipped to respond to these questions. To echo Sjoberg and Norlin: “observing and understanding what people do and what is going on is not sufficient” . Fortunately, there is a move within HCI to begin to incorporate aspects of criticism within our work that could support a response. Approaches such as The Third Paradigm of HCI, Reflective HCI, and Critical HCI are evolving, equipping HCI researchers and practitioners with the notions to engage with the more complex facets of humanity (e.g. culture) necessary in supporting our deeper explorations of technology and design within people’s lives [3, 4, 5]. However, the challenge continues in developing and further couching these notions within HCI in REALizing their potential. I offer that design lenses could support this endeavor.
The Case for Alternative Lenses in Design
Elizabeth Churchill explored gender in design in a March + April 2010 interactions article, asserting that we as designers “are not passive bystanders (of the process)...we design products with implicit or explicit assumptions about how products will be used and by whom” . Reflecting on this notion, I cannot help but revel in its implications and consequences, even outside of such considerations as gender.
Designers approach design on the basis of “personal experience, knowledge and ideas derived from a particular sociocultural background,” projecting onto the design through the “plane of their cultural filter.”
“Whether they share the same cultural origin or are foreign to that culture, the designer is required to be sensitive to the user’s culture and to be able to view it through the user’s cultural filter plane” .
Acquiring this requisite sensitivity is not easy. While conceptually the relevancy of culture and associated considerations in design are well understood “technology is not a good traveler unless it is culturally calibrated” there still remains a need for tools in assisting designers in understanding and dealing with these sorts of considerations in informing design. “There is a notable lack of research on how culture and society affect technological decisions” . The need is pressing, especially as the reach of our efforts as designers is extending beyond a work or workplace focus into differing domains and within communities and constituencies that are often not culturally reflective of “us,” which is becoming more the case than not.
As Churchill notes, the “us”, product/technology designers, are most often male. Further, I would add that these males are most often white, most likely are members of a higher socioeconomic status, and to further provoke, identify as heterosexual. Thus, expanding on Elizabeth’s thoughts, design decisions, while I am sure well intended, will most likely be made through “planes” aligned and reflective of this characterization male, white, heterosexual, etc. However, if we are to realize our future of fully imparting the tools to affect the future to the whole of society as Genevieve Bell postulates as our mission, Houston, we’ve truly got a problem.
A white, heterosexual, “malestream” filter/plane of understanding is just not going to do it. Even as we engage design, within the U.S., considerations of culture remain omnipresent. The recognition of the existence of subcultures and their associated values, practices, behaviors, activities, etc. is paramount, especially as we hope to realize the vision of pervasive and ubiquitous technologies. Through the dominant “planes” that now exist within our community, certain design decisions “may feel natural and logical within a given context, but might not to a target culture” . Lenses of design (i.e., design lenses) to afford design perspective are needed.
A notion borrowed from game design and situated in the field of interaction design by Bill Scott , a design lens, as I conceptualize it, frames the designer’s eyes and brings focus to a given design dilemma. Furthering assertions offered by Jeffrey Bardzell  and Shaowen Bardzell  in exploring the role of critical theory (e.g., critical strategies such as feminism) in HCI and couched within the context of evolving a culture-centered design approach, a design lens could offer a more culturally responsivesituatedperspective of viewing a given design dilemma. This perspective brings a more appropriate set of assumptions, notions, and understandings that could better align with the constructs, values, and motives offered by the given design dilemma. This is especially of import in our deeper dives.
Conceptually, the power of a lens challenges the designer to consider the design activity from a different perspective. This could render transparent those conceptions that could more adequately underpin decision-making throughout the entire design lifecyclefrom problem space identification and exploration to solution implementation. Moreover, the lens equips the designer with the ability to see through the end user’s eyes (e.g. their cultural filter), bridging gaps between the designer’s perception and the end user’s perceptionmaking visible those things that may be clouding a design response. Which I often feel is the case in the response of the HCI community to the domestic HIV crisis.
