Your picture is your bait: use and meaning of cyberspace among gay men

Latent Class Analysis of Online Platforms for Partner-Seeking and Sexual Behaviors Among Men Who Have Sex with Men from Central Kentucky

Little is known whether engagement in sexual behaviors associated with potential HIV risks differs by subgroups of men who have sex with men (MSM), who are distinct regarding patterns of use of online tools for partner-seeking. Using latent class analysis, we revealed four classes of app-using MSM (n = 181, 18-34 y.o., 82.4% identified as White and non-Hispanic) residing in Central Kentucky: the Grindr/Tinder class; the Poly App Use class of MSM-oriented apps; the General Social Media class, and the Bumble class. Unadjusted penalized logistic regressions showed associations of the Poly App Use class with increased numbers of receptive anal sex partners and reporting condomless receptive anal sex. Adjusting for other covariates, poly app users versus others were more likely to be older (25-34 vs. 18-24, AOR = 3.81, 95%CI = 1.70-9.03), to report past six-month illicit drug use (AOR = 2.93, 95%CI = 1.25-7.43) and to have ever used pre-exposure prophylaxis (AOR = 2.79, 95%CI = 1.10-7.12). Poly app users had behavior profiles associated with an elevated HIV risk and also reported HIV-related protective behaviors likely indicating increased risk awareness among this class. Our findings warrant differentiation of behavior profiles by patterns of app use and suggest not to generalize sexual behaviors associated with potential HIV risks to all app-using MSM.

More than mateship: exploring how Australian male expatriates, longer-term and frequent travellers experience social support

PURPOSE

Those travelling overseas for work or leisure including male expatriates, longer-term and frequent travellers (ELoFTs) may be at heightened risk for a range of health and wellbeing issues. Social support may mediate this risk. However, from a public health perspective, little is written about how ELoFTs access health information and support and the role of their social networks in facilitating health and wellbeing outcomes. This research was part of a study examining social network processes of Australian male ELoFTs travelling, living, or working in Southeast Asia (SEA).

METHODS

Symbolic Interactionism and Grounded Theory were the conceptual framework and methodology supporting semi-structured, in-depth interviews (n = 25) conducted in Australia and Thailand with Australian male ELoFTs to SEA, aged 18 years or older.

RESULTS

Findings highlight supports that assist ELoFT transition and adjustment to country of destination or manage their transnational experience. Influential places, people, and points in the migration journey mediated engagement with social support.

CONCLUSIONS

ELoFT social networks and the support provided within them may provide a mechanism for intervention across a range of public health issues. Findings may support the development of policy and practice across industries charged with supporting successful ELoFT adjustment.

Attitudes toward sexual behaviors: relationship with gender and sexual orientation

Most studies that have compared sexual attitudes between men and women have focused on heterosexual individuals or have not controlled for sexual orientation. In addition, many have used measures of general sexual attitudes, which have more difficulty in predicting sexual behaviors and sexual health than measures of attitudes toward specific sexual behaviors. Therefore, the present study aimed to analyze whether gender and sexual orientation are related to attitudes toward specific sexual behaviors in Spain. The study sample consisted of 1725 participants (55.8% women) aged between 18 and 35 years and of different sexual orientations. All participants completed an instrument to measure attitudes toward specific contextualized sexual behaviors. After controlling for age and current relationship status, the results reveal that while women have more positive attitudes toward solitary sexual behaviors and erotic material than men, men have more positive attitudes toward unconventional and online sexual behaviors than women. Bisexual people have more positive attitudes toward frequent dyadic sexual behaviors with casual partners than homosexual people. Finally, bisexual and homosexual people have more positive attitudes towards solitary sexual behaviors and erotic material, unconventional sexual behaviors, and online sexual behaviors than heterosexuals. It is concluded that gender and sexual orientation are related to attitudes toward different types of sexual behaviors.

The effect of pre-exposure prophylaxis (PrEP) on negotiating casual sex between gay men: disclosure, assumptions, and communication

BACKGROUND

The disclosure of HIV status and pre-exposure prophylaxis (PrEP) use can be important in the negotiation of safe sex. With the rapid uptake of PrEP in Australia, norms and expectations about discussion and disclosure may have changed.

METHODS

We explored the disclosure of PrEP use, HIV status and communication with sex partners by HIV-negative gay men in Sydney, Australia. We conducted semi-structured interviews from October 2017 to May 2018 and analysed data using a codebook thematic analysis approach.

RESULTS

Participants had a variety of expectations of what they should tell their partners and what they expected in return. For some participants, PrEP had negated the need for any discussion about HIV. Many participants assumed their partners would find information about their HIV status or PrEP use on their online profiles or that partners would ask, if necessary.

CONCLUSIONS

Building a stronger, shared understanding among gay men that disclosure and discussion no longer automatically occur before sexual encounters may be useful.

A Good App Is Hard to Find: Examining Differences in Racialized Sexual Discrimination across Online Intimate Partner-Seeking Venues

Young sexual minority Black men (YSMBM) report widespread instances of Racialized Sexual Discrimination (RSD) when seeking intimate partners online. RSD is associated with negative psychological health outcomes; however, little is known about the differences between virtual environments, and whether users are exposed to differential types/frequencies of RSD across different virtual environments. Using data from a cross-sectional web survey of YSMBM (N = 548), a multivariate Kruskal–Wallis test was conducted comparing those who primarily used Jack’d and those who primarily used Grindr to meet intimate partners; the frequency with which these two groups encountered six RSD domains was compared. Men who primarily used Grindr reported more frequent instances of White superiority and rejection from White men compared with men who primarily used Jack’d. Men who primarily used Jack’d reported more frequent instances of physical objectification from Black men compared with men who primarily used Grindr. RSD may manifest differentially based on the specific venue that YSMBM use. Such differences may reflect the sociodemographic makeup of these spaces, as well as differences in acceptability/normalization of different forms of RSD. These findings have implications for the development of anti-RSD initiatives that target the specific sociocultural norms that are unique to different virtual environments.

