Geosocial networking app use associated with sexual risk behavior, but also PrEP use, among gay, bisexual, and other men who have sex with men: Cross-sectional web-based survey (Preprint)

Geosocial Networking ◽

BACKGROUND In the United States, geosocial networking (GSN) applications (i.e., mobile dating apps) have become central to dating and sexual interactions in recent years. Among gay, bisexual, and other men who have sex with men (GBM), these apps play an important role in reducing barriers and facilitating partner-seeking. However, despite these benefits, there are concerns that these apps may facilitate risky sexual behavior and transmission of sexually transmitted infections (STIs) among GBM. OBJECTIVE The present study examined the association between GSN app use and sexual risk among a U.S. sample of GBM. METHODS Using a cross-sectional design, respondents (N = 223) completed an online survey assessing their use of GSN apps, sexual risk and protective behaviors, HIV serostatus, and previous STI diagnoses. RESULTS Respondents were ages 21-78 (M = 31.90, SD = 10.06), 69.5% Non-Hispanic White, and from 40 States and the District of Columbia. Nearly half (47%; n = 104) of the sample reported using GSN apps. GSN users were more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p < .001), and a previous STI diagnosis (p = .001) relative to non-users, and also reported more frequent use of recreational drugs before sex (p = .001), alcohol use before sex (p < .001), and cannabis use before sex (p = .01). Interestingly, GSN users were also more likely to report having ever received an HIV test (p < .001) and using pre-exposure prophylaxis (PrEP; p = .03). Rates of HIV seropositivity did not significantly differ between GSN users and non-users (p = .53). Among the subset of GSN users, 38 participants reported using only GBM-specific GSN apps (e.g., Grindr), while 27 participants reported using only sexuality nonspecific GSN apps (e.g., Tinder). Exclusive users of sexual minority-specific apps reported more frequent recreational drug use before sex (p = .01) and were also more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p = .004), a previous STI diagnosis (p = .002), and HIV testing (p = .003). Alcohol use before sex, cannabis use before sex, PrEP use, and HIV rates were similar between both groups (ps > .11). CONCLUSIONS Findings suggest that GSN apps may be a useful pathway for interventions aimed at reducing STI-risk among GBM. Future, prospective studies should examine how risk levels change after initiation of GSN app use.

Partner meeting venue typology and sexual risk behaviors among French men who have sex with men

International Journal of STD & AIDS ◽

10.1177/0956462418775524 ◽

2018 ◽

Vol 29 (13) ◽

pp. 1282-1288 ◽

Cited By ~ 3

Author(s):

Yazan A Al-Ajlouni ◽

Su H Park ◽

John A Schneider ◽

William C Goedel ◽

H Rhodes Hambrick ◽

...

Keyword(s):

Hiv Infection ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors ◽

Anal Intercourse ◽

Adjusted Relative Risk ◽

Geosocial Networking ◽

Sex With Men ◽

Group Sex

Previous research has given considerable attention to venues where men who have sex with men (MSM) meet their sex partners. However, no previous study examined a vast range of sexual risk behaviors. The objective of this study was to examine the association between the types of venues for meeting sexual partners, condomless anal intercourse, engagement in group sex, and HIV and sexually transmitted infection (STI) risk among a sample of MSM. Users of a popular geosocial-networking app in Paris were provided an advertisement with text encouraging them to complete an anonymous web-based survey ( n = 580), which included questions about sex-seeking venues, condomless anal intercourse, HIV status and STI history, and sociodemographic characteristics. A log-binomial model was used to assess association between venues (i.e. public venues [gay clubs, bars, and discos], cruising venues [such as gay saunas, beaches, and parks], and internet-based venues [internet chat sites and geosocial-networking apps]), condomless anal intercourse, engagement in group sex, and HIV infection as well as infection with other STIs, after adjustment for sociodemographics. In multivariable models, attending cruising venues was associated with condomless receptive anal intercourse (adjusted relative risk [aRR] = 1.47; 95% confidence interval [CI] = 1.20–1.81), any kind of condomless anal intercourse (aRR = 1.34; 95% CI = 1.14–1.58), an STI (aRR = 1.50; 95% CI = 1.09–2.05), engagement in group sex (aRR = 1.42; 95% CI = 1.27–1.59), and multiple partners for both condomless insertive (aRR = 2.00; 95% CI = 1.38–2.88), and receptive (aRR = 1.70; 95% CI = 1.23–2.36) anal intercourse, STI infection (aRR = 1.50, 95% CI = 1.09–2.05) and HIV infection (aRR = 1.76; 95% CI = 1.05–2.96). No associations were found with other venue types and sexual risk behaviors, STIs, and HIV infection, except for group sex, which was associated with all venue types. Use of cruising where the primary aim is to have sex was found to be associated with risky sexual behavior. Risky behavior reduction strategies such as preexposure prophylaxis campaigns should be targeted to MSM who frequent cruising venues.

