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Luo R, Xie Z, Silenzio VMB, Kuang Y, Luo D. Gay App Use, Sexuality Traits, and High-Risk Sexual Behaviors Among Men Who Have Sex With Men in China: Mediation Analysis. J Med Internet Res 2023; 25:e49137. [PMID: 37910154 PMCID: PMC10652192 DOI: 10.2196/49137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Gay geosocial networking apps, also known as "gay apps," have gained increasing popularity in the men who have sex with men (MSM) community. Certain sexuality traits and gay app use are both associated with high-risk sexual behaviors among MSM. However, little is known about the underlying mechanism of such relationships. OBJECTIVE Based on the uses and gratifications theory, this study aimed to test the mediation effect of gay app use on the relationship between sexuality traits (sexual compulsivity and sexual sensation seeking) and high-risk sexual behaviors (multiple sexual partners and unprotected anal intercourse) among MSM. METHODS A cross-sectional, multicenter study was conducted in Wuhan and Changsha, China, from August to October 2020. A representative sample of 402 MSM was recruited through respondent-driven sampling. A self-administered web-based structured questionnaire was used to collect data on sociodemographic information, high-risk sexual behaviors, gay app use, sexual compulsivity, and sexual sensation seeking. Path analysis was conducted to assess the mediation effect. RESULTS Our study revealed that 67.42% (n=271) of MSM used gay apps for seeking potential sexual partners, with 37.06% (n=149) of them engaging in unprotected anal intercourse, and 45.42% (n=218) of them having multiple sexual partners. Of the participants, 17.16% (n=69) reported significant sexual compulsivity, while 29.10% (n=117) reported significant sexual sensation seeking. Notably, gay app usage partially mediated the relationship between sexual compulsivity and multiple sexual partners but fully mediated the relationship between sexual compulsivity and unprotected anal intercourse. Furthermore, gay app usage partially mediated the relationship between sexual sensation seeking and multiple sexual partners but fully mediated the relationship between sexual sensation seeking and unprotected anal intercourse. CONCLUSIONS High-risk sexual behaviors are common among MSM. Most MSM rely on gay apps to find sexual partners, which, when combined with higher levels of sexual compulsivity and sexual sensation seeking, can increase the likelihood of engaging in high-risk sexual behaviors. Therefore, interventions aimed at reducing these behaviors among MSM should focus on addressing the use of gay apps, while also considering the influence of their sexuality traits on gay app use.
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Affiliation(s)
- Rui Luo
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhi Xie
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Vincent M B Silenzio
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, NJ, United States
| | - Yun Kuang
- Changsha Zonda-sunshine Social Work Center, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Abboud S, Veldhuis C, Ballout S, Nadeem F, Nyhan K, Hughes T. Sexual and gender minority health in the Middle East and North Africa Region: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100085. [PMID: 38745607 PMCID: PMC11080540 DOI: 10.1016/j.ijnsa.2022.100085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/18/2022] [Accepted: 06/25/2022] [Indexed: 01/05/2023] Open
Abstract
Background Researchers in studies from multiple countries suggest that sexual and gender minority people experience high rates of violence, stigma, and discrimination, as well as mistrust of health care providers and systems. Despite growing evidence related to sexual and gender minority health in North America and Europe, we know little about the health of this population in the Middle East and North Africa. Objectives We aimed to comprehensively examine the literature related to the health of sexual and gender minority people in the Middle East and North Africa and to identify research gaps and priorities. Design We conducted a scoping review informed by the framework recommended by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) tool. Data sources We searched the following databases: PubMed (using Medline All on the Ovid platform), PsycINFO (Ovid), CINAHL (Ebsco), and Embase (Ovid). The search strategy combined terms for the geographic region of interest (Middle East and North Africa) and the population of interest (sexual and gender minority). Each was operationalized using multiple search terms and, where available, controlled vocabulary terms. Review Methods Research articles were identified and assessed for inclusion using an explicit strategy. Relevant information was extracted and synthesized to present a descriptive summary of existing evidence. Results Research designs of the 98 articles we reviewed included quantitative (n = 73), qualitative (n = 20), and mixed methods (n = 5). Most studies were conducted in Lebanon (n = 33), Pakistan (n = 32), and Iran (n = 23) and focused mainly on gender minority individuals (n = 46) and men who have sex with men (n = 32). Five themes emerged from the review: sexual health (52; 53%); mental health (20; 20%); gender identity (17; 17%); violence and discrimination (7; 7%); and experiences with the healthcare system (2; 2%). Although researchers focused on multiple health outcomes in some studies, we included them under the theme most closely aligned with the main objective of the study. Conclusion Although our study is limited to few countries in the Middle East and North Africa region, we found that sexual and gender minority individuals face multiple adverse sexual and mental health outcomes and experience high rates of stigma, discrimination, and violence. More research is needed from countries outside of Lebanon, Pakistan, and Iran, including community-based participatory approaches and multi-level intervention development. Nurses and other healthcare providers in the region need training in providing inclusive care for this population.
