A qualitative study of the dating experiences and sex behaviors of young Black MSM who use dating phone apps Público

Abstract

Background: HIV incidence is increasing among young Black men who have sex with men (YBMSM) despite relatively stable rates in the general United States population. Dating phone applications (apps) have become popular among YBMSM to find sexual partners; however, the impact of these apps on decision-making around sex behaviors is understudied in this group. The purpose of this study was to understand the dating and sex behaviors of a sample of YBMSM who regularly use dating phone apps

Methods: We conducted a qualitative interview study to explore the dating experiences and sex behaviors of both HIV- negative and -positive YBMSM who reported regular use of dating phone apps. We used the Integrated Behavior Model to frame our investigation of the potential influences of phone apps on condom use, HIV status disclosure, and HIV testing. Twenty YBMSM aged 18-24 were recruited from community organizations and HIV clinics in Atlanta, Georgia, to participate in in-depth, semi-structured interviews. A modified grounded theory approach was used to guide our inductive and deductive qualitative analysis.

Results: IBM was an appropriate theoretical framework to describe and contextualize the dating and sex behaviors of this sample of YBMSM. Perceived norms, attitudes, and self-agency were influential in participants' intentions of having casual sex with men met using dating phone apps, consistently using condoms, and disclosing and discussing HIV status. Perceived hook up cultural norms within the BMSM community and on dating phone apps influenced condom use and HIV stigma in this community affected participants' intentions of using the dating phone apps to openly disclose and discuss HIV status. Participants used serosorting based on dating app profiles and app-based communication to inform condom use behaviors.

Conclusions: Using dating phone apps to find partners does affect YBMSM's intentions to use consistently use condoms, disclose and discuss HIV status, and get tested for HIV. Understanding how perceived norms, HIV stigma, serosorting and personal-agency influence sex behaviors when YBMSM use dating phone apps is essential to developing future interventions. Future research should further explore the relationship between perceived norms and protective sex behaviors for YBMSM who use dating phone apps.

Table of Contents

Table of Contents Introduction 1 Study Purpose 6 Research Questions 6 Significance of the Study 6 Theoretical Framework 7 Operationalization of Terms 10 Literature Review 11 Introduction 11 YBMSM and the HIV epidemic. 11 Protective sex behaviors 12 Condoms.12 HIV status awareness.14 HIV disclosure.15 HIV testing. 16 Sex Seeking Behaviors & Emerging Technologies 19 Dating phone applications and online dating. 19 Risks and online venues 22 Theoretical Framework 26 Summary 28 Methodology 29 Introduction 29 Participants 29 Participant Recruitment 29 Participant self-referrals from e-mail distribution of flyers.30 Participant self-referrals from posted flyers.31 Participant referral/snowball method.31 Health care provider referrals31 Data Collection Methods32 Data Collection Process32 Semi