Contextual factors in geosocial-networking smartphone application use and engagement in condomless anal intercourse among gay, bisexual, and other men who have sex with men who use Grindr

Sexual Health ◽

10.1071/sh16008 ◽

2016 ◽

Vol 13 (6) ◽

pp. 549 ◽

Cited By ~ 5

Author(s):

William C. Goedel ◽

Dustin T. Duncan

Keyword(s):

Smartphone Application ◽

Anal Intercourse ◽

Sexual Partners ◽

Sexual Practices ◽

Receptive Anal Intercourse ◽

Sexual Behaviours ◽

Insertive Anal Intercourse ◽

Geosocial Networking ◽

Background Geosocial-networking smartphone applications (apps) have been used increasingly by men who have sex with men (MSM) to meet new sexual partners. The purpose of this study was to examine associations between contexts of app use (e.g. using apps when drinking) and condomless anal intercourse among a sample of MSM who use these apps. Methods: MSM (n = 174) in New York City were recruited through Grindr, a geosocial-networking app popular among MSM, using broadcast advertisements asking MSM to complete an Internet-based survey about their app use and sexual behaviours. Log-binomial regression models were fit to assess the association between each of the six app-use contexts (e.g. using apps when lonely, when drinking) and engagement in condomless insertive and receptive anal intercourse with one or more partners in the past 3 months. Results: Engagement in condomless receptive and insertive anal intercourse with one or more partners in the preceding 3 months was common (39.7% and 43.1% respectively) and was associated with several app-use contexts. For example, significant associations (P < 0.05) were observed between alcohol and other drug use when using these apps and engagement in condomless receptive and insertive anal intercourse. Conclusion: Given that 57.5% of respondents had engaged in condomless anal intercourse in the preceding 3 months and the associations of app-use contexts with condomless sexual behaviours, these findings suggest that reductions in substance use may lead to safer sexual practices among MSM who use apps to meet sexual partners.

Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

10.2196/preprints.28508 ◽

2021 ◽

Author(s):

Li Shangcao ◽

Jing Zhang ◽

Xiang Mao ◽

Tianyi Lu ◽

Yangyang Gao ◽

...

Keyword(s):

Social Media ◽

Online Survey ◽

Sexual Partners ◽

Cross Sectional ◽

Self Testing ◽

Hiv Test ◽

Secondary Distribution ◽

Self Test ◽

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

Cross-Sectional Study of Sexual Behavior, Alcohol Use, and Mental Health Conditions Associated With Sexually Transmitted Infections Among Deploying Shipboard US Military Personnel

Military Medicine ◽

10.1093/milmed/usz070 ◽

2019 ◽

Vol 184 (11-12) ◽

pp. e693-e700 ◽

Cited By ~ 2

Author(s):

Judith Harbertson ◽

Paul T Scott ◽

Hector Lemus ◽

Nelson L Michael ◽

Braden R Hale

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Sexually Transmitted Infections ◽