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Affiliation(s)
- Sarah Abboud
- University of Illinois Chicago, College of Nursing, Chicago, IL, United States of America
| | - Cindy Veldhuis
- Columbia University, School of Nursing, New York, New York, United States of America
| | - Suha Ballout
- University of Massachusetts Boston, College of Nursing and Health Sciences, Boston, Massachusetts, United States of America
| | | | - Kate Nyhan
- Yale University Cushing/Whitney Medical Library, New Haven, Connecticut, United States of America
| | - Tonda Hughes
- Columbia University, School of Nursing, New York, New York, United States of America
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Chu JH, Huang JH. Psychosociobehavioral characteristics associated with high condomless anal intercourse intention: a comparison of receptive, versatile, and insertive MSM in Taiwan. AIDS Care 2019; 32:770-778. [PMID: 31422670 DOI: 10.1080/09540121.2019.1653433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In Taiwan, men who have sex with men (MSM) continue to be disproportionately affected by HIV, and the main route of HIV transmission is condomless anal intercourse (CAI). This study examined the associations between psychosociobehavioral characteristics and CAI intention among MSM in Taiwan who had ever engaged in anal intercourse with men, and compared the differences across three sexual roles (receptive, versatile, and insertive) using online survey data (N = 563). For all MSM, those that were in a relationship (AOR = 2.55; 95% CI: 1.61-4.03), had three or more steady partners (AOR = 2.58; 95% CI: 1.19-5.58), did not use a condom during last anal intercourse (AOR = 6.81; 95% CI: 4.36-10.63), perceived high HIV risk (AOR = 2.13; 95% CI: 1.26-3.60), and had high sexual sensation seeking (AOR = 2.80; 95% CI: 1.82-4.30) were more likely to have high CAI intention. After stratification, the significant characteristics differed depending on sexual role, except for no condom use during last anal intercourse remaining significant in all models (AOR = 5.09-20.30; 95% CI: 2.49-66.69, depending on sexual role). Tailoring the programs for MSM of different sexual roles may improve the effectiveness of future prevention efforts.
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Affiliation(s)
- Jen-Hao Chu
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jiun-Hau Huang
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
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Abstract
Sexual Sensation Seeking has been identified as a main predictor of unsafe sex that particularly affects LGB people. This study adapts and validates the Sexual Sensation Seeking Scale to Spanish LGB people. For this purpose, we tested the factor structure in 1237 people, ranged from 17 to 60 years old, 880 self-defined as homosexuals and 357 as bisexuals. The results support the appropriateness of this scale for Spanish LGB people and determine two factors, explaining the 49.91% of variance: "physical sensations attraction" and "sexual experiences". Our findings reveal optimal levels of internal consistency in the total scale (α = 0.81) and each factor (α = 0.84 and α = 0.71). Additional analyses have demonstrated convergent validity for this scale. Important implications of the validated Sexual Sensation Seeking Scale in Spanish LGB people are discussed, in order to early detection and preventive interventions for HIV and other sexual health problems.
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Card KG, Lachowsky NJ, Cui Z, Shurgold S, Armstrong HL, Rich AJ, Forrest JI, Gislason M, Moore DM, Roth EA, Hogg RS. An Event-Level Analysis of the Interpersonal Factors Associated With Condomless Anal Sex Among Gay, Bisexual, and Other Men Who Have Sex With Men (MSM) With Online-Met Partners. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:154-174. [PMID: 28467159 PMCID: PMC5564309 DOI: 10.1521/aeap.2017.29.2.154] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The interpersonal determinants of condomless anal sex (CAS) within online-initiated sexual relationships remain poorly understood. Therefore, respondent-driven sampling was used to recruit a prospective cohort of sexually active gay, bisexual, and other men who have sex with men (MSM), aged ≥ 16 years in Vancouver, Canada. Follow-up occurred every 6 months, up to seven visits; at each visit participants reported their last sexual encounter with their five most recent partners. Stratified by self-reported HIV status, individual-level, interpersonal, and situational covariates of event-level CAS with partners met online were modeled using generalized estimating equations (GEE). CAS was reported during 32.4% (n = 1,015/3,133) of HIV-negative/unknown men's events, and 62.1% (n = 576/928) of HIV-positive men's events. Social (i.e., collective identity, altruism, network size social embeddedness) and situational (i.e., number of encounters, location, comparative age, seroconcordance, substance use) factors were identified as important correlates of CAS. Implications include the need for HIV prevention addressing social contexts associated with CAS.