Online Partner Seeking and Sexual Behaviors Among Men Who Have Sex With Men From Small and Midsized Towns: Cross-sectional Study

BACKGROUND

Men who have sex with men (MSM) residing outside of large urban areas are underrepresented in research on online partner seeking and sexual behaviors related to transmission of HIV.

OBJECTIVE

We aimed to determine associations between the use of the internet or social networking apps (online tools) to meet partners for sex, dating, or for both purposes (online partner seeking) and sexual behaviors among MSM residing in small and midsized towns in Kentucky, United States.

METHODS

Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18 to 34 years, who had recently (past 6 months) engaged in anal sex with another man and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of online partner seeking and HIV-related sexual behaviors.

RESULTS

Most (181/252, 71.8%) of the participants reported using online tools for partner seeking. Of these 181 respondents, 166 (91.7%) had used online tools to meet partners for sex (n=45, 27.1% for sex only; and n=121, 72.9% for sex and dating) and 136 (75.1%) had used online tools to meet partners for dating (n=15, 11% for dating only; and n=121, 89% for sex and dating). Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report online partner seeking (adjusted odds ratio [aOR] 0.22, 95% CI 0.07-0.68; P=.009 and aOR 0.25, 95% CI 0.10-0.66; P=.005, respectively). Increased number of insertive and receptive anal sex partners and substance use before or during sex were associated with higher odds of online partner seeking (aOR 1.31, 95% CI 1.11-1.55; P=.001; aOR 1.20, 95% CI 1.05-1.39; P=.008; and aOR 2.50, 95% CI 1.41-4.44; P=.002, respectively).

CONCLUSIONS

Among MSM who reside outside of large urban areas and practice online partner seeking, HIV risk-reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drug use before or during sex. MSM who do not practice online partner seeking are in need of continued outreach to reduce condomless anal sex.

A Variational Approach to Scripts

This paper proposes a formal reconstruction of the script construct by leveraging the active inference framework, a behavioral modeling framework that casts action, perception, emotions, and attention as processes of (Bayesian or variational) inference. We propose a first principles account of the script construct that integrates its different uses in the behavioral and social sciences. We begin by reviewing the recent literature that uses the script construct. We then examine the main mathematical and computational features of active inference. Finally, we leverage the resources of active inference to offer a formal model of scripts. Our integrative model accounts for the dual nature of scripts (as internal, psychological schema used by agents to make sense of event types and as constitutive behavioral categories that make up the social order) and also for the stronger and weaker conceptions of the construct (which do and do not relate to explicit action sequences, respectively).

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.

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.

The safe use of dating applications among men who have sex with men: a study protocol for a randomised controlled trial to evaluate an interactive web-based intervention to reduce risky sexual behaviours

Background

Notably, both international and local studies have found a high prevalence of sexually transmitted infections (STIs) and risky sexual behaviours, such as condomless anal sex, substance misuse in conjunction with sex (‘chemsex’) and group sex, among men who have sex with men (MSM) dating application (app) users. Although the use of dating apps is an emerging sexual risk factor, little effort has been expended on the promotion of safe sex and good sexual health among the users of those apps. Therefore, the aim of the proposed study is to develop and evaluate the effectiveness of an interactive web-based intervention in improving the sexual health of MSM dating app users in Hong Kong.

Methods

A two-armed randomised controlled trial will be conducted. Chinese MSM dating app users will be recruited and randomly allocated into either the intervention (n = 200) or control group (n = 200). Subjects in the intervention group will receive the web-based intervention containing interactive content that (1) encourages a positive attitude towards consistent condom use and HIV/STI testing and negative attitude towards chemsex and group sex; (2) positions condom use and regular HIV/STI testing as normative; and (3) targets improved perceived self-efficacy concerning condom use and negotiation and HIV/STI testing. The control group will receive only web-based information without sexual health components. Subjects in both groups will be evaluated at baseline and three and 6 months after baseline. The primary outcome will be the frequency of condomless anal sex in the past 3 months.

Discussion

The proposed study will aid development of culturally relevant health promotion programmes aimed at minimising the potential harm of dating app use and promoting the sexual health of MSM dating app users. The web-based intervention, if found successful, will have important clinical and policy implications, as it can be adopted by the government and non-governmental organisations targeting MSM. Moreover, the proposed intervention can reach many MSM at relatively low cost, and thus has the potential to check the burgeoning HIV/STI epidemic among MSM in Hong Kong in a cost-effective manner.

Trial registration

International standard randomized controlled trial number (ISRCTN) registry: ISRCTN16681863 registered on 28 April 2020.

