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)

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.

Sexual Behaviors and HIV/STI Prevention Strategies Among Sexual Minority Men in Ecuador Who Use Geosocial Networking Apps

Around the world, geosocial networking apps have become widely popular among sexual minority men (SMM). This research analyzed the sexual behaviors and HIV and STI prevention strategies (HIV/STI testing, HIV/STI inquiry, and HIV/STI disclosure) of an online-recruited sample of 284 SMM living in Ecuador. Sexting and oral sex were the most common sexual behaviors among SMM in the sample. Most participants had low perceptions of HIV and STI risk; 85% reported being tested for HIV and 70% for STIs. Being older predicted higher odds of being tested for either HIV or STIs at least once. Being single also predicted HIV testing. Future interventions in the country should explore apps’ utility as intervention tools to spread information about sexual health and HIV prevention strategies, such as condom use and event-driven PrEP. Apps can also facilitate connections to sexual health services, including programs for PrEP initiation and linkage to HIV treatment. They should also focus on promoting sexual harm reduction conversations among potential app-met sexual partners.

Pre-exposure prophylaxis awareness, use, and intention to use in a regional sample of Latin American geosocial networking application users in 2018–2019

Pre-exposure prophylaxis (PrEP) access is increasing in Latin America. We explored PrEP use among Spanish-speaking, Hornet geosocial networking application users from Latin American countries with limited PrEP data via an online survey completed between December 2018 and February 2019. A total of 718 Hornet users from 10 countries were included, of whom 72.1% reported PrEP awareness. Few (5.6%) were currently taking PrEP, though 32.1% intended to take PrEP in the subsequent 6 months. PrEP awareness was lower in 18–25 year olds compared to 26+ (62.4% vs. 75.6%, aOR 0.67, [95% CI 0.46–0.97]), and higher among those living in larger versus smaller cities (74.4% vs. 58.8%, aOR 1.96, [95% CI 1.25–3.07]) or countries with at least partial versus no PrEP policy adoption (79.1% vs. 60.8%, aOR 2.20, [95% CI 1.56–3.12]). Intention to use PrEP was higher among PrEP-eligible respondents (51.8% vs. 29.6%, aOR 2.26, [95% CI 1.26–4.07]) and those recently tested for a sexually transmitted infection (35.4% vs. 25.5%, aOR 1.58, [95% CI 1.01–2.48]). Efforts to expand PrEP use in Latin America should focus on national PrEP policy adoption, and research should explore barriers to awareness and use among young men who have sex with men.

Geosocial Networking Apps Use Among Sexual Minority Men in Ecuador: An Exploratory Study

Geosocial networking applications (GSN apps) have become important socialization contexts for sexual minority men (SMM). Despite their popularity, there is limited research carried out in Latin American countries and no single previous study done in Ecuador. To fill this gap, this exploratory study described and analyzed the relationships between the sociodemographic characteristics of SMM using GSN apps, their sought and fulfilled expectations, profile shared and sought characteristics, and the evaluation of their experiences as users including their perceptions of support, and discrimination. We used an online recruited sample of 303 participants enrolled between November 2019 and January 2020. Most respondents used Grindr and reported spending up to 3 h per day using apps. Most common sought expectations were getting distracted, meeting new friends, and meeting people for sexual encounters. The least met expectation was meeting someone to build a romantic relationship with. When asked about their profiles, participants reported sharing mainly their age, photographs, and sexual role. Participants also prioritized these characteristics when looking at others’ profiles. When asked about their experiences, most reported having been discriminated against, weight being the main reason for it. Some participants also indicated having received emotional support from other users. Correlation analyses indicated significant but weak relationships among the variables. Results indicated a positive correlation between time as an active GSN app user and higher experiences of discrimination. Likewise, higher number of used apps related positively with levels of received support. These results provide information that could inform future research in the country and the region regarding GSN apps use among SMM, socialization practices, and modern dating tools.