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Affiliation(s)
- Kiffer G Card
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia
| | - Nathan J Lachowsky
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- School of Public Health & Social Policy, University of Victoria, Victoria, British Columbia
| | - Zishan Cui
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Susan Shurgold
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Heather L Armstrong
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver
| | - Ashleigh J Rich
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jamie I Forrest
- School of Population and Public Health, University of British Columbia, Vancouver
| | | | - David M Moore
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver
- B.C. Centre for Disease Control, Vancouver
| | - Eric A Roth
- Department of Anthropology, University of Victoria, British Columbia
| | - Robert S Hogg
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia
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Zheng L, Zhang X, Feng Y. The new avenue of online sexual activity in China: The smartphone. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.10.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Danko M, Buzwell S, Earle M. Men at Risk of HIV: Sexual Sensation Seeking, Sexual Compulsivity and Sexual Risk Behavior Among Australian MSM Who Frequently Present for Post-Exposure Prophylaxis. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10720162.2016.1140605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Kuhn E, Potthoff A, Dirks H, Borgmann R, Esser S, Scherbaum N, Brockmeyer NH, Skaletz-Rorowski A. Viral load strategy: impact on risk behaviour and serocommunication of men who have sex with men in specialized care. J Eur Acad Dermatol Venereol 2016; 30:1561-6. [PMID: 27393373 DOI: 10.1111/jdv.13672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 02/15/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Incidence and prevalence of HIV are continuously high in German men, who have sex with men (MSM). Different transmission risk minimizing strategies have been observed. The viral load strategy rates patients unlikely to be sexually infectious if their viral load under effective therapy is stably suppressed during 6 months and no other sexually transmitted infections are present. OBJECTIVES We aim to objectify the current popularity of the viral load strategy, the adherence to basic conditions and its impact on risk behaviour and serocommunication. Until now, no data on a German sample of HIV-positive MSM in regular specialized outpatient care are available. METHODS Cross-sectional study with group comparisons between user group and non-user-group of the viral load strategy. Self-report questionnaires were conducted with 269 sexually active German HIV+MSM under effective treatment in specialized outpatient care. Structured interviews gathered additional information about approach to and realization of definite action levels concerning sexual risk behaviour and transmission risk minimizing strategies. RESULTS Twenty-seven of 269 participants (10%) affirmed knowledge of having an undetectable viral load and stated this to be criteria for unprotected sexual behaviour. This subgroup reported more unprotected insertive (P = 0.018) and receptive anal intercourse (P = 0.042), more anonymous sex partners (P = 0.008) and less consistent safer sex. Analysing serocommunication, less addressing HIV/AIDS in general (P = 0.043) and less disclosing to sex partners (P = 0.023) was found, especially in anonymous settings. Differentiating serocommunication characteristics, a focus on seroguessing was depicted. CONCLUSIONS The user group of the viral load strategy is small. But a less frequent, more reactive and assumptive serocommunication leads to an imprecise information exchange paired with higher frequency of risky behaviour, especially in anonymous settings, where frank serocommunication is often avoided. The targeted group of the viral load strategy diverges greatly from the user group.