Mind, Body and Boundaries: Self-Presentation on the Nordic LGBTQ Online Dating Scene

Online dating is continually on the rise and nowadays a widely used and accepted way to find different kinds of companionship. This relatively new interpersonal phenomenon has provided an especially important virtual space for non-heterosexuals. Previous research on behaviors and trends on dating communities online for sexual minorities has focused primarily on sites for gay men in Anglo-Saxon countries. The purpose of the present study is to examine self-presentations on the Nordic LGBTQ online dating scene and possible gender-dependent differences in self-presentation. The Nordic countries are commonly perceived as progressive in issues regarding gender equality and LGBTQ rights. The countries on average also have low population density with large rural areas and consequently limited scenes for non-heterosexuals. A testimony of this is the study's selected dating site, which is based in Sweden but encompasses the neighboring countries and markets itself as a Nordic meeting venue. The present study embarks on new territory within psychology-, gender-, and queer research by examining self-presentations on a mixed-gender LGBTQ dating site, situated in the supposedly liberal Nordic countries. Based on qualitative and quantitative data from a stratified sample of 716 cis-gendered, predominantly Swedish online dating profiles, on a well-established Nordic online dating site for non-heterosexual men and women, statistical calculations and a thematic analysis (TA) were executed. The findings show that central self-presentations concern mind versus body, lust and longings, and boundaries, where gender frequently functions as the dividing line. Women self-present more through personality and romantic longings compared to men, who to a higher degree emphasizes body, and lust. Self-presentation is also expressed through resistance against boundary-breaking contact on the site. The boundaries that are guarded regard age, anti-racism and most pronounced - boundaries against male harassment of non-heterosexual women. The implications of self-presentation, possible discrimination and misrepresentation on the Nordic LGBTQ online dating scene are discussed.

Interaction Patterns of Men Who Have Sex With Men on a Geosocial Networking Mobile App in Seven United States Metropolitan Areas: Observational Study

BACKGROUND

The structure of the sexual networks and partnership characteristics of young black men who have sex with men (MSM) may be contributing to their high risk of contracting HIV in the United States. Assortative mixing, which refers to the tendency of individuals to have partners from one's own group, has been proposed as a potential explanation for disparities.

OBJECTIVE

The objective of this study was to identify the age- and race-related search patterns of users of a diverse geosocial networking mobile app in seven metropolitan areas in the United States to understand the disparities in sexually transmitted infection and HIV risk in MSM communities.

METHODS

Data were collected on user behavior between November 2015 and May 2016. Data pertaining to behavior on the app were collected for men who had searched for partners with at least one search parameter narrowed from defaults or used the app to send at least one private chat message and used the app at least once during the study period. Newman assortativity coefficient (R) was calculated from the study data to understand assortativity patterns of men by race. Pearson correlation coefficient was used to assess assortativity patterns by age. Heat maps were used to visualize the relationship between searcher's and candidate's characteristics by age band, race, or age band and race.

RESULTS

From November 2015 through May 2016, there were 2,989,737 searches in all seven metropolitan areas among 122,417 searchers. Assortativity by age was important for looking at the profiles of candidates with correlation coefficients ranging from 0.284 (Birmingham) to 0.523 (San Francisco). Men tended to look at the profiles of candidates that matched their race in a highly assortative manner with R ranging from 0.310 (Birmingham) to 0.566 (Los Angeles). For the initiation of chats, race appeared to be slightly assortative for some groups with R ranging from 0.023 (Birmingham) to 0.305 (Los Angeles). Asian searchers were most assortative in initiating chats with Asian candidates in Boston, Los Angeles, New York, and San Francisco. In Birmingham and Tampa, searchers from all races tended to initiate chats with black candidates.

CONCLUSIONS

Our results indicate that the age preferences of MSM are relatively consistent across cities, that is, younger MSM are more likely to be chatted with and have their profiles viewed compared with older MSM, but the patterns of racial mixing are more variable. Although some generalizations can be made regarding Web-based behaviors across all cities, city-specific usage patterns and trends should be analyzed to create targeted and localized interventions that may make the most difference in the lives of MSM in these areas.

The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV

We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.

Prevention of HIV and Other Sexually Transmissible Infections in Expatriates and Traveler Networks: Qualitative Study of Peer Interaction in an Online Forum

Background

In high-income countries such as Australia, an increasing proportion of HIV cases have been acquired overseas, including among expatriates and travelers. Australia’s national strategies have highlighted the need for public health interventions for priority populations. One approach is to expand efforts to places or spaces where expatriate communities reside. Online settings such as forums used by expatriates and travelers have potential for preventing sexually transmissible infections with those hard to reach through more traditional interventions.

Objective

Our objectives were to (1) identify and describe domains of social interaction and engagement in 1 online forum used by Australian expatriates and travelers living or working in Thailand; and (2) make recommendations to health-promoting organizations and policy makers regarding the role of these forums in public health interventions with mobile populations who may be at risk of acquiring HIV or other sexually transmissible infections.

Methods

We identified forums and users in 2 stages. We identified 13 online forums and analyzed them for inclusion criteria. We searched 1 forum that met the required criteria for users who met inclusion criteria (n=5). Discussion threads, rather than individual posts, were units of analysis. For each user, we collected as transcripts the first 100 posts and 10 most recent posts, including the thread in which they were posted. We analyzed and thematically coded each post (n=550). Transcripts and analyses were reviewed and refined by multiple members of the research team to improve rigor. Themes were not totally emergent but explored against symbolic interactionism concepts of presentation of self, meaning, and socialization.

Results

Key domains were as follows: the forum (characteristics of the space and reasons for use), gaining access (forum hierarchy and rules), identity (presentation of self and role of language), advice, support, and information (sources of information, support provided, influencers, topics of discussion, and receptiveness to advice), and risk (expectations and perceptions). The forum exhibited evidence of unique language, rules and norms, and processes for managing conflict and key influencers. The forum was a substantial source of health information and advice provided to users via confirmation, reassurance, or affirmation of beliefs and experiences. Risk perception and expectations varied. Risk taking, including around sex, appeared to be a key expectation of travel or the experience of being an expatriate or traveler.

Conclusions

Australian expatriate and long-term traveler participation in the online forum formed, influenced, and reinforced knowledge, attitudes, interaction, and identity. Such forums can be used by policy makers and health-promoting organizations to provide supplementary sources of support and information to hard-to-reach mobile populations who may be at risk of acquiring HIV or other sexually transmissible infections. This will complement existing engagement with health professionals and other public health interventions.

