July 2013 marked a significant milestone. For the first time, most people accessed the HIV.gov website via mobile devices. We anticipated this day would eventually come. In truth, it came sooner than we expected, even as we saw mobile use increase week-by-week and month-by-month.

It's been two years since our move to responsive web design (RWD). There are three things that stand out, as we consider how our efforts have worked for mobile and HIV.gov.

1. We have optimized for mobile, for access anytime, anywhere, on any device.
2. Mobile devices are personal devices. HIV/AIDS is a sensitive and personal health issue.
3. Emotion matters, especially with regard to personal health topics.

Optimizing for Mobile

We have spoken previously about our work with responsive web design. In acknowledging the need to meet a broader audience, we knew we needed a more comprehensive mobile solution. Assessing our technical environment and capabilities, we felt responsive design provided a mobile experience that was as ubiquitous as possible, spanning the greatest number of device types without relying on a device detection platform.

Our first months showed an average of about 20-25% mobile users, already an increase over the 10-15% we saw before the responsive redesign. Later 2012 and early 2013 saw significant growth for the website, not just with mobile but overall. By July 2013, a year after our responsive launch and following National HIV Testing Day, we averaged over 50% mobile ( 6% tablet and 44% smartphone) users in a calendar month for the first time.

The percentages continue to grow. As of July 2014, tablets have plateaued at around 6% of site traffic, but smartphone traffic now exceeds 57%. An average day in July 2014 exceeds our absolute peak day (World AIDS Day) back in 2009.Percent of HIV.gov traffic (July 2014) by browser (Operating System)

• Safari (iOS, Mac): 31%
• Chrome (PC, Android, Mac): 30%
• Android browser (Android): 10%
• Internet Explorer (PC): 10%
• Opera Mini (iOS, Android, other mobile): 8%

We did more than just build for responsive design in those years - we optimized much of our content for mobile and built some other tools that were specific to mobile users, like the HIV/AIDS Locator and the Facing AIDS website. The overall trend really starts with our responsive design release in 2012. It was a key trigger for the growth we’ve seen, not just in mobile visits, but in overall site traffic.

Mobile devices are personal devices. HIV/AIDS is a personal and sensitive health topic

Dr. Google has been the first line of defense for many in their quest for health answers. A Healthline study in 2011Exit Disclaimer found a significant difference between the top health searches on desktop and mobile. Desktop health searches tended to be related to broader health topics like cancer, diabetes, and fitness. Mobile searches were more closely aligned with personal health topics: chlamydia, bipolar disorder, and smoking cessation. Studies like this convinced our team that our audience was more likely to find us on their own personal devices.

In addition to searching more personal health topics, mobile users were more direct and explicit in their language and their search terms. Diving into the long tail of search queries, and correlating them with browser and operating system provided us with evidence of this general trend. We found that people were more honest and descriptive on their phones.

Emotion matters, especially with regard to personal health topics

The Pew Research Center’s Internet & American Life ProjectExit Disclaimer releases regular insights regarding internet use related to health topics. Susannah Fox, the Associate Director at the Pew Research Center’s Internet & American Life Project, and her research have provided data points that have shaped the HIV.gov site and its features. One statistic highlighted the role emotion plays in health search and mobile behavior - 40% of those in a health crisis turned to their mobile phones for health informationExit Disclaimer. With the redesign of HIV.gov, we tried to put ourselves in those shoes and view our content in that context.

For us, responsive design was the most empathetic choice. It doesn’t assume a mobile point of view, but builds content with a philosophy that one experience should work for all. Users arrive without having to pinch or zoom the site. There are no barriers to mobile users who can’t play a media file or view an image. Touch and gestures work. The font size is readable and clear and the content is written for a broad audience.

Jeremy KeithExit Disclaimer, a web developer who has written much on HTML5 and the beginnings of the web, regularly cites The Robustness Principle - “Be conservative in what you send; be liberal in what you accept.” There is an inherent empathy in this principle, the computer version of being quick to listen and slow to speak. Beyond any other current design practice, RWD embraces this concept.

Conclusion

The sources of HIV.gov’s surge in mobile use cannot be distilled down into a short list of defined steps or actions. The sheer speed of mobile adoption in the general public has exceeded our ability to respond to it comprehensively. Our choice of responsive web design was a critical factor, as essential as our subject matter or target audience, in successfully addressing the transition to a post-PC, always-connected world.

There is a body of evidence supporting the effectiveness of responsive web design, not just in health, but commerceExit Disclaimer, mediaExit Disclaimer, and higher educationExit Disclaimer. It has emerged as a best practice. Our metrics lack the endpoints necessary to paint the full picture of successful conversions. The HIV.gov website cannot escort each and every visitor to a health clinic for an HIV test, or encourage them to manage their HIV, know their status, or adhere to their medication. All of that requires a human touch at many stages.

But that human touch is best approximated, for now, in responsive web design. Mobile has merged the digital and physical environments like no other technology before it, placing our human connections at our fingertips in a device that we can carry in our pockets and take with us wherever we can go.

How has responsive design made health information more accessible for your organization? Leave your comments below!