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Affiliation(s)
- E Kuhn
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany
| | - A Potthoff
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
| | - H Dirks
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - R Borgmann
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - S Esser
- Department of Dermatology and Venerology, University Hospital Duisburg-Essen, Essen, Germany
| | - N Scherbaum
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - N H Brockmeyer
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
| | - A Skaletz-Rorowski
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
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Souleymanov R, Huang YT. 'Men who use the Internet to seek sex with men': Rethinking sexuality in the transnational context of HIV prevention. Glob Public Health 2016; 11:888-901. [PMID: 27142110 DOI: 10.1080/17441692.2016.1180701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
MISM (i.e. men who use the Internet to seek sex with men) has emerged in public health literature as a population in need of HIV prevention. In this paper, we argue for the importance of rethinking the dominant notions of the MISM category to uncover its ethnocentric and heteronormative bias. To accomplish this, we conducted a historical, epistemological and transnational analysis of social sciences and health research literature (n = 146) published on MISM between 2000 and 2014. We critically unravel the normative underpinnings of 'westernised' knowledge upon which the MISM category is based. We argue that the essentialist approach of Western scholarship can homogenise MISM by narrowly referring to behavioural aspects of sexuality, thereby rendering multiple sexualities/desires invisible. Furthermore, we argue that a Eurocentric bias, which underlies the MISM category, may hinder our awareness of the transnational dynamics of sexual minority communities, identities, histories and cultures. We propose the conceptualisation of MISM as hybrid cultural subjects that go beyond transnational and social boundaries, and generate conclusions about the future of the MISM category for HIV prevention and health promotion.
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Affiliation(s)
- R Souleymanov
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Y-T Huang
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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Brown MJ, Pugsley R, Cohen SA. Meeting sex partners through the Internet, risky sexual behavior, and HIV testing among sexually transmitted infections clinic patients. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:509-519. [PMID: 25567074 DOI: 10.1007/s10508-014-0463-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 03/01/2014] [Accepted: 04/18/2014] [Indexed: 06/04/2023]
Abstract
The Internet has now become a popular venue to meet sex partners. People who use the Internet to meet sex partners may be at a higher risk for contracting HIV and STIs. This study examined the association between meeting sex partners from the Internet, and HIV testing, STI history, and risky sexual behavior. Data were obtained from the Virginia Department of Health STD Surveillance Network. Logistic regression models were used to obtain crude and adjusted odds ratios, and 95 % confidence intervals for the associations between meeting sex partners through the Internet and ever tested for HIV, HIV testing in the past 12 months, STI history, and risky sexual behavior. Logistic regression was also used to determine if gender and men who have sex with men interaction terms significantly improved the model. Women who met a sex partner from the Internet were more likely to have had an HIV test in the past 12 months than women who did not meet a partner in this way. On the other hand, men who met a sex partner through the Internet were more likely to have ever had an HIV test than other men, but this was only seen for heterosexual men. All populations who met a sex partner from the Internet were more likely to take part in risky sexual behavior. HIV prevention strategies should emphasize annual testing for all populations.
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Affiliation(s)
- Monique J Brown
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main St., 8th Floor, Richmond, VA, 23219, USA,
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Zheng L, Zheng Y. Online sexual activity in Mainland China: Relationship to sexual sensation seeking and sociosexuality. COMPUTERS IN HUMAN BEHAVIOR 2014. [DOI: 10.1016/j.chb.2014.03.062] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Grosskopf NA, LeVasseur MT, Glaser DB. Use of the Internet and mobile-based "apps" for sex-seeking among men who have sex with men in New York City. Am J Mens Health 2014; 8:510-20. [PMID: 24658284 DOI: 10.1177/1557988314527311] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Internet continues to be a popular venue for men who have sex with men (MSM) to seek sexual partners. Increased sexual risk behavior has been linked to MSM who use the Internet to seek partners. However, there has been little research on how new mobile-based social networking applications ("apps") may affect sex-seeking and sexual risk behaviors of MSM. One hundred twenty-six MSM in New York City were recruited to complete an online survey on the use of the Internet and other technology for sex-seeking. The authors collected data on variables of interest including sexual sensation seeking, gay identity affirmation, internalized homophobia, Internet/app use, and sexual behavior with men met via the Internet and mobile apps. Results indicated that men who use both the Internet and mobile apps to seek partners were younger and reported higher incomes (p<.05) than men who used the Internet only. There were no significant differences between the groups with regard to race, sexual sensation seeking, gay identity affirmation, or internalized homophobia, indicating that the use of mobile-based apps for sex-seeking may be simply an example of evolving technologies. These findings may provide insight for the feasibility and planning of effective mobile app-based HIV/STI programs for MSM.
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Affiliation(s)
- Nicholas A Grosskopf
- York College of The City University of New York, Jamaica, NY, USA The Graduate Center of The City University of New York, New York, NY, USA
| | | | - Debra B Glaser
- York College of The City University of New York, Jamaica, NY, USA
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