Blue-Ribbon Boys: factors associated with PrEP use, ART use and undetectable viral load among gay app users across six regions of the world

INTRODUCTION

Gay social networking apps have grown in popularity among men who have sex with men offering opportunities for rapid and confidential collection of vital data as well as social connection. The goal of our study was to explore factors associated with utilization of pre-exposure prophylaxis (PrEP) and antiretroviral treatment (ART), and self-reported undetectable viral load (UVL) using data collected by the gay social networking app Hornet.

METHODS

In 2016, the Global Forum on MSM & HIV (MSMGF) partnered with Hornet, to support an educational initiative called Blue-Ribbon Boys. One aspect of the initiative prompts Hornet users to answer a short series of yes-no questions about their sexual health. Using survey responses, we evaluated factors associated with PrEP and ART use as well as self-reported UVL by fitting separate multivariable generalized estimating equation models.

RESULTS

In total, 16,008 unique Hornet users started the survey, of which 12,126 (76%) provided sufficient data for analyses. Of the 10,774 HIV-negative men, 13% reported PrEP use in the past year. PrEP use was associated with a recent sexually transmitted infection (STI) test or treatment (aOR = 2.19, CI = 1.49 to 3.21); and taking steps to protect oneself from HIV (aOR = 1.41, CI = 1.13 to 1.76). Among HIV-positive Hornet users (n = 1243), ART use was associated with older age (each year increase aOR = 1.02, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.54, CI = 2.65 to 7.78); and awareness of unlikely HIV transmission with UVL (aOR = 1.53, CI = 1.03 to 2.26). UVL was associated with older age (each year increase aOR = 1.03, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.84, CI = 2.74 to 8.55), and awareness of unlikely HIV transmission with UVL (aOR = 1.98, CI = 1.37 to 2.85).

CONCLUSIONS

Study findings underscore the importance of STI testing and treatment as well as information about HIV transmissibility for encouraging PrEP and ART use. Our findings also reveal age disparities, which can undermine incidence reduction among gay men. Gay social networking apps can be effectively used for rapid data collection and sexual health promotion with men who have sex with men. STI testing and treatment programmes offer important opportunities for encouraging PrEP and ART use. Information about HIV transmissibility with consistent ART use should be incorporated into prevention messaging tailored to various age groups.

Changing Communities, Changing Spaces: The Challenges of Health Promotion Outreach in cyberspace

This article is a case study of an Internet chat room outreach project in Perth, Western Australia. The CyberReach project sought to adapt current peer based health promotion outreach, training and supervision frameworks to an online outreach setting in a way that was effective and supported by the online community. It targeted marginalised groups to trial the provision of online mental and sexual health promotion incorporating a participatory action research model into its development and implementation. Three 6-week trial periods were conducted and significant changes were made in response to changes in the online environment and to improve sustainability and effectiveness of the protocols. Four themes arose from CyberReach's experience: online group processes are unique due to the creation of extensive personal networks and occurrence of disclosure without face-to-face contact across potentially large geographic barriers; flexibility is required to adapt to technological changes and online community flux; enforcing boundaries and delineating peer education from therapeutic support can be challenging when only using text-based communication; and Internet outreach can be time intensive with small returns in actual community engagement and constant technological up-skilling of staff may be required. Based on the project's experiences we offer the following recommendations when planning similar Internet outreach strategies: Funding and planning groups need to be aware that the Internet environment is constantly changing and planning and funding arrangements need to reflect a capacity to remain flexible; Programs need to be firmly connected to the communities they are outreaching therefore a peer-based education component is strongly encouraged; Careful consideration should be taken regarding data collection so that the environment and the individuals within are respected; Further research needs to be conducted to understand the styles and approaches of different online interactions, and the relative influence of technical platforms, gender and age.

The Role of Gay Identity Confusion and Outness in Sex-Seeking on Mobile Dating Apps Among Men Who Have Sex With Men: A Conditional Process Analysis

Mobile dating apps are now a popular platform for men who have sex with men (MSM) to connect with others. Based on the uses and gratifications (U&G) theory, this study explores the relationship between sex-seeking and the number of casual sex partners met through MSM-based mobile dating apps (Grindr, Jack'd, and SCRUFF). The conditional process analysis (N = 401) shows that this relationship was significant and was mediated by the intensity of app use. That is, sex-seeking indirectly affected the number of casual sex partners through the intensity of app use. Furthermore, gay identity confusion and outness to the world moderated this indirect effect: it was stronger when the user was either more confused about his sexuality or was less out to the world. This research introduces an alternative way to incorporate psychographics variables into the U&G framework.

'Men who use the Internet to seek sex with men': Rethinking sexuality in the transnational context of HIV prevention

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.

Understanding the public's health problems: applications of symbolic interaction to public health

Public health has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding public health problems and developing interventions.

Understanding internet sex-seeking behaviour and sexual risk among young men who have sex with men: evidences from a cross-sectional study

OBJECTIVE

Internet sex-seeking is common among young men who have sex with men (MSM). However, research examining its association with risky sexual behaviour has produced mixed findings, possibly due to various operational definitions of internet sex-seeking which fail to account for its multi-dimensionality. This study purposed to: (1) examine if the way internet sex-seeking behaviour is operationalised influences its association with risky sexual behaviour (unprotected anal intercourse (UAI) and casual sex) and (2) determine the association of each operational definition with sexual risk.

METHODS

We recruited 263 sexually-experienced young MSM (18-29 years) and operationalised internet sex-seeking behaviour in four ways: (i) ever used the internet to meet other men, (ii) currently own a profile on a website dedicated to meeting other men, (iii) ever physically met a man you initially met online and (iv) ever had sex with a man you met online. Using binomial regression, we examined the association of each operationalisation with UAI and casual sex.

