HIV Risk and Protective Behaviors Among Men Who Have Sex With Men and Partners Met Via Geosocial Networking Mobile Apps Open Access

Abstract

HIV disproportionately impacts men who have sex with men (MSM), with MSM accounting for approximately 60% of new HIV cases in the US each year. Major risk factors for HIV incidence in the MSM population include anal sex without a condom, high number of sexual partners, and intercourse with sexual partners of unknown status. With the advent of smartphones, MSM have been able to use geosocial networking (GSN) mobile apps, such as Tinder or Grindr, to meet sexual partners. MSM using these apps have been shown to have more sexual partners and a higher prevalence of STIs, as well as different HIV testing behavior; however, differences in the prevalence of unprotected anal intercourse in this population have not been shown and no national studies on the HIV risk factors of MSM who use GSN mobile apps has been done. The focus of this study was to characterize HIV risk with last sexual partner for MSM who met their last partner via mobile app, versus those who met online or in-person. Meeting via GSN mobile apps was associated with significantly higher likelihood of condom use during anal intercourse (OR 1.21), even accounting for factors such as main versus casual partnership and frequency of partnership. Those who met via GSN mobile app were also more likely to take preventative measures such as having been tested for HIV in the last 12 months and having ever used pre-exposure prophylaxis (PrEP). They were also more likely to have a larger number of sexual partners, report a higher proportion of last partnerships as casual partnerships, and not know the HIV status of their last partner. The co-occurrence of increased risk and protective behaviors among app-using MSM indicates that tailored intervention strategies may be appropriate, and such strategies should build on enhanced prevention behaviors while simultaneously addressing areas of likely increased risk.

Table of Contents

Introduction 1

Methods 4

Data Source 4

Measures 4

Exclusion Criteria 6

Data Analysis 6

Results 8

Demographics and Sexual Characteristics 8

Associations with Venue of Meeting 9

Associations with Anal Intercourse with a Condom 10

Discussion 12

Limitations and Further Research 15

Conclusion 17

References 23

Tables

Table 1 18

Demographic and sexual characteristics of the study population (N=6,286), by venue for meeting last sexual partner.

Table 2 20

Bivariate and multivariable logistic regression analysis of venue of meeting last sexual partner and potential behavioral covariates of interest.

Table 3 22

Multivariate logistic model for the relationship between condom sex with last sexual partner and venue of meeting last sexual partner (via mobile app, the internet, or in-person), adjusted for appropriate covariates.

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Behavioral Health Sciences, Epidemiology
Keyword	HIV Public Health MSM
Committee Chair / Thesis Advisor	Siegler, Aaron J, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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