Affording the Deeper Dives
The domestic HIV crisis reflects a design dilemma that is steeped in, among other things, deeper notions of sex, specifically notions of sexual orientation. Not only would I offer that sexual orientation lies on a continuum of social discomfort from the prevailing white heterosexual malestream or heteronormative perspective that dominates our profession, but also that the analogous “cultural plane” may offer an underlining assumption: Sex between individuals of the same gender is not normal (i.e., men who have sex with men (MSM)). This may, fundamentally, be restraining and/or compromising the response by the HCI community to this domestic crisis even in light of the continued pressing calls for the exploration of technology in prevention efforts .
Though almost “meteoric” in use in their infancy, the understanding that there may be implications to sexuality, intimacy, and relationships in the use of [mobile] technologies is just beginning to emerge.
“Even the most well-meaning theorist or researcher who may ‘sympathize’ with the ‘plight’ of gay men and lesbians, may nonetheless operate with the unquestioned understanding that upholds heterosexuality as more natural, viable and normal than nonheterosexuality”.
Though not unique to HCI, the design implications of such an understanding offered by this underlining assumption are profound. Further evidence of the manifestation of this understanding is highlighted in recent works that challenge the efficacy of traditionally motivated condom-centric HIV prevention interventions for MSMs. It has been argued that these “one size fits all” intervention designs are not only non-responsive to the dynamic nature MSM communities, but that don’t fully address the complexity of pleasure within this socio-cultural context. In response to these sorts of intervention designs: “Gay men say they feel cheated…and many have come to perceive condoms as emblems of a still hostile world, imposed on them by a culture that continues to stigmatize gay sex. To use a condom every time you have sex, for the rest of your life?” says Daniel Siconolfi, of New York, University’s HIV-prevention think tank, the Center for Health, Identity, Behavior, and Prevention Studies. “That’s a very, very big burden. That’s a lot to ask of somebody. And it’s not being asked of anybody other than gay men.” 
This may be why the public health community is witnessing upticks in domestic HIV infection rates, especially among MSM. A phenomenon tagged “condom fatigue,” viewed by many as a backlash to condom-centric approaches, has entered the picture .
There is truly an opportunity for differing approaches to this design dilemmaones that could be furthered by viewing this dilemma through a more appropriate lens. Criticism as framed by “queer theory” could offer such a lens. Queer theory looks at, studies, and has a political critique of anything that falls into normative and deviant categories, particularly sexual activities and identities. Queer theorists insists that all sexual behaviors, all concepts linking sexual behaviors to sexual identities, and all categories of normative and deviant sexualities are social constructs of signifiers that create certain types of social meaning . In essence, queer theory represents “a stance that denies and interrogates the privileges of heterosexuality and tries to openly question dominant ideas of normalcy and appropriate behavior” .
Framing HCI Engagement in HIV Prevention within the Context of Queer Theory
Queer theory truly changes the framing of the dilemma; as how a problem is framed directs the types of solutions generated. In the context of HIV prevention, Michael Warner, a renowned queer theorist, argues the design of any HIV-prevention intervention requires taking into account the diversity of people’s sex lives and should be grounded in people’s desires and pleasures. “What we have to achieve is an eroticization of safer sex practices and the incorporation of safer sex rules into these negotiations” . Warner states “The prohibition against sexiness in HIV prevention is so powerful that people take it for granted, forgetting that it is even there. AIDS activists learned quickly that effective prevention cannot be based on shame and a refusal to comprehend; it requires collective efforts at honest discussion, a REALism about desire and a respect for pleasure” .
Something that is often missing in legacy approaches. One reality in particular, as we begin to explore opportunities for engaging interactive technologies in HIV-prevention efforts, is the more central role of mobile technologies, especially location-aware (GPS enabled) social-networking mechanisms (i.e. location-based social networking (LBSN) technologies) in the sex lives of MSM. This is evidenced by the rise in use by MSM of one such application, Grindr. Reported as having more than 750,000 users in 162 countries since launching in early 2009.