RESULTS

Only MSM who reported physically meeting a man they met online and those who ever had sex with a man they met online were more likely to report a history of UAI (p<0.05), while MSM who engaged in all forms of internet sex-seeking were more likely to engage in casual sex (p<0.05). However, the strength of these associations varied according to the mode of operationalisation.

CONCLUSIONS

The way internet sex-seeking is operationalised in research is differentially associated with sexual risk. Against this backdrop, the utility of these operational definitions in future research and inferences drawn from such research must be interpreted with caution. Findings have important implications for sexual health research and methodology, survey development, sexual health prevention interventions, and evaluating sexual risk among young MSM.

Online Social Networking, Sexual Risk and Protective Behaviors: Considerations for Clinicians and Researchers

Online social networking refers to the use of internet-based technologies that facilitate connection and communication between users. These platforms may be accessed via computer or mobile device (e.g., tablet, smartphone); communication between users may include linking of profiles, posting of text, photo and video content, instant messaging and email. This review provides an overview of recent research on the relationship between online social networking and sexual risk and protective behaviors with a focus on use of social networking sites (SNS) among young people and populations at high risk for sexually transmitted infections (STIs). While findings are mixed, the widespread use of SNS for sexual communication and partner seeking presents opportunities for the delivery and evaluation of public health interventions. Results of SNS-based interventions to reduce sexual risk are synthesized in order to offer hands-on advice for clinicians and researchers interested in engaging patients and study participants via online social networking.

Mobilisation, politics, investment and constant adaptation: lessons from the Australian health-promotion response to HIV

ISSUE ADDRESSED

The Australian response to HIV oversaw one of the most rapid and sustained changes in community behaviour in Australia's health-promotion history. The combined action of communities of gay men, sex workers, people who inject drugs, people living with HIV and clinicians working in partnership with government, public health and research has been recognised for many years as highly successful in minimising the HIV epidemic.

METHODS

This article will show how the Australian HIV partnership response moved from a crisis response to a constant and continuously adapting response, with challenges in sustaining the partnership. Drawing on key themes, lessons for broader health promotion are identified.

RESULTS

The Australian HIV response has shown that a partnership that is engaged, politically active, adaptive and resourced to work across multiple social, structural, behavioural and health-service levels can reduce the transmission and impact of HIV.

CONCLUSIONS

The experience of the response to HIV, including its successes and failures, has lessons applicable across health promotion. This includes the need to harness community mobilisation and action; sustain participation, investment and leadership across the partnership; commit to social, political and structural approaches; and build and use evidence from multiple sources to continuously adapt and evolve. So what? The Australian HIV response was one of the first health issues to have the Ottawa Charter embedded from the beginning, and has many lessons to offer broader health promotion and common challenges. As a profession and a movement, health promotion needs to engage with the interactions and synergies across the promotion of health, learn from our evidence, and resist the siloing of our responses.

Use of the Internet and mobile-based "apps" for sex-seeking among men who have sex with men in New York City

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.

Self-Presentation, Desired Partner Characteristics, and Sexual Behavior Preferences in Online Personal Advertisements of Men Seeking Non-Gay-Identified Men

Despite attention to the sexual behaviors of non-gay-identified (NGI) men who have same-sex encounters, virtually no research has focused on issues of partner desirability and selection. Limited evidence suggests that a subgroup of men who have sex with men (MSM) advertise online for sexual encounters with NGI men. Exchange theory provided a framework to investigate this seeking of NGI men, based on the content of Internet personal advertisements for same-sex encounters. Researchers analyzed 282 ads posted to an online bulletin board. Ads by men who explicitly desired encounters with NGI men were compared with those by men who did not indicate this preference in potential partners. Multivariate analyses revealed that NGI-seeking men had significantly increased odds of identifying as discreet (Adjusted odds ratio [AOR] = 2.82), seeking a discreet encounter (AOR = 4.68), seeking a masculine partner (AOR = 2.18), being willing to host (AOR = 2.77), as well as seeking oral-receptive sex (AOR = 2.69), unprotected oral sex (AOR = 6.76), and anal-receptive sex (AOR = 2.18). Further, NGI-seeking ads were more likely to not mention condom use or safer sex practices (AOR = 4.13) and were less likely to indicate a desire for oral-insertive sex (AOR = 0.34) and rimming (AOR = 0.21). Findings suggest that some men may deliberately present themselves in ways that they perceive as being attractive to NGI men, and have research implications for NGI MSM, their partners, and the risk outcomes of these online ads.

"Aren't labels for pickle jars, not people?" Negotiating identity and community in talk about 'being gay'

Understanding how people in any given population think about and experience their sexuality is fundamental to developing and implementing good health policy, research, and practice. Yet despite several decades of focus on sexual identity and HIV risk within health research, gay men as a category are often treated in an uncomplicated way. This article reports on focus group discussions held with 45 gay and other men who have sex with men in New Zealand to identify how they talked about issues of gay identity and gay community/ies. The men negotiated and renegotiated their gay identity and being gay was reported as just one part of most men's lives. Many men did not like to be labeled as gay and downplayed aspects of their gay identity. Only a few men proclaimed being gay. Men reported very mixed experiences with the gay community/ies. Understanding how men experience being gay, provides information vital to enhancing policy, research and practice responses to gay men's health issues. A major challenge for health service provision to appropriately engage with men who have sex with other men but resist being labeled as gay was identified.