Military Personnel ◽

Cross Sectional Study ◽

Sexual Partners ◽

Cross Sectional ◽

Sexually Transmitted ◽

Us Military ◽

Abstract Introduction Limited comprehensive data exist on risk behavior associated with sexually transmitted infections (STI) among ship-assigned US military personnel during the predeployment time period (PDT). This study examined whether sexual risk behaviors, alcohol use, involuntary drug consumption (IDC), posttraumatic stress disorder (PTSD), and depression during the 12 months prior to deployment were associated with provider-diagnosed STIs in this population. Materials and Methods Using cross-sectional data collected during 2012–2014 among sexually active personnel, multivariable regression assessed factors associated with STIs among all men (n = 1,831). Stratified analyses were conducted among men who have sex with women (MSW, n = 1,530), men who have sex with men or men and women (MSM, n = 83), and excluded those not reporting sexual partner gender (n = 218). Results Among MSW, transactional sex (AOR 3.8, 95% CI 1.5–9.4) meeting sexual partners at work (AOR 4.3, 95% CI 2.0–9.2), IDC (AOR 6.6, 95% CI 3.0–14.5), and incomplete mental health assessments (AOR 4.4, 95% CI 1.6–12.0) were significantly associated with STIs after adjustment. Among all men, those who identified as MSM (AOR 4.6, 95% CI 1.9–11.2) and drug screen positive (AOR 3.3, 95% CI 1.3–8.6) were significantly more likely to report an STI. Conclusions Previously unreported factors significantly associated with STIs at the PDT among MSW in the adjusted analysis were meeting sexual partners at work and IDC. IDC during the PDT warrants further exploration. These results can inform tailored STI reduction interventions among shipboard personnel and similarly aged civilians undergoing similar transition/travel experiences.

Contextualizing condoms: a cross-sectional study mapping intersections of locations of sexual contact, partner type, and substance use as contexts for sexual risk behavior among MSM in Peru

BMC Infectious Diseases ◽

10.1186/s12879-019-4517-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

R. Colby Passaro ◽

Angelica Castañeda-Huaripata ◽

Williams Gonzales-Saavedra ◽

Susan Chavez-Gomez ◽

Eddy R. Segura ◽

...

Keyword(s):

Substance Use ◽

Sexual Risk ◽

Public Spaces ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sexual Contact ◽

Sectional Study ◽

Cross Sectional ◽

Partner Type ◽

Condomless Anal Intercourse

Abstract Background Condomless anal intercourse (CAI) appears to be increasing among men who have sex with men (MSM) globally, and is reported to be as high as 70% in recent studies in Peru. To improve understanding of the evolving context of CAI among MSM in Peru, we studied associations between partner type, substance use, and condomless anal intercourse (CAI) in locations where MSM commonly report having sexual encounters. Methods In a 2017 cross-sectional study of rectal STI screening and HIV prevention, a convenience sample of MSM recruited from community venues in Lima completed a survey of demographic characteristics and sexual risk behavior with their three most recent partners. Generalized estimating equations estimated correlations of CAI with location of last sexual contact, participant substance use prior to sex, and negotiation of condom use before or during sex. The network data integration application, Cytoscape, mapped intersections of partner type, sexual orientation, substance use, and CAI by four types of locations where sex occurred: 1) Home, 2) Hotel, 3) Sauna or Internet Cabin, and 4) Public Spaces. Results Of 447 MSM (median age 27 years), 76.9% reported CAI with ≥1 of their last three partners. Participants reported sex with casual partners most commonly in homes (64.6%) and hotels (60.4%), and with anonymous partners most often in saunas/Internet cabins (57.5%) and public spaces (52.6%). CAI was less commonly reported in hotels (aPR, 95% CI: 0.85, 0.75–0.97) compared to homes. Participants who used marijuana before sex at home were more likely to report CAI than MSM who did not use marijuana (1.36, 1.01–1.92). Partner alcohol use before sex was associated with CAI in saunas/Internet cabins (3.17, 1.45–6.91) and public spaces (2.65, 1.41–4.98). In the sexual network maps, almost all MSM who used drugs prior to their sexual encounters used drugs with more than one of their last three partners. Conclusions CAI was common and associated with different risk factors, like partner type and substance use, based on location where sex occurred. Novel combination HIV, STI, and substance use prevention interventions must consider how the social environments of MSM influence condom use and other sexual risk behaviors. Trial registration ClinicalTrials.gov Identifier NCT03010020, January 4, 2017.

Sexual network characteristics of men who have sex with men with syphilis and/or gonorrhoea/chlamydia in Lima, Peru: network patterns as roadmaps for STI prevention interventions

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053865 ◽

2019 ◽

Vol 95 (5) ◽

pp. 336-341

Author(s):

Cherie Blair ◽

Ryan Colby Passaro ◽

Eddy R Segura ◽

Jordan E Lake ◽

Amaya G Perez-Brumer ◽

...

