Geosocial Networking App Use Among Men Who Have Sex With Men in Serious Romantic Relationships

Strengthening couple relationships through a digital connection

The proliferation of technology has accelerated exponentially over the past 50 years. Contemporarily, researchers have explored the influences technology use is having on individuals and relationships. Theoretical frameworks such as the couple, family, and technology (CFT) Framework have been applied to individuals and couples in committed relationships to better understand the implications of technology adoption and use within this relational subsystem. Research examining technology's impact on couple relationships recognizes the potential for technology use to be either helpful or unhelpful to the relationship but fails to fully examine the helpful aspects of technology use. This study addresses this gap with the creation of a theory grounded in data from N = 45 couples (n = 90 individuals) in committed relationships. Results indicate couples' technology use can augment emotional connection and unity within the relationship as couples manage the influence of technology in a way that is relationally helpful.

Young Men Who Have Sex With Men and Substance Use: A Comparison of Venue-Based Sampling and Geosocial Networking Application Sampling

To compare the demographics, sexual risk behaviors, and substance use characteristics of two probability samples of young men who have sex with men (YMSM): one recruited using a geosocial networking application (GSNA) and one recruited using venues. In 2017 and 2018, a cross-sectional online survey was utilized with a sample of 122 YMSM recruited in Los Angeles, CA. Recruitment procedures included both venue-based (n = 68) and GSNA-based probability sampling (n = 54). Sample substance use, sexual risk behaviors (e.g., unprotected sex at last encounter), and demographics were compared using chi-square tests and t-tests. The samples significantly differed in demographics characteristics (e.g., race, education, employment, outness). Samples did not significantly differ in sexual risk variables. Regressions indicated significant differences (higher in the venue sample) in substance use (marijuana, prescription drugs, alcohol, and poppers) between the two samples. Results indicate that recruitment method impacts demographics and substance use prevalence levels for YMSM. GSNA- based recruitment appears to recruit samples from a broader range of social demographics. GSNA-based methods may be especially applicable to areas in which venues are not readily accessible (e.g., rural areas), allowing social research with the most marginalized sexual minority populations.

Social Media and Online Dating Safety Practices by Adolescent Sexual and Gender Diverse Men: Mixed-Methods Findings From the SMART Study

PURPOSE

Sexual and gender diverse youth (SGDY) develop and employ safety strategies on their own to manage risks while using dating apps. This study aimed to describe the online dating safety practices of SGDY and determine the effectiveness of an eHealth HIV-prevention educational intervention with dating safety content to promote future safety behaviors.

METHODS

SGDY aged 13-18 from across the United States (N = 1087) were assigned to increasingly intensive HIV-prevention educational programs using a sequential multiple-assignment randomized trial design. Data were collected at three time points, each three months apart. Participants were asked multiple-choice and open-ended questions about the safety practices they used online and in person; mixed-methods described the safety behaviors of SGDY. Logistic regressions were used to determine psychosocial predictors of safety behaviors and the effectiveness of the intervention in promoting future safety practices.

RESULTS

60% (n = 662) of participants used dating apps, most of whom reported using online (96.4%, n = 638) and in-person (92.9%, n = 615) safety strategies, such as limiting the disclosure of personal information or meeting other users in public. Outness and previous victimization were important psychosocial predictors of engaging in safety behaviors. Additionally, participants who received the online safety education were over 50% more likely to employ certain safety behaviors than SGDY who did not.

DISCUSSION

While most SGDY reported at least 1 type of safety strategy when dating online, safety practices differed across psychosocial variables, such as outness. This study provides evidence for the effectiveness of an eHealth educational intervention tailored to SGDY to promote additional safety behaviors.