The eroticism of Internet cruising as a self-contained behaviour: a multivariate analysis of men seeking men demographics and getting off online

Most studies on men seeking men and who use the Internet for sexual purposes have focused on the epidemiological outcomes of Internet cruising. Other research has only focused on online sexual behaviours such as cybersex. The present study examines men who find the acts of Internet cruising and emailing to be erotic as self-contained behaviours. We surveyed 499 men who used craigslist.org for sexually-oriented purposes, and ran an ordinary least squares multiple regression model to determine the demographic characteristics of men seeking men who found Internet cruising erotic. Our results showed that younger compared to older men seeking men found the acts erotic. Likewise, men seeking men from mid-sized cities and large cities compared to men from smaller cities found Internet cruising and emailing to be erotic. Most notably, bisexual- and heterosexual-identifying men seeking men compared to gay-identifying men found these acts to be more erotic. Our results suggested that self-contained Internet cruising might provide dual functions. For some men (e.g., heterosexual-identifying men), the behaviour provides a sexual outlet in which fantasy and experimentation may be explored without risking stigmatization. For other men (e.g., those from large cities), the behaviour may be an alternative to offset sexual risk while still being able to 'get off'.

Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey

BACKGROUND

Continuous prevention efforts for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are recommended among those men who have sex with men (MSM). Creative use of e-technologies coupled with a better understanding of social networks could lead to improved health interventions among this risk population.

OBJECTIVE

The aims of the study were to (1) compare the impact of various advertising strategies on recruiting MSM participants to an online HIV/AIDS survey, and (2) explore the feasibility of using a social network service (SNS) for study advertising.

METHODS

A cross-sectional online survey was conducted in 2009. South Australian men over 18 years were invited to participate if they had had sexual intercourse with men in the previous year. A short questionnaire was used to collect demographics and information on sexual behavior, HIV history, use of the Internet for dating purposes, and sources of health information. The survey was promoted in community settings and online, including advertisements through social networks.

RESULTS

A total of 243 men completed the online survey during the 8-week data collection period. Online advertisements recruited 91.7% (220/240) of the sample. Conversely, traditional advertisements in the community recruited only 5.8% (14/240) of the sample. Ten volunteers were asked to advertise on their personal SNS application, but only 2 effectively did so. Only 18/240 (7.5%) of the respondents reported having learned of our study through the SNS application. In this sample, 19.3% (47/243) of participants had never been tested for HIV. Among the participants who had been tested, 12.8% (25/196) reported being HIV-positive. Regarding Internet use, 82.3% (200/243) of participants had dated online in the previous 6 months. Among the participants who had dated online, most (175/200, 87.5%) had found an Internet sexual partner and two-thirds (132/200, 66.0%) had had anal sex with these partner(s). Among men who had anal sex with an Internet partner, 68.2% (90/132) used a condom during sex.

CONCLUSIONS

The MSM participants in this study had high-risk profiles for HIV and other sexually transmitted diseases (STDs), which highlights the need for ongoing health interventions among this group. In this study, the SNS marketing strategy did not appear to create a viral effect and it had a relatively poor yield.

[Attitudes toward online HIV/sexually-transmitted infection prevention programs and Internet user profiles among men who have sex with men]

OBJECTIVES

To describe the attitudes of men who have sex with men (MSM) toward online HIV/sexually-transmitted infection (STI) prevention programs and to identify and characterize user profiles with regard to their attitudes toward online prevention programs.

METHOD

A survey in gay venues or via the internet was completed by 2,044 participants from Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey explored socio-demographic variables, sexual behavior and other risk behaviors associated with HIV infection, as well as attitudes toward online prevention programs. The statistical analysis included factor analysis and non-hierarchical cluster analysis.

RESULTS

Most MSM had positive attitudes towards online HIV/STI prevention programs. Factor analysis revealed two factors: online prevention aimed at interaction and online prevention aimed at information. Based on these factors, three user profiles were identified: users oriented toward informative and interactive online prevention (53.5%), users oriented toward interactive online prevention (25.9%) and users were not oriented toward online prevention (20.7%). On characterizing these profiles, we observed a significant presence of men who were not interested in online prevention among those with a lower educational level, bisexual men and HIV-positive men. Conversely, those most receptive to online prevention were men self-identified as gay, those with a bachelors degree, those who had been tested for HIV and those who were HIV-negative.

CONCLUSION

The internet can facilitate sexual health promotion among MSM. Characterization of user profiles offers the possibility of segmenting prevention programs and of combining online and offline strategies.

Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men

The Internet has opened many doors with its accessibility to information, entertainment and web-based communities. For young men who have sex with men (YMSM), the Internet can provide access to information on relevant sexual behavior and health information, stories from other men about relationship issues, and a venue for locating potential sexual and dating partners. Understanding YMSM's motivations for going online for information, advice or sexual relationships, is important as the Internet becomes increasingly used not only as a space to find sexual partners, but also as a venue for HIV and STI interventions. Having an understanding of the risks associated with searching for partners online, and how and why YMSM use the Internet for a variety of purposes, can inform the development of more effective Internet-based risk reduction programs. This article presents qualitative and quantitative data from the Healthy Young Men's Study, a longitudinal study of an ethnically diverse cohort of 526 YMSM. Qualitative interviews (N = 24) described not only the prevalence of using the Internet for finding sexual partners and the possible benefits and risks associated with that practice, but also the processes and perceptions of using this mechanism. Our data indicate that YMSM used the Internet to find information related to sex and sexuality, seek friendships, sexual partners as well as "hook-ups" or casual sex. Findings were presented in relation to how YMSM researchers and interventionists can identify how to most effectively reach YMSM through online methods.