HIV prevalence and risk behaviours among men who have sex with men using geosocial networking smartphone applications: a cross-sectional study in Beijing, China (Preprint)

BACKGROUND Extensive use of geosocial networking (GSN) apps has substantially changed the behaviors and HIV risk among men who have sex with men (MSM). OBJECTIVE We aim to examine the HIV prevalence and risky behaviors among GSN app-using MSM. METHODS We conducted a cross-sectional study among MSM users of Blued (a GSN app) from July 2017 to December 2018. Sociodemographic and behavioural data in the preceding six months were collected through an app-assistant questionnaire, and blood samples were also obtained to test for HIV. HIV prevalence was calculated, and multivariable logistic regression models were constructed to explore the correlates of HIV infection RESULTS A total of 7252 app-using MSM in Beijing were included. The HIV prevalence was 4.7% (95%CI 4.2%-5.2%). In the last six months, nearly half (49.0%) had multiple sexual partners, 3.3% reported having HIV-positive partners, 50.9% were not sure about their current partners’ HIV status. The majority (62.3%) of participants reported consistent condom use, 6.1% had engaged in group sex, and 19.1% had used recreational drug in the past six months. Having college or undergraduate (AOR=0.35, 95%CI 0.16-0.75), or postgraduate (AOR=0.22, 95%CI 0.06-0.78) education, being exclusively insertive in anal intercourse (AOR=0.18, 95%CI 0.07-0.48) were correlated with decreased odds of HIV infection. However, having anal sex (AOR=4.74, 95%CI 1.17-19.19), having 2 to 5 (ORa=1.47 95%CI 1.17-1.86) or six and more (AOR=2.18, 95%CI 1.34-3.55) male sex partners, not consistently using condoms during anal sex (AOR=1.93, 95%CI 1.06-3.52), and being diagnosed with STIs (AOR=3.02, 95%CI 0.95-9.56) in the preceding six months were associated with greater odds of HIV infection. CONCLUSIONS HIV risky behaviors were prevalent among app-using MSM, suggesting more targeted interventions are needed among this population.

Venue-based versus Geosocial Networking Application-based Recruitment of Young Men Who Have Sex with Men: An Examination of Feasibility

Because of the high cost, venue-based probability sampling of young men who have sex with men (YMSM) is largely inaccessible to social researchers. The aim of this study is to compare the feasibility of implementing geosocial networking application-based (GSNA) and venue-based prob`ability sampling of young men who have sex with men. A cross-sectional survey conducted in Los Angeles in 2017 and 2018 recruited 124 YMSM using both methods. We compared costs and hours of work for each method. Per participant, GSNA-based methods cost approximately 157 USD compared to 383 USD for the venue-based methods. For sample sizes up to 1,000, venue-based methods cost over two times more than GSNA-based methods. Findings indicate that research teams with limited resources may be able to implement probability-based recruitment by using GSNA. By lowering the cost of research and maintaining probability-based methodological rigor, GSNAs can increase the amount of social research with YMSM.

HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study

Background Sexual transmission among men who have sex with men (MSM) is the dominant route of HIV transmission in China. Extensive use of geosocial networking (GSN) smartphone application (app) has dramatically changed the pattern of sexual behaviors and HIV risk among MSM, but data on HIV incidence and the changing risk behaviors of GSN app-using MSM are limited. We aims to assess the HIV incidence and its correlates among gay GSN app-using MSM in China. Methods We constructed an open cohort which was initiated and maintained using a GSN app to assess the HIV incidence among app-using MSM, recruited from June 2017 to December 2018. MSM completed an online questionnaire on their sociodemographic characteristics, sexual behaviors, recreational drug use and sexually transmitted infections status. Then each man had an HIV test, and those tested negatives were enrolled into the cohort. Participants completed follow-ups with additional HIV tests though the app during the study period, and were censored at HIV seroconversion or study end date. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed person-time. Univariate (Chi-square test and Fisher’s exact test) and multivariate (proportional hazards regression) analyses were used to examine correlates of HIV incidence. Results A total of 6957 HIV negative MSM were enrolled in the open cohort, 37 seroconversions occurred among 1937 men contributing 1065 observed person-years: HIV incidence was 3.47 per 100 person-years [95% confidence interval (CI): 2.37–4.57]. More than five sexual partners [hazard ratio (HR) = 2.65, 95% CI: 1.04–6.67], and sex with HIV positive partners (HR = 3.82, 95% CI: 1.16–12.64) in the preceding six months were positively associated with HIV seroconversion. Consistent condom use for anal sex (HR = 0.27, 95% CI: 0.07–0.96), and reporting insertive anal sex only (HR = 0.23, 95% CI: 0.08–0.62) in the preceding six months were protective factors for HIV seroconversion. Conclusions Tailored interventions targeting app-using MSM are urgently needed given their high risk of HIV. As a new tool for accessing MSM at higher HIV risk, GSN smartphone app could play an important role in HIV research among MSM.