Gay Dating App Users Support and Utilize Sexual Health Features on Apps

A snapshot of the presence of HIV-related features in MSM social media dating apps in New Zealand

The men who have sex with men (MSM) social media dating apps have emerged as a new channel for HIV prevention and education. However, there is a lack of clarity regarding the availability of specific HIV-related features on these apps, making it uncertain what features related to HIV are offered. This study provided a comprehensive overview of the existing HIV-related features of MSM social media dating apps in New Zealand by screening 39 apps, selected from a total of 1296 search results obtained from the Google Play Store and Apple App Store. The HIV-related features within these apps were categorized into 10 groups, including safety practices, HIV status, tribe Poz, where to get tested, last tested, test reminder, HIV/Sexual health information center, link to an outside organization, getting support from health practitioners, and search filters for HIV status, safety practice and tribe Poz, totaling 12 features. Results demonstrated that only about one-third of the apps contained HIV-related information but this ratio significantly increased during the last decade, suggesting a trend of normalization in incorporating such information in the apps. The safety practices and HIV status were identified as the two features most frequently incorporated into these apps and the underlying mechanisms were analyzed using the political economy of communication theory and the uses and gratifications theory. Overall, this study contributed to helping the stakeholders such as app developers, public health agencies, health practitioners and policymakers to make evidence-based decisions to incorporate and promote HIV prevention-related initiatives within the digital realm.

Dating apps as health allies? Examining the opportunities and challenges of dating apps as partners in public health

In recent years, dating apps have become important allies in public health. In this paper, we explore the implications of partnering with dating apps for health promotion. We consider the opportunities and challenges inherent in these collaborations, paying special attention to privacy, trust, and user care in a digital environment.Despite their potential as targeted health promotion tools, dating apps raise significant ethical concerns, including the commodification of user data and privacy breaches, which highlight the complexities of blending healthcare initiatives with for-profit digital platforms. Furthermore, the paper delves into issues of discrimination, harassment and unequal access within these apps, factors which can undermine public health efforts.We develop a nuanced framework, emphasising the development of transparent data policies, the decoupling of content moderation from health initiatives and a commitment to combat discrimination. We underscore the importance of embedding app-based health initiatives within broader care pathways, ensuring comprehensive support beyond the digital domain. This essay offers vital insights for public health practitioners, app developers and policymakers navigating the intersection of digital innovation and healthcare.

Increases in Awareness and Uptake of Dating Apps' Sexual Health Features Among US Men Who Have Sex with Men, 2018 to 2021

Dating apps are now used by the majority of MSM to meet sexual and romantic partners. While research has demonstrated an association between app use and greater number of sex partners and STIs, dating apps also pose an opportunity for intervention. By advocating for new and improved sexual health features on dating apps, Building Healthy Online Communities (BHOC) aims to increase communication about sexual health on the apps. As a follow-up to our previous paper assessing the uptake of sexual health-related profile options on dating apps through Emory's annual survey of 10,000 MSM in the US, BHOC and Emory partnered to explore the change in uptake over time, again through their annual survey. Among survey participants in 2021, 85% reported using dating apps to meet a partner in the past year, and among this group, 93% reported awareness of sexual health features, up from 77% in 2018 (p < 0.0001). 71% of app users who were aware of features in 2021 reported using one or more sexual health feature, up from 61% in 2018 (p < 0.0001). BHOC will continue to advocate for increased uptake of these features, especially among subgroups with lower levels of uptake.

Swiping right on PrEP: a qualitative study of MSM preferences for PrEP public health messaging on dating apps

Men who have sex with men (MSM) are disproportionately affected by HIV. Given that over 70% of MSM meet sexual partners via dating apps, such apps may be an effective platform for promoting HIV pre-exposure prophylaxis (PrEP) use. We aimed to describe preferences among MSM for PrEP advertisements displayed on dating apps. We conducted individual in-depth interviews with 16 MSM recruited from a mobile sexual health unit in Boston, Massachusetts. Two focus groups were also held: one with mobile unit staff (N = 3) and one with mobile unit users (N = 3). Content analysis was used to identify themes related to advertisement content and integration with app use. Mean participant age was 28 (SD 6.8); 37% identified as White and 63% as Latinx. 21% of interviews were conducted in Spanish. Preferences were organized around four themes: (1) relevant and relatable advertisements, (2) expansion of target audiences to promote access, (3) concise and captivating advertisements, and (4) PrEP advertisements and services as options, not obligations. MSM are supportive of receiving information about PrEP on dating apps, but feel that existing advertisements require modification to better engage viewers. Dating apps may be an underutilized tool for increasing PrEP awareness and knowledge among MSM.

HIV Risk Behaviors and the Use of Geosocial Networking Dating Apps among Men Who have Sex with Men and Transgender Women in Lima, Peru: a Cross-Sectional Study

Geosocial networking dating apps (GSN apps) are an increasingly widespread technology used by populations throughout the world to facilitate sexual encounters. Studies from a variety of settings suggest a possible association between GSN app use and HIV risk behaviors, including among sexual and gender minority populations such as men who have sex with men (MSM) and transgender women (TW). However, it remains unclear to what extent GSN apps play a causal role. We explored the relationship between GSN app use and sexual risk behaviors among MSM and TW in Lima, Peru by analyzing data from a multi-site cross-sectional survey assessing both general and partner-specific sexual behaviors. We performed bivariate analysis to estimate the association of GSN app use with different individual and partner-specific factors, then fit multivariable regression models adjusting for age and education. Among 741 total participants (698 MSM, 43 TW), 64% met at least one sex partner in the prior three months using a GSN app. GSN app users were significantly more likely to report engaging in HIV risk behaviors in general, including condomless receptive anal sex, group sex, transactional sex, and sex under the influence of alcohol or drugs. Having condomless anal sex with a given partner was not associated with meeting that partner via GSN app. These findings highlight GSN app users as a particularly vulnerable subpopulation among MSM and TW in Lima. GSN apps could provide a useful vehicle for targeted HIV prevention efforts for priority populations in Peru.