Other recent additions in this mobile application space include BoyAhoy, DList, Skout, StreetSpark, MeetMoi, and West Fourth with a growing number of the applications now catering to other constituencies (e.g. heterosexuals).
Though almost “meteoric” in use in their infancy, the understanding that there may be implications to sexuality, intimacy, and relationships in the use of these sorts of technologies is just beginning to emerge. A recent LifeLube forum explored how intimacy needs are met in a world that is increasingly turning to “realtime” technologies. LifeLube is an initiative of the Sexual Health Exchange (SHX) collaboration to raise public awareness about the sexual health needs of all gay men and other men who have sex with men and to expand the range of sexual health education options available to gay men, especially those of color.
Moreover, the 2010 National Gay Men’s Health Summit held this past August featured a workshop entitled “Negotiation in the Bright Colored Bubble: Grindr and the development of specialized ‘sexting.’” While the impact of these technologies in the sexual lives of MSM is being discerned, the potential consequences and opportunities availed in the context of HIV transmission and prevention are elucidating.
HIV Prevention in the Age of Grindr
November 2009 brought the news story of a Copperas Cove, Texas, man being charged with aggravated sexual assault with a deadly weapon in a sexual encounter initiated via Grindr. The victim stated that he was not informed of the accused’s HIV status and that he learned later through another Grindr user that the accused claimed to be HIV-positive, which was subsequently confirmed . I don’t mean to implicate Grindr, but this unfortunate event brings to light some of the challenges and opportunities in HIV prevention in the context of Grindr and the use of similar technologies.
The manner by which these technologies are shaping disclosure behaviors is presenting new challenges in prevention. The nature of how HIV-status disclosure is navigated both directly and even more so indirectly, in the context of these real-time technologies, is evolving and needs to be understood. Early work has shown the prevalence of “preempting” safer sex through scanning online profiles, forgoing more explicit discussions about the need for safer sex during the actual physical encounter. This phenomenon is offering evidence that suggests users of these technologies may construct unfounded trust in pre-meeting chats that may lead to false security in engaging in unprotected sex .
Guided by an overarching premise that health is a decision-making problem as much as a healthcare problem, a rich test bed of HCI-related design and research questions is emerging. How is trust and/ or trustworthiness constructed through the computer-mediated communication (CMC) offered by these technologies? What are the implications of location or the knowledge of whereabouts? Could proximity or awareness of location influence/impact decisions around behavior? Reflecting on work by John Suler, what constitutes/reflects the presentation of self in this context ? Furthermore, what are the implications of social networking to status disclosure and veracity within these contexts? Answering these and similar questions could provide insight in understanding and describing the reality of decision-making within these sorts of contexts of use, which could prove valuable in informing the design of prevention interventions.
As some of these questions are answered and addressed, opportunities to more effectively engage design in this context could unfold. Some sexual-health experts argue the more traditional methods of MSM “hookups” provide safe-sex information and speculate that the use of Grindr and similar technologies has the potential to promote unsafe sex practices . For example, safe-sex messaging is often prominently displayed in physical bars and/ or clubs that target MSM. Even Internet sites that facilitate MSM connections provide similar messaging. The question now is what are the role and place for messaging and other preventative interventions in the context of use of social networking technologiesor is there a role at all?
In one of the first studies to begin to explore Internet use among young MSM in meeting sexual partners, Garofalo, Herrick, Mustanski, and Donenberg state not only do a high number use the Internet, in general, to find romantic or sexual partners (e-dating), but also, of those to utilize this mechanism, higher rates of risky sexual behaviors (i.e., increased number of partners, less consistent condom use during anal intercourse, etc.) are reported . So, from a prevention perspective, do we support the condemnation of these mechanisms? Attempt to shut them down?