How the smartphone apps can improve your sexual wellbeing

The use of smartphones and other technological devices has rapidly increased in the last few years, along with the availability of various applications that can be downloaded on iOS or Android devices. In this narrative review, we included most of the literature found on the specific topic of smartphone apps related to sexual health. Using the two databases PubMed and PsycInfo, we conducted research by the following terms: "apps" and "sexual wellbeing"; "apps" and "sexual health"; "mhealth" and "sex"; "mhealth", "apps" and "sex". We selected all articles written in English within the last 6 years to ensure the accessibility and consider the rapid changes in this field. The article highlights that many populations are interested in gaining information on a wide range of topics relating to sexual practices, potential risks, coercion, sexual violence and the prevention and recognition of potentially dangerous situations. Some findings suggest that sex education for sexual minority adolescents should focus on online sexual safety. Despite their value, many concerns and limitations must be solved, and future research studies are needed to explore how to fix them.

Sexual Partner Referral for HIV Testing Through Social Networking Platforms: Cross-sectional Study

Background

Men who have sex with men (MSM) who undergo voluntary HIV counseling and testing (VCT) often report condomless anal sexual intercourse, having many sexual partners, and being exposed to risky sexual networks. Limited research has discussed the application of motivational interviewing and convenience referral platforms to facilitate the referral of sexual partners for HIV testing among MSM.

Objective

This study aimed to evaluate the effects of VCT referral by sexual partners through social networking platforms and the test results after elicited interviews with MSM; compare the characteristics and risk behaviors among MSM tested without referral, index subjects, and referred sexual partners; and explore unknown sexual affiliations through visualizing and quantifying the social network graph.

Methods

This was a cross-sectional study. Purposeful sampling was used to recruit index subjects from a community HIV screening station frequented by MSM in Taipei City on Friday and Saturday nights. Respondent-driven sampling was used to recruit sexual partners. Partner-elicited interviews were conducted by trained staff before VCT to motivate MSM to become index subjects and refer sexual partners via the Line app, or to disclose the accounts and profiles of sexual partners on relevant social networking platforms. Referred sexual partners received rapid HIV testing, and the recruitment process was repeated until leads were exhausted.

Results

After the interviews, 28.2% (75/266) of MSM were successfully persuaded to become index subjects in the first wave, referring 127 sexual partners via the Line app for rapid HIV testing and disclosing 40 sexual partners. The index subjects and tested sexual partners had more sexual partners (F₂=3.83, P=.02), more frequent anal intercourse (F₂=10.10, P<.001), and higher percentages of those who had not previously received HIV testing (χ²₁=6.1, P=.047) compared with MSM tested without referrals. The new HIV-seropositivity rate among tested sexual partners was 2.4%, which was higher than the rate in the other 2 groups. The social network analysis revealed the following 4 types of sexual affiliation: chain, Y, star, and complicated. Among the HIV-negative sexual partners, 26.9% (43/160) had sexual affiliations with HIV-positive nodes, and 40% (10/25) were untested sexual partners with a direct sexual affiliation with an HIV-positive node. Four transmission bridges were found in the network graph.

Conclusions

Partner-elicited interviews can effectively promote referral for HIV testing and case identification via Line, and can clarify unknown sexual affiliations of MSM to facilitate the development of a tailored prevention program. Social network analysis is needed for an insightful understanding of the different network structures.

Mapping and size estimation of men who have sex with men in virtual platforms in Delhi, India

Introduction

In India, the HIV epidemic is concentrated among Key Populations (KPs), such as men who have sex with men (MSM), who bear a disproportionate burden of HIV disease. Conventional targeted interventions (TI) mitigate HIV transmission among MSM by focusing on physical hotspots. As increasingly, there is a shift within India’s MSM community to connect with sex partners online, novel approaches are needed to map virtual platforms where sexual networks are formed. The objective of this study was to estimate the number of MSM in Delhi using virtual platforms to connect for sex and to describe patterns of their use.

Methods

The study was conducted in the state of Delhi among MSM over 18 years of age who used virtual platforms to look for sexual partners. Virtual platforms were identified through community consultations. Size estimation was carried out by enumerating the number of online users, accounting for duplication across sites and time and based on interviews with 565 MSM.

Results

28,058 MSM (95% CI: range 26,455–29,817) use virtual sites to find sexual partners. We listed 14 MSM specific virtual sites, 14 general virtual sites, 19 social networking pages and 112 messenger groups, all used by MSM. Five virtual sites met feasibility criteria to be included in the virtual mapping. Of the MSM on these sites, 81% used them at night and 94% used them on Sundays, making these the peak time and day of use. Only 16% of users were aware of organizations providing HIV services and 7% were contacted by peer educators in the preceding three months. Two-fifths (42%) also visited a physical location to connect with sexual partners in the month prior to the study.

