Social media use by health practitioners helps articulate a subculture-centered approach to public health communication. This article explores public health practitioners’ communication strategies with one subculture: young (18- to 29-year-old) men who have sex with men (MSM). Interviews with staff at a public health clinic reveal the use of a variety of social media systems to engage potential MSM clients (e.g. Facebook, Twitter, Instagram, Grindr, and Google+). Public health communicators’ social media use reflected the esthetic, behavioral, and media preferences of a high-risk target group and the ethical risks associated with publicly viewable communication. Social media became a platform for integrated multi-channel communication that comprised both top-down (i.e. institution centric) and bottom-up (i.e. subculture centric) communication flows that work together in a complementary fashion. Ultimately, subculture-centered social media use in this setting helps minimize cultural barriers between members of a public health subculture and the institutions that provide critical care.