HIV Prevention: From Intervening to Enabling a Safer Experience
Analogous to what Michal Warner articulated at the height of the domestic AIDS crisis around what should be done around the prevalence of risky sexual acts happening in bathhouses and movie theaters: It’s not a matter of closing them down, but rather, HIV prevention should be in these places . This thesis is being explored in the context of use of interactive technologies. Manhunt.net, a popular social networking site for MSM, maintains the website Manhunt Cares that promotes safer sex behaviors. Specific to LBSN technologies, the AIDS Council of New South Wales Australia (ACON) has initiated discussions with Grindr to see how to best include some element of condom reinforcement within the app. Tentatively, this will occur through safe-sex warnings being displayed before the application launches and by allowing sexual-health organizations to make their own user profiles as outlined in a recent news story that highlighted this effort. This is a great first step by Grindr; however, continued opportunity exists.
Through a queer theory lens, the perspective changes. The viability of viewing HIV prevention within this emerging context as an aspect (i.e. a component) of the experience versus a desperate intervention becomes clear. A recognition (in getting REAL) of what these technologies affordpleasure and that this pleasure often occurs via an activitysex (and in its many forms)that comes with an inherent level of risk becomes essential in framing an appropriate design exploration. How do we now design or afford a user experience that allows one to “clarify their own motives” and “to keep themselves safe” in the context of risk becomes a framing worthy for investigation.
As a result of such a framing availed by a queer theory lens, a more empathetic design exploration diveis engendered. An exploration that, as Jeffrey Bardzell  asserts, could enhance our ability to discover phenomena that may enrich the design activity. A design space is evolved that is potentially more culturally responsive and situated. As such, a more diverse set of design solutions, inclusive of insights and/or perspectives, may emerge that could offer innovation in addressing this dire domestic crisis.
Akin to the “thinking through prototyping” perspective offered by Klemmer et al. in response to the “reflexive” nature of design , the design lens challenges the designer to more actively reflect on the dilemma. This reflection affords a conversation between the designer and the design dilemma. This I offer, echoing work by Gregory Gargarian , could engender differing degrees of design freedom for the design exploration and support “confidence building” in the designer through offering an evaluative mechanismthe lensthrough which the framing of the design dilemma can evolve.
I agree with Shaowen Bardzell that, conceptually, the notion of insight birthed through an alternative perspective is not new in HCI. The sociotechnical systems traditions that have influenced HCI efforts offer approaches to design that appreciate these sorts of methods and tools in informing design. Established approaches, such as ethnocomputing from the computer science tradition and cultural ergonomics from the human factors tradition, provide such grounding. The same applies to design methods such as value-sensitive design and culturecentered design that advocate empathy in design. While these approaches seemingly accommodate Bardzell’s notion, opportunity still remains to further REALize these concepts.
When one starts to look at where we as a community are now participating in exploring opportunities to engage design and technologies, deeper in the “messiness” of the lives of real peoplefrom cradle to grave, the vision of ubiquitous computingthe relevancy of this notion of lenses is now much greater. Echoing Jeffrey and Shaowen Bardzell , “as domestic, ubiquitous, mobile, and entertainment computing work their way into the most intimate recesses of all human life, matters of aesthetics and enlightenment, social justice and oppression, self-actualization, and wisdom will matter just as much. Interaction designers need to engage with all of these issues and they need to do so not merely with rigor but with the right kinds of rigor.” As illustrated in the presented example of engaging interactive technologies in domestic HIV prevention, conceptually, lenses of design could begin to offer that rigor. The requisite rigor that could assist us as a design community in seeing and REALlizing the beauty that we can offer in the mess.
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Woodrow W. Winchester, III, is an assistant professor of industrial and systems engineering at Virginia Tech. A faculty affiliate of Virginia Tech’s Center for Human-Computer Interaction (CHCI), Winchester directs the Laboratory for User-Centric Innovation in Design (LUCID) and is cofounder and a program coordinator of Building Interfaces for Tomorrow’s Technology: The Virginia Tech Research Experience for Undergraduates (REU) in Human-Computer Interaction, sponsored by the National Science Foundation. He received his B.S., M.S., and Ph.D. in industrial and systems engineering from North Carolina A&T State University.
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