Discussion

TI programs that focus on physical hotspots do not reach the majority of MSM who use virtual sites. MSM active on virtual sites have a low awareness of HIV services. Virtual mapping and programmatic interventions to include them must be incorporated into current public health interventions to reach MSM at risk of HIV.

"Safe Behind My Screen": Adolescent Sexual Minority Males' Perceptions of Safety and Trustworthiness on Geosocial and Social Networking Apps

Dating and social media application ("app") use for sexual and romantic partner-seeking is increasingly ubiquitous among adolescent sexual minorities assigned male at birth (ASMM). Previous work suggests that ASMM use the Internet, including apps, for normative aspects of sexual identity exploration and development. However, there may be risks associated with their use of sexualized apps designed for adults and with sexual interaction with adult app users. Little is known about how they assess and mitigate risk or gauge the trustworthiness of potential partners on such apps. We recruited ASMM in the U.S. (N = 268; ages 15-18 years, mean age = 16.9) to complete an online survey with open- and closed-ended questions about their perceptions of safety and trustworthiness of others while using apps to find partners. Participants perceived various risks on apps (e.g., physical harm, being "catfished") but did not appear to have clear strategies for measuring or mitigating it. They often assessed trustworthiness by observing other users' behavior or profiles. Participants frequently described interacting with older app users as risky or untrustworthy. Sexual health risks were seldom mentioned and the legal risks of sexual interaction with adults were never mentioned. Although app use may meet some of ASMM's sexual development needs, they may lack the knowledge and skills to do so safely in sexualized online adult spaces. These findings suggest that sex education for sexual minority adolescents should address online sexual safety.

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.

Engaging Sexual and Gender Minority Youth in HIV Interventions Through Gay Dating Apps: Recruitment Protocol

BACKGROUND

HIV continues to disproportionately impact sexual and gender minority youth (SGMY) in the United States. Public health efforts have increasingly focused on developing efficacious interventions to curb the spread of HIV among SGMY and help those living with HIV achieve and sustain viral suppression. However, recruiting and engaging SGMY in prevention and care interventions is challenging.

OBJECTIVE

During the past decade, gay dating apps have quickly emerged as popular web-based spaces in which SGMY congregate. Although the recruitment of SGMY through these apps has been commonly reported, advertisement is the typical modality used, and direct recruitment approaches are not adequately described. This study aims to describe the process for developing a direct recruitment protocol for use in gay dating apps.

METHODS

The Adolescent Medicine Trials Network Comprehensive Adolescent Research and Engagement Studies is a community-based research program consisting of 3 interrelated studies testing scalable behavioral interventions to improve HIV prevention and care engagement among youth aged 12-24 years in Los Angeles and New Orleans. To supplement our in-person recruitment approaches for Comprehensive Adolescent Research and Engagement Studies, the New Orleans site formed a gay dating app recruitment team. In April 2018, the team developed a loosely structured protocol that included study-specific profiles and sample language to guide initial recruitment efforts. Two self-identified Black, gay cisgender male field recruiters field-tested the protocol on the popular gay dating app Jack'd. During the field test, the recruitment team met weekly to discuss the recruiters' experiences and user reactions. For example, we learned the importance of addressing concerns about study legitimacy and identifying appropriate ways to describe the study. We iteratively incorporated these lessons learned into the final protocol and developed a training program and tracking procedures before moving to full-scale implementation at both sites.

RESULTS

Adhering to this protocol yielded 162 enrollments in New Orleans (332 total enrollments across the two sites) throughout the recruitment period (April 2018 to August 2019). Most of these participants were sexual minority cisgender males (91%), and the remainder were identified as members of gender minority groups. We outlined step-by-step instructions on training staff, engaging users, and scheduling and tracking recruitment activities.

