Frequent and systematic unprotected anal intercourse among men using the Internet to meet other men for sexual purposes in France: results from the "Gay Net Barometer 2006" survey

The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking

The use of websites and GPS-based mobile applications ("apps") designed for social and sexual networking has been associated with increased HIV risk; however, little is known about Latino sexual minorities' and transgender persons' use of these websites and apps and the risk profiles of those who use them compared with those who do not. Data from 167 participants who completed the baseline survey of a community-level HIV prevention intervention, which harnesses the social networks of Latino sexual minorities and transgender persons, were analyzed. One quarter of participants (28.74%, n = 48) reported using websites or apps designed for social and sexual networking, and 119 (71.26%) reported not using websites or apps designed for social and sexual networking. Those who used websites or apps were younger and reported more male sex partners, a sexually transmitted disease diagnosis, and illicit drug use other than marijuana. HIV prevention interventions for those who use websites or apps should consider addressing these risks for HIV.

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.

Online sex-seeking behaviors among men who have sex with men: implications for investigation and intervention

To investigate factors associated with online sex-seeking behaviors among men who have sex with men (MSM) in Beijing, China. MSM participants were recruited from two cohort studies with multiple enrollment methods from November 2006 to February 2007 and from March to June 2008, respectively. Data collected included demographics and sexual behaviors. Of the 901 participants, 68.1% were single; 69.3% were non-Beijing residents; 94.4% considered themselves to be homosexual; 65.2% received college or higher levels of education; the median age was 26 years; 73.0% sought male sex partners via the Internet in the past 3 months; 66.2% had ≥2 sex partners. Younger age, higher levels of education and having had ≥2 male sex partners in the past 3 months were independently associated with seeking sex partners on the Internet. These findings indicate that Internet-based intervention programs could encourage younger high-risk MSM to use condoms and reduce their numbers of sexual partners.

The meanings and practices of barebacking among Brazilian internet users

This article originates from an online ethnography on barebacking (intentional unprotected anal sex) in Brazil, between the years 2004 and 2008. More specifically, some elements or conceptual dimensions present in discussions on barebacking will be examined. Based on internet discussion forums and 23 open online interviews, using the Windows Live Messenger program, it was possible to organise the practice of barebacking into two principal modalities: more extensive and involving greater contact and partial or involving reduced risks. The individuals who practise bareback sex may experience situations that include various forms of barebacking during their lives, such as the men who contract HIV and try to develop strategies to reduce the risks in their sexual interactions by, for example, avoiding ejaculating inside their partner or trying to establish sexual relationships with men of the same serological status. Therefore, in general, the different motivations for barebacking constitute a frontier region (of tension) between the pleasure of sensory contact and the risk of infection. Beyond producing a dichotomy between pleasure and risk, the various meanings described by the potential barebackers must be taken into account.

[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.

Predictors of reporting bareback sex among a diverse sample of MSM recruited through a Swedish website

This study aimed to understand how person, health and sexual behavior, HIV-risk cognitions, and gay community involvement relate to barebacking among 3634 men who have sex with men (MSM) recruited by way of the Swedish website QX.se. In this sample, 10% reported that they had engaged in barebacking in the past year. Variables found to be statistically significant in the bivariate analyses were incorporated into a logistic regression domain-specific model. Variables that remained significantly associated with barebacking in domain 1 were being HIV-positive and having had a sexually transmitted infection (STI) in the past year. The variable talked with someone in HIV services remained significant in domain 2, and for domain 3, the variable used the Internet to look for a bareback partner remained significant. Two variables, believing taking semen in one's mouth involves no or low risk of HIV transmission and believing that engaging in insertive unprotected anal intercourse (IUAI) involves no or low risk of HIV transmission, remained significant in domain 4. The final multivariate regression analysis included six variables (from domains 1 to 4) and had a significant fit (χ (2)(6) = 2.571, p=0.958). The likelihood of engaging in barebacking was higher for those men who reported being HIV-positive (odds ratio [OR] = 2.77), having had an STI in the past year (OR = 1.67), and having used the Internet to look for a bareback partner (OR = 12.59). This first study to explore the predictors of bareback sex among a Nordic MSM sample suggests that bareback sex among northern European MSM is less common than among other samples. The findings reconfirm that MSM who engage in bareback sex may represent a unique subset of MSM with distinct HIV prevention needs.