Using the Internet in Pursuit of Public Sexual Encounters

The current study investigated a subgroup of 112 men who have sex with men who use the Internet in search of partners for sex venue encounters to understand what types of venues they frequent and whether their behaviors are associated with an increased risk of HIV/STI transmission. An initial cluster analysis revealed two patterns of Internet use—low and high frequency—among these men. Although frequency of Internet use to find partners for venue encounters did not cluster with venue attendance, there was a trend among high-frequency Internet users to attend gyms, public bathrooms, and sex clubs more than low-frequency users. Furthermore, high-frequency users attended more venues, preferred venues where multiple partners can be found, and were marginally more likely to engage in unprotected anal sex across venues compared with low-frequency users. Knowing that some venue users initiate venue encounters on the Internet may be useful in targeting appropriate HIV/STI interventions.

Internet use and sexual health of young men who have sex with men: a mixed-methods study

Young gay, bisexual, and other men who have sex with men (MSM) experience sexual health disparities due to a lack of support in settings that traditionally promote positive youth development. The Internet may help to fill this void, but little is known about how it is used for sexual health purposes among young MSM. This mixed-methods study reports quantitative results of a large survey of 18- to 24-year-old MSM in an HIV testing clinic (N = 329) as well as qualitative results from interviews. Level of Internet use was high in this sample and the majority of participants reported using the Internet to find HIV/AIDS information. Black and Latino youth used the Internet less frequently than White youth, and after controlling for age, education, and frequency of Internet use, Black youth were 70% less likely to use the Internet to find HIV/AIDS information. Qualitative analyses identified themes related to the role of the Internet in finding sexual health information, sexual minority identity development, and sexual risk taking behaviors. Participants reported that the Internet filled an important and unmet need for sexual health education. It allowed for connections to the gay community and support during the coming out process, but also exposure to homophobic messages. There was no evidence of increased risk behaviors with partners met online, but at the same time the potential for the use of the Internet to facilitate safer sex communication was largely untapped. Our findings generally present an optimistic picture about the role of the Internet in the development of sexual health among young MSM.

Internet sex ads for MSM and partner selection criteria: the potency of race/ethnicity online

The explosive growth in Internet use by MSM to find sexual partners has been noted in the research literature. However, little attention has been given to the impact of participating in this online sexual marketplace for MSM of color, despite race/ethnicity as a frequently used selection criterion in personal ads or profiles. Six focus group discussions [n=50], and 35 in-depth qualitative interviews were conducted with African American, Latino, Asian and Pacific Islander MSM in Los Angeles, which included discussion of their use of Internet sites to meet/interact with other MSM. Men reported race/ethnicity as a pervasive and powerful factor in facilitating or derailing Internet-mediated sexual encounters. The racialized interactions that MSM of color reported ranged from simple expressions of race-based preferences to blatantly discriminatory/hostile interactions and often demeaning race-based sexual objectification. Experiences of rejection and a perceived hierarchy of value in the sexual market based on race had definite costs for these MSM using these online sites. Furthermore, the private and solitary nature of seeking partners online meant that there was little to buffer the corrosive aspects of those negative experiences. These online dynamics have implications for the power balance in Internet-mediated sexual liaisons, including sexual decision-making and sexual risk.

A cibersexualidade e a pesquisa online: algumas reflexões sobre o conceito de barebacking

Este artigo é decorrente de uma pesquisa online sobre aspectos da sexualidade masculina, mais precisamente sobre as interações masculinas em novos contextos da epidemia de HIV/Aids. Busca discutir as possibilidades da internet como campo de pesquisa, considerando os aspectos socioculturais abertos pelas novas tecnologias de informação. Este é o caso das práticas de barebacking, geralmente definido como sexo anal desprotegido de forma intencional. Mais especificamente, neste artigo, serão problematizadas algumas tensões e ambiguidades conceituais do barebacking, sobretudo no que diz respeito ao sexo desprotegido entre parceiros fixos e entre parceiros ocasionais, de acordo com a discussão desenvolvida por alguns usuários das comunidades do Orkut, no contexto brasileiro. Finalmente, destaca-se que os atores que se dizem barebackers não são, necessariamente, mais os mesmos, tampouco entendem o conceito da mesma forma, o que exige uma reflexão mais ampla sobre seus distintos usuários e contextos de uso.

Perceived risks and protective strategies employed by young men who have sex with men (YMSM) when seeking online sexual partners

This study examined the perceptions of risk by young men who have sex with men (YMSM) regarding meeting sexual partners through the Internet. Fifty-four YMSM ages 18-29 who reported engaging in bareback sex ("intentional unprotected anal intercourse in high-risk contexts") completed a structured assessment and a face-to-face interview. Participants reported using the Internet to meet sexual partners at least once per week, having had multiple sexual partners in the past 2 months (M = 10.50, SD = 9.25), and engaging in occasions of unprotected receptive (M = 5.35, SD = 6.76) and insertive (M = 5.06, SD = 10.11) anal intercourse. A third of the sample reported having had unprotected sex with a partner who was serodiscordant or of unknown serostatus. Despite the obvious HIV risks, the most commonly perceived risks included threats to physical safety and difficulties trusting a stranger. Risk reduction strategies included leaving information about partner and whereabouts with a friend, meeting in a public place, and screening partner through online chatting. Those YMSM who meet partners online may be at risk for physical violence in addition to HIV or sexually transmitted infections (STIs). Public health campaigns should increase awareness of safety concerns when meeting sexual partners online and support YMSM's self-protective actions.

Online sex-seeking behaviors of men who have sex with men in New York City

The ongoing HIV epidemic among men who have sex with men (MSM) in New York City and the increased use of Internet sexual social networking websites by MSM fosters a need to understand the characteristics and sex-related behaviors of this group. The authors conducted an online survey of 195 MSM who use sexual social networking websites in New York City. Demographic characteristics, sexual sensation seeking, and HIV optimism-skepticism were compared among participants reporting sex with and without condom use (safe sex and high-risk sex, respectively) with partners met online. There was no difference in income, education, race, or employment status between the groups. The groups differed significantly in age, sexual sensation seeking, and HIV optimism-skepticism. In a multivariate logistic regression both HIV optimism-skepticism (p < .05) and sexual sensation seeking (p < .05) were significant predictors of high-risk sexual behavior (pseudo-R(2) = .24). This information should be considered when developing interventions for this group. For example, to reach those with high sexual sensation seeking, public health professionals should design sex-positive prevention messages for online distribution that highlight safer sex without condemning risky sexual practices.