CONCLUSIONS

This paper provides a practical guide for researchers and community-based providers to implement a gay dating app recruitment protocol. Our experience indicates that gay dating app recruitment is feasible and fruitful when the staff members are knowledgeable, flexible, honest, and respectful to the user. Perhaps the most salient lesson we learned in approaching gay dating app users is the importance of setting clear and transparent intentions without judgment. As gay dating apps continue to increase in popularity, researchers need to stay vigilant to changing formats and develop systematic approaches to harness their potential as invaluable recruitment strategies for SGMY.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/28864.

Mobile HIV Testing Through Social Networking Platforms: Comparative Study

Background

Improving HIV screening in key populations is a crucial strategy to achieve the goal of eliminating AIDS in 2030. Social networking platforms can be used to recruit high risk-taking men who have sex with men (MSM) to promote the delivery of voluntary counseling and testing (VCT) as mobile HIV testing. Therefore, client recruitment and availability of mobile HIV testing through social networking platforms requires further evaluation.

Objective

The aim of this study is to compare the effects of targeting high risk-taking MSM and HIV case finding between two mobile HIV testing recruitment approaches: through the traditional website-based approach and through social networking platforms.

Methods

A comparative study design and propensity score matching was applied. The traditional VCT model, that is, the control group, recruited MSM through a website, and a trained research assistant visited the walk-in testing station at a gay village on Friday and Saturday nights. The social networking VCT model, the experimental group, recruited MSM from social networking platforms by periodically reloading into and conducting web-based discussions on dating apps and Facebook. The participants then referred to others in their social networks via a popular messenger app in Taiwan. The test was conducted at a designated time and place during weekdays by a trained research assistant. Across both modes of contact, before the mobile HIV testing, participants needed to provide demographic characteristics and respond to a questionnaire about HIV risk-taking behaviors.

Results

We recruited 831 MSM over 6 months, with a completion rate of 8.56% (616/7200) in the traditional VCT model and 20.71% (215/1038) in the social networking VCT model. After propensity score matching, there were 215 MSM in each group (mean age 29.97, SD 7.61 years). The social networking model was more likely to reach MSM with HIV risk-taking behaviors, that is, those seeking sexual activity through social media, having multiple sexual partners and unprotected anal intercourse, having experience of recreational drug use, and never having or not regularly having an HIV test, compared with the traditional model. HIV positive rates (incidence rate ratio 3.40, 95% CI 1.089-10.584; P=.03) and clinic referral rates (incidence rate ratio 0.03, 95% CI 0.001-0.585; P=.006) were significantly higher among those in the social networking VCT model than in the traditional VCT model.

Conclusions

Through effective recruitment strategies on social networking platforms, the social networking VCT mode can be smoothly promoted, as compared with the traditional VCT model, to target high risk-taking MSM and increase testing outcomes.

Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya

Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.

A Picture is Worth 1000 Messages: Investigating Face and Body Photos on Mobile Dating Apps for Men Who Have Sex with Men

The present study investigated the way men visually self-present on MSM-specific mobile dating app profiles, as well as the connection between visual self-presentation strategies, demographic variables, and psychosocial attitudes about masculinity and the body. In particular, emphasis was placed on two aspects of men's visual self-presentation: face-disclosure and body-disclosure. Using a selective self-presentation framework, findings indicated that the majority of men presented their face in their profile photo and that nearly one in five presented their unclothed torso. Face-disclosure was connected to higher levels of app usage, longer-term app usage, and levels of outness. The use of shirtless photos was related to age, a higher drive for muscularity, more self-perceived masculinity, and stronger anti-effeminacy attitudes. The findings are discussed in relation to both strategic self-presentation, and the distinct meanings of face and body photos within MSM online culture.