Keyword(s):

Network Size ◽

Sexual Partners ◽

Sexual Network ◽

Syphilis Infection ◽

Screening Process ◽

Cross Sectional ◽

Sti Prevention ◽

Network Characteristics ◽

ObjectiveWhile men who have sex with men (MSM) are disproportionately affected by Peru’s overlapping HIV and STI epidemics, there are few data on how partnership-level and network-level factors affect STI transmission in Peru. We explored partnership-level and network-level factors associated with gonorrhoea/chlamydia (Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT)) and/or syphilis infection among MSM in Peru.MethodsWe present the results of a cross-sectional secondary analysis of MSM (n=898) tested for syphilis and NG/CT infection as part of the screening process for two STI control trials in Lima, Peru. Participants completed questionnaires on demographics, sexual identity and role, characteristics of their three most recent sexual partners (partner sexual orientation, gender, role, partnership type, partner-specific sexual acts) and 30-day sexual network characteristics (number of sexual partners, partnership types, frequency of anal/vaginal intercourse). Participants were tested for syphilis and urethral, rectal and oropharyngeal NG/CT. Differences in network characteristics were analysed with χ2 and Kruskal-Wallis tests.ResultsApproximately 38.9% of participants had a new STI diagnosis (syphilis (rapid plasma reagin ≥16): 10.6%; NG/CT: 22.9%; syphilis-NG/CT coinfection: 5.4%). Condomless anal intercourse (CAI) was not significantly associated with an STI diagnosis. Gay-identified participants with exclusively homosexual networks had a higher prevalence of STIs (47.4%) than gay-identified MSM with only heterosexual/bisexual partners (34.6%, p=0.04), despite reporting fewer sexual partners (any partners: 2, 1–4 vs 3, 2–6; p=0.001; casual partners: 1, 0–3 vs 2, 1–4; p=0.001) and more stable partnerships (1, 0–1 vs 0, 0–1; p=0.003) in the last month.ConclusionsNetwork size and the number of casual sexual partners were associated with NG/CT infection among MSM in Peru. Despite reporting fewer sexual risk behaviours (smaller network size, more stable partnerships, less CAI), MSM with homosexual-only sexual networks had a higher prevalence of NG/CT and syphilis. These findings suggest network composition among MSM in Peru plays an important role in the risk for STI acquisition.

App use frequency and condomless anal intercourse among men who have sex with men in Beijing, China: a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/0956462419860293 ◽

2019 ◽

Vol 30 (12) ◽

pp. 1146-1155 ◽

Cited By ~ 3

Author(s):

Qianqian Luo ◽

Zunyou Wu ◽

Zihuang Chen ◽

Yue Ma ◽

Guodong Mi ◽

...

Keyword(s):

Logistic Regression ◽

Sexual Behaviors ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adjusted Logistic Regression ◽

Sex With Men ◽

Beijing China

Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, frequency of app use, and sexual behaviors were collected and analyzed. Multivariable logistic regression and restricted cubic splines were used to evaluate the association between app use frequency and CAI. Of the 9280 participants, the proportion of CAI within one month prior to the survey was 43.3%, and 43.7% logged onto the app ≥11 times per week. In adjusted logistic regression analysis, logging onto the app 6–10 times per week and ≥11 times per week were inversely associated with CAI (adjusted odds ratio [AOR] =0.88 [95%CI, 0.78–0.99]; AOR = 0.88 [95%CI, 0.82–0.97], respectively). Among those 40 years of age or older, logging onto the app ≥11 times per week was associated with lower rates of CAI (AOR = 0.57 [95%CI, 0.40–0.81]). Results indicate that frequent app use was associated with lower odds of CAI among MSM in Beijing, China. Innovative interventions, which take advantage of this popular media platform, should be developed as such apps have been found to reduce the odds of CAI in Beijing.