A relative profile of HIV-negative users of French websites for men seeking men and predictors of their regular risk taking: a comparison with HIV-positive users

The Net Gay Barometre is a biennial survey among users of France's most popular websites for men who have sex with men (MSM). Given the recent increases in HIV infection and sexual risk practices among French MSM, this study aims to: (1) create a socio-sexual profile of HIV-negative men (HIV-); (2) identify predictors of regular unprotected anal intercourse (RUAI) in this group, and responding to a call for stratifying analyses of online samples of MSM by HIV status; and (3) perform the former two aims by comparing HIV- men with HIV-positive men (HIV+). Statistical analyses were conducted with 11,771 HIV- men and 2130 HIV+ men who completed the online survey between December 2008 and March 2009. Regarding the first aim, fewer HIV- men, relative to HIV+ men, were exposed to factors conducive to sexually transmitted infection; in the previous 12 months, smaller proportions of this group had gone to venues where sexual encounters were possible, engaged in an esoteric sexual activity, had a high number of casual partners, and practiced unprotected anal sex, RUAI or barebacking. However, multivariate regression analyses identifying predictors of RUAI in each group revealed common predictors: sensation-seeking, esoteric activities, oral contact with sperm, and barebacking (in a couple), although odds were generally higher in HIV+ men. Our findings raise the possibility of a sexual culture accentuating pleasure and adventurism that may gain in amplitude once seroconversion takes place.

Sampling methods used in developed countries for behavioural surveillance among men who have sex with men

The aim of this review was to develop an overview of the sampling methods used in developed countries for behavioural surveillance among men who have sex with men. We abstracted information from peer-reviewed and non-peer-reviewed publications and, when needed, contacted first authors and surveillance authorities. Out of the 40 developed countries, 26 surveillance systems were identified in 23 countries. These surveillance systems made use of one or a combination of: venue-based sampling (n = 16); web-based sampling (n = 11); gay press/mail-out (n = 8); or respondent-driven sampling (n = 4). Differences in the sampling methods used were found by year of implementation and by region. More information is needed to better assess the strengths and limitations of the range of sampling methods. There was substantial variation in the way sampling methods were applied, most especially in venue-based sampling. To improve the ability to compare indicators across countries, key elements of the sampling methods should be standardized.

HIV prevention: What have we learned from community experiences in concentrated epidemics?

Drawing on lessons learned from community experiences in concentrated epidemics, this paper explores three imperatives in the effort to reduce the sexual transmission of HIV: combat prevention fatigue, diversify HIV testing and combat stigma and discrimination. The paper argues for a non-judgmental harm reduction approach to the prevention of sexual transmission of HIV that takes into account the interpretation of risk by diverse individuals and communities in the era of antiretroviral therapy. This approach requires greater attention to increasing access to opportunities to know one's serostatus, especially among key populations at greater risk. Novel approaches to diversifying HIV testing approaches at community level are needed. Finally, the paper makes a plea for bold measures to combat stigma and discrimination, which continues to represent a formidable barrier for access to services for affected populations and may contribute to HIV-related risk behaviours. A "triple therapy" approach to address stigma and discrimination is discussed, which includes greater acceptance of people living with HIV and AIDS (PLWHA), improving relevant laws and policies, and involving prevention users- working with people rather than for people-.Note: this paper corresponds to the plenary talk of Bruno Spire at the XVIIth World AIDS Conference, August 8th, Mexico city: http://www.kaisernetwork.org/health_cast/player.cfm?id=4383.