Geosocial Networking Application Use, Characteristics of App-Met Sexual Partners, and Sexual Behavior Among Sexual and Gender Minority Adolescents Assigned Male at Birth

Although many sexual and gender minorities (SGM) assigned male at birth (AMAB) use sexual networking applications intended for adult sexual minority men, little is known about adolescents' use of these technologies and characteristics of their online-met partners. We conducted an online survey of 219 sexually experienced SGM AMAB adolescents in the USA aged 15-17 (39.3% racial/ethnic minority; 74.9% gay; 94.1% cisgender male). Questions assessed app use patterns, partner-seeking behaviors on sexual minority male-specific apps vs. social media/other dating apps, app-met partner characteristics, and sexual behavior with app-met partners. Most (70.3%) used apps for sexual minority men, 14.6% used social media/other apps to meet partners, and 15.1% used neither. Nearly 60% of adolescents who used any type of app reported having met people from the apps in person, and nearly 90% of these reported at least one online-met sexual partner. Most partners were reportedly older than participants, and participants were more likely to report condomless receptive anal sex with older (vs. younger) online-met partners. Although partnerships were primarily sexual in nature, a minority reported friendships or serious partnerships. Meeting same-sex/gender partners via applications for adults may be common among SGM AMAB adolescents, which has implications for their sexual health and well-being.

Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya

Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.

Acceptability of Using Geosocial Networking Applications for HIV/Sexually Transmitted Disease Partner Notification and Sexual Health Services

BACKGROUND

Geosocial networking (GSN) app use among men who have sex with men (MSM) has presented new opportunities for increasing the reach and efficiency of sexual health interventions but also poses challenges to HIV/sexually transmitted disease partner notification. Understanding MSM's attitudes toward app-based preventive sexual health services can help inform their development and delivery.

METHODS

We recruited US MSM who had met a sex partner on GSN apps in the last year to participate in an online survey assessing acceptability and preferences regarding app-based partner notification, health department presence, and sexual health services. Three app-based notification strategies were presented: sending notification messages through participant's/partner's app profile, health department app profile, or in-app anonymous messaging.

RESULTS

Of 791 respondents, a majority (70%) preferred to be notified by their partner directly; however, most would get tested if notified by health department profile (95%) or anonymous in-app message (85%). Given the options provided, 50% preferred notifying a partner using their own profile, 26% with health department assistance, and 24% via in-app anonymous message. A majority (71%) were comfortable notifying a partner through a health department profile, and 74% were comfortable using in-app anonymous messaging. Most participants (82%) were comfortable with health departments having app profiles to provide sexual health services.

CONCLUSIONS

Our results suggest that GSN app-based partner notification and sexual health services would be used by and are acceptable to US MSM. Partnering with app companies to integrate these services and increase access to public health programs has potential to improve MSM sexual health.

Network Evolution of a Large Online MSM Dating Community: 2005-2018

Due to multiple sexual partners and low rates of condom use, the HIV infection rate among MSM (men who have sex with men) is much higher than that of the general population. In order to analyze the characteristics of online activities of MSM, and to understand the evolution of their social networks, in this study we collect a comprehensive dataset, covering the period from January 2005 to June 2018, from the largest Chinese online community, Baidu Tieba. We build an online dating network for MSM-related individuals in the gay-bar community, and analyze the network from static and dynamic aspects. It is found that there is a strong homophily regarding the cities where users reside when developing interactions with others, and that most network measurements tend to be stable at the later stages of evolution, while the size of the largest community fluctuates. This is an indication that the network is formed of rapidly flexible interactions which changes quickly. In comparison with studies on heterosexual networks, we find that the MSM dating network shows differences in many aspects, such as the positive degree-degree correlation and high clustering coefficient, suggesting different thinking and measures should be taken in the policy making of public health management towards the MSM population.

Imagining Online Sexual Health Outreach: A Critical Investigation into AIDS Service Organizations Workers' Notions of 'Gay Community'

This paper examines how online outreach workers within AIDS Service Organizations (ASOs) discursively imagine notions of "gay community" and the tensions between inequities in varying conceptions of "community" that operate in providers' and managers' sexual health online outreach. Through a Foucauldian Discourse Analysis (FDA) of interview data from a community-based research project examining sexual health outreach among gay, bisexual, and queer (GBQ) men, we provide an analysis that problematizes notions of a unitary "gay community" while illustrating how certain privileged subjects are deemed ideal for inclusion and representation within both online and ASO communities. Moreover, we interrogate how online medical health regimes constitute the ideal neoliberal gay male subject who self-responsibilizes and individualizes his sexual health while erasing inequities relating to social location and intersecting identities. Our analysis highlights how homonormative politics infiltrates GBQ sexual health programming and the ways in which understandings of the "self" and gay subjectivities are constituted through biopolitical apparatuses and online sexual health surveillance. We argue that it is necessary to move online sexual health outreach beyond specifically focusing on the needs of white GBQ men by bringing a greater awareness to the continual exclusions which operate within GBQ "communities".