Uptake and willingness to use PrEP among Chinese men who have sex with men with experience of sexualized drug use

10.21203/rs.2.22067/v1 ◽

2020 ◽

Author(s):

Zixin Wang ◽

Phoenix K.H. Mo ◽

Mary Ip ◽

Yuan Fang ◽

Joseph T.F. Lau

Keyword(s):

Drug Use ◽

Hiv Testing ◽

Behavioral Control ◽

Anal Intercourse ◽

Perceived Behavioral Control ◽

Future Health ◽

Cross Sectional ◽

Sex With Men ◽

Willingness To Use

Abstract Background Sexualized drug use (SDU, use of any psychoactive substance before/during sexual intercourse) is prevalent among men who have sex with men (MSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among MSM with experience of SDU. Methods A total of 580 Hong Kong Chinese speaking MSM self-reported to be HIV negative/unknown sero-status completed a cross-sectional anonymous telephone interview. Results Of the participants, 107 (18.4%) and 56 (9.7%) had experience of SDU and chemsex in their lifetime. The prevalence of PrEP use was 4.0% among all participants and 12.1% among those with experience of SDU. Among MSM with experience of SDU who were not on PrEP (n=94), 59.6% were willing to use daily oral PrEP in the next six months. After adjustment for significant background variables (age group, HIV testing in the past year, and anal intercourse with non-regular male sex partners), having ≥3 episodes of SDU per month (adjusted odds ratios (AOR): 3.87, 95%CI: 1.01, 15.28), presence of condomless anal intercourse during SDU (AOR: 2.96, 95%CI: 1.03, 9.55), positive attitudes toward PrEP (AOR: 2.01, 95%CI: 1.37, 2.95), perceived support from significant others to use PrEP (AOR: 11.63, 95%CI: 3.93, 34.37)), and perceived behavioral control of using PrEP (AOR: 20.82, 95%CI: 6.51, 66.64) were significantly associated with higher willingness to use PrEP. Conclusion MSM with experience of SDU are potential good candidates of PrEP implementation. Effective strategies to increase PrEP coverage are needed even if affordable PrEP became available, future health promotion may make use of HIV testing and counseling settings and modify perception related to PrEP.

Screening HIV-positive men who have sex with men for hepatitis C re-infection risk: is a single question on condom-use enough? A sensitivity analysis

BMC Infectious Diseases ◽

10.1186/s12879-019-4456-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Patrizia Künzler-Heule ◽

◽

Sandra Engberg ◽

Manuel Battegay ◽

Axel J. Schmidt ◽

...

Keyword(s):

At Risk ◽

Hepatitis C ◽

Drug Use ◽

Sexual Risk ◽

Anal Intercourse ◽

The Other ◽

Hiv Positive ◽

Risk Behaviours ◽

Abstract Background Hepatitis C virus (HCV) is common in men who have sex with men (MSM) with HIV. The Swiss HCVree Trial targeted a micro-elimination by using a treat and counsel strategy. Self-reported condomless anal intercourse with non-steady partners was used as the selection criterion for participation in a counselling intervention designed to prevent HCV re-infection. The purpose of this study was to assess the ability of this criterion to identify men who engaged in other sexual risk behaviours associated with HCV re-infection. Methods Men who disclosed their sexual and drug- use behaviours during the prior 6 months, at study baseline, were included in the current study. Using a descriptive comparative study design, we explored self-reported sexual and drug-use risk behaviours, compared the odds of reporting each behaviour in men who reported and denied condomless anal intercourse with non-steady partners during the prior year and calculated the sensitivity/specificity (95% CI) of the screening question in relation to the other at-risk behaviours. Results Seventy-two (61%) of the 118 men meeting eligibity criteria reported condomless anal intercourse with non-steady partners during the prior year. Many also engaged in other potential HCV transmission risk behaviours, e.g., 52 (44%) had used drugs. In participants disclosing drug use, 44 (37%) reported sexualised drug use and 17 (14%) injected drugs. Unadjusted odds ratios (95% CI) for two well-known risk behaviours were 2.02 (0.80, 5.62) for fisting and 5.66 (1.49, 37.12) for injecting drug use. The odds ratio for sexualised drug use - a potential mediator for increased sexual risk taking - was 5.90 (2.44, 16.05). Condomless anal intercourse with non-steady partners showed varying sensitivity in relation to the other risk behaviours examined (66.7–88.2%). Conclusions Although condomless anal intercourse with non-steady partners was fairly sensitive in detecting other HCV relevant risk behaviours, using it as the only screening criterion could lead to missing a proportion of HIV-positive men at risk for HCV re-infection due to other behaviours. This work also points to the importance of providing access to behavioral interventions addressing other sexual and drug use practices as part of HCV treatment. Trial registration Clinical Trial Number: NCT02785666, 30.05.2016.