Internet advertisements for public sexual encounters among men who have sex with men: are safe behaviors communicated?

Public and commercial sex venues typically provide easy access to sexual encounters that are often anonymous and, therefore, may facilitate HIV/STD transmission among those men who attend. Recently, researchers have suggested that men who have sex with men may be using the Internet to search for sexual encounters to occur within sex venues. The current study explored the extent to which men who advertise for public or commercial sexual encounters initially communicate to potential partners their safe-sex intentions. Advertisements for sexual encounters (n = 99) were collected from a publicly accessible website and examined for content related to venue type, sexual behavior, and indications of sexual safety or risk. Word frequencies were calculated to provide a closer investigation of how individuals negotiate safe sex within these communications. The findings revealed that approximately half of the men who advertised for sex in a public or commercial sex venue failed to communicate to potential partners in their initial advertisement a desire to be safe during sexual encounters involving oral and anal practices. Additionally, a small percentage of men advertised specifically for risky encounters (e.g., barebacking). Together, these findings suggest that men do use the Internet to coordinate public sexual encounters, some of which may be unprotected from HIV/STD transmission. Future research should address the process of condom negotiation among men who initially meet their male sex partners on the Internet for subsequent encounters in sex venues.

Stigmatization, Stress, and the Search for Belonging in Black Men Who Have Sex With Men Who Use Methamphetamine

Black men who have sex with men (BMSM) continue to be disproportionately affected by HIV. Methamphetamine use has been identified as a source of HIV risk in gay and bisexually identified men, yet the relationship between methamphetamine use and sexual risk among BMSM specifically remains unclear. The goal of this qualitative study was to investigate psychological, contextual, and developmental factors informing methamphetamine use and HIV risk behavior among a sample of heterosexual, gay, and bisexual BMSM (N = 52) in New York City. Methamphetamine use and sexual risk were associated with stress induced by stigmatization arising from and within larger dominant White gay culture, stigmatization incurred within the community, internalized homophobia, and stress induced by living under the shadow of the perceived inevitability of contracting HIV as BMSM. Methamphetamine use was associated with venues where participants could be sheltered from experiences of racism, homophobia, and dominant hegemonic images of Black masculinity, while exploring and developing same-sex desires, thereby instilling a sense of community belonging. Suggestions for culturally appropriate strategies for treating both methamphetamine use and HIV risk behaviors among BMSM are discussed.

Cruising in cyber space: comparing Internet chat room versus community venues for recruiting Hispanic men who have sex with men to participate in prevention studies

Difficulties with recruitment of hidden populations, such as Hispanic men who have sex with men (MSM), have hampered HIV prevention research, leading researchers to explore alternative recruitment modalities such as the Internet. In this paper, we compare the efficiency and cost of recruiting HMSM from Internet chat rooms versus community venues and examine the differences between participants recruited from each type of venue. Internet recruitment was more efficient and somewhat less costly than community recruitment. Although the two groups were comparable in most demographic factors and HIV risk behaviors, Internet recruits were more likely to be bisexual, more likely to be HIV seropositive, had a higher level of education, and reported higher levels of psychological distress and lower levels of gay community attachment. Implications of our findings for using Internet chatrooms as recruitment venues are discussed.

Tip of the Iceberg: young men who have sex with men, the Internet, and HIV risk

OBJECTIVES

We examined the prevalence of Internet use for meeting sexual partners (Internet partners) and HIV risk behaviors associated with this use among young men who have sex with men (aged 16-24 years).

METHODS

A sample of 270 young men who have sex with men completed a computer-assisted survey. We used bivariate chi(2) analyses and hierarchical logistic regression to assess factors associated with Internet-facilitated sexual encounters.

RESULTS

Using the Internet to meet sexual partners was common; 48% of our sample had sexual relations with a partner they met online. Of these, only 53% used condoms consistently, and 47% reported having sexual partners older (>4 years) than themselves. Regression analyses showed increased age, White race/ethnicity, history of unprotected anal intercourse, multiple anal intercourse partners, and engaging in sexual activity at a sex club or a bathhouse were associated with meeting sexual partners through the Internet. Only history of unprotected anal intercourse was associated with risky sexual behaviors with Internet partners (P<0.025).

CONCLUSIONS

Young men who have sex with men and who seek partners online also engage in other behaviors that place them at risk for HIV and other sexually transmitted infections.

Using the Internet to find offline sex partners

We aimed to expand upon the demographic characteristics and gender differences among those who have met someone on the Internet who they later met offline and had sex with as well as any relationship with cybersex, sexually transmitted infections, and online sexual problems. We analyzed data collected through an online questionnaire in 2002 in Sweden including a total population of 1836 respondents of which 1458 used the Internet for sexual purposes. Of those, 35% men and 40% women reported to have met offline sex partners online. The majority reported an occurrence of one to two times, whereas 10% reported six or more times. The analysis suggested women aged 34-49 and 50-65 years, homo- and bisexual men, and singles more likely to have this experience. They were also more likely to have engaged in cybersex. No relationships were found with sexually transmitted infections or online sexual problems. The results suggest that using the Internet to find sex partners may be less hazardous for the general Internet users than pointed out by prior research about this behavior often focusing on specific sub groups of Internet users.