Preferences for Sexual Health Smartphone App Features Among Gay and Bisexual Men

Given the popularity of geosocial networking applications ("apps") among gay, bisexual, and other men who have sex with men (GBMSM), this study sought to examine GBMSM's willingness to use sexual health and behavior tracking features if integrated within apps they are already using to meet sexual partners. Most GBMSM (91%) recruited on a popular app reported interest in one or more sexual health app features, including features to find LGBT-friendly providers (83%), receive lab results (68%), schedule appointment reminders (67%), chat with a healthcare provider (59%), and receive medication reminder alerts (42%). Fewer GBMSM were interested in tracking and receiving feedback on their sexual behavior (35%) and substance use (24%). Our data suggest that integrating sexual health and behavior tracking features for GBMSM who use apps could be promising in engaging them in HIV prevention interventions. Further research is needed on GBMSM's perspectives about potential barriers in using such features.

Hookup App Use, Sexual Behavior, and Sexual Health Among Adolescent Men Who Have Sex With Men in the United States

PURPOSE

Geosocial networking applications (e.g., "hookup apps") are widely used among adult men who have sex with men (MSM). Little is known about adolescent MSM's (AMSM) use of these apps. Exploratory research is needed as AMSM's app use poses various ethical, legal, and sexual health concerns. This article examined AMSM's app use patterns and its associations with their sexual health and behavior.

METHODS

Two hundred sexually experienced AMSM in the United States (M age = 16.6, 49% racial/ethnic minority) completed online survey questions assessing their use of apps specific to MSM and not specific to MSM to meet partners for dating and sex, as well as their sexual behavior and HIV risk.

RESULTS

Overall, 52.5% of participants (n = 105) reported using MSM-specific apps to meet partners for sex. Of these, most participants reported having oral (75.7%, n = 78) and anal sex (62.1%, n = 64) with those partners. Of those who reported having anal sex, 78.1% (n = 50) had sex with those partners more than once, and only 25.0% (n = 16) always used condoms with those partners. Relative to those who used only non-MSM-specific apps, MSM-specific app users reported more sex partners and condomless anal sex partners, greater perceived risk of HIV, more engagement in sexual health services, and greater odds of HIV testing.

CONCLUSIONS

Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM.

Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016

BACKGROUND

Current Chinese studies continue to view male homosexuality through a disease focused lens which pays limited attention to socio-cultural aspects of sexual behavior and HIV transmission. This qualitative study aimed to investigate how socio-cultural factors influence gay men's sexual beliefs and behaviors in contemporary China, and their implications for HIV epidemic.

METHODS AND FINDINGS

Qualitative methodology was used in this study. During 2015-2016, in-depth interviews were conducted with 61 self identified gay men in Jiangxi, Henan, Heilongjiang, Guangdong, Jiangsu provinces and Chongqing municipality of China. Our study revealed that: 1) influenced by Chinese traditional culture, gay men have conflicts on self-identity, which led to low self-acceptance and negative attitude on sex, and huge socio-psychological stress; 2) a generational differences within gay community was observed, reflected in varied sexual attitudes and practices as well as way for approaching new friends, both of which have implications and challenges on HIV control and prevention; 3) socio-cultural barriers, including open minds towards casual sex and nonmonogamous relationship, and low priority of health demands were widely observed and led to negative coping with AIDS among gay community.

CONCLUSIONS

It is essential to take a holistic view into gay men's HIV epidemic in China. Socio-cultural barriers for HIV control and prevention found in this study call for serious and imperative consideration on integrated measures, including targeted efforts towards effective sex education and further inclusion of socio-cultural perspectives in HIV/AIDS interventions for gay men.