Shifting Norms and Value Conflicts: Exploring the Effects of HIV Status Disclosure Fields in Sex-Social Apps

Sex-social applications used by men who have sex with men (MSM) often provide options to disclose HIV status to encourage more positive language and reduce stigma. Yet, little research has sought to understand how in-app disclosure fields impact on disclosure motivation. We interviewed MSM living with HIV and those who self-reported being HIV-negative ( N = 27 ) in the UK and applied a hierarchical model of motivation to interpret our data. We found conflicting motivations for disclosure and point to HIV status disclosure fields having shifted disclosure norms, limiting their perceived optionality. Moreover, the pairwise and location-aware nature of these apps fails to support narrative forms of disclosure, reducing motivation. We highlight an opportunity to support users in disclosing by linking apps more explicitly to the social narratives developed through public health campaigns. This could reduce the required effort to explain "the science" behind different treatment and prevention options and promote a more consistent narrative.

Using Machine Learning to Identify Predictors of Sexually Transmitted Infections Over Time Among Young People Living With or at Risk for HIV Who Participated in ATN Protocols 147, 148, and 149

BACKGROUND

Sexually transmitted infections (STIs) among youth aged 12 to 24 years have doubled in the last 13 years, accounting for 50% of STIs nationally. We need to identify predictors of STI among youth in urban HIV epicenters.

METHODS

Sexual and gender minority (gay, bisexual, transgender, gender-diverse) and other youth with multiple life stressors (homelessness, incarceration, substance use, mental health disorders) were recruited from 13 sites in Los Angeles and New Orleans (N = 1482). Self-reports and rapid diagnostic tests for STI, HIV, and drug use were conducted at 4-month intervals for up to 24 months. Machine learning was used to identify predictors of time until new STI (including a new HIV diagnosis).

RESULTS

At recruitment, 23.9% of youth had a current or past STI. Over 24 months, 19.3% tested positive for a new STI. Heterosexual males had the lowest STI rate (12%); African American youth were 23% more likely to acquire an STI compared with peers of other ethnicities. Time to STI was best predicted by attending group sex venues or parties, moderate but not high dating app use, and past STI and HIV seropositive status.

CONCLUSIONS

Sexually transmitted infections are concentrated among a subset of young people at highest risk. The best predictors of youth's risk are their sexual environments and networks. Machine learning will allow the next generation of research on predictive patterns of risk to be more robust.

Experiences of Stigma and HIV Status Associated with Awareness and Usage of Safer Sex Functions in Dating Apps Among MSM, 2019 American Men's Internet Survey (AMIS) Study

Dating apps represent opportunities to implement sexual health interventions among gay, bisexual, and other men who have sex with men (MSM), particularly those who may avoid traditional health services due to intersecting stigmas. We used multivariable models to explore whether stigma experience was associated with awareness and usage of safer sex functions in dating apps among 7700 MSM who completed a 2019 US nationwide online survey. Perceived community intolerance of gay and bisexual men was associated with reduced awareness of sexual health strategy profile options (adjusted prevalence ratio [aPR] 0.95; 95% confidence interval [95% CI] 0.93-0.98) and sexual health information and resources (aPR 0.97; 95% CI 0.94-0.99). Stigma from family and friends was associated with increased usage of app-based sexual health reminders (aPR 1.14; 95% CI 1.02-1.28) and sexual health information and resources (aPR 1.16; 95% CI 1.04-1.31). Stigma experience of MSM should be considered in optimizing app-based sexual health interventions.

Associations of adverse and protective childhood experiences with thwarted belongingness, perceived burdensomeness, and suicide risk among sexual minority men

BACKGROUND

Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM.

METHODS

Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up.

RESULTS

424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09-1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11-1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81-0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82-0.98). Perceived burdensomeness partially mediated these prospective associations.

CONCLUSION

To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.

Understanding sexual transmission dynamics and transmission contexts of monkeypox virus: a mixed-methods study of the early outbreak in Belgium (May-June 2022)

OBJECTIVE

The available epidemiological and clinical evidence from the currently ongoing monkeypox (MPX) outbreak in non-endemic areas suggests an important factor of sexual transmission. However, limited information on the behaviour and experiences of individuals with an MPX infection has to date been provided. We aimed to describe the initial phase of the MPX outbreak in Belgium, and to provide a more in-depth description of sexual behaviour and transmission contexts.

METHODS

We used routine national surveillance data of 139 confirmed MPX cases with date of symptom onset until 19 June 2022, complemented with 12 semistructured interviews conducted with a subsample of these cases.

RESULTS

Sexualised environments, including large festivals and cruising venues for gay men, were the suspected exposure setting for the majority of the cases in the early outbreak phase. In-depth narratives of sexual behaviour support the hypothesis of MPX transmission through close physical contact during sex. Despite awareness of the ongoing MPX outbreak, low self-perceived risk of MPX acquisition and confusing initial signs and symptoms for other STIs or skin conditions delayed early detection of an MPX infection. In addition, we describe relevant contextual factors beyond individual behaviour, related to sexual networks, interpersonal interactions and health systems. Some of these factors may complicate early MPX detection and control efforts.

CONCLUSION

Our results highlight the role of sexual contact and networks in the transmission of MPX during the early phase of the outbreak in Belgium. Risk communication messages should consistently and transparently state the predominant sexual transmission potential of MPX virus, and prevention and control measures must be adapted to reflect multilevel factors contributing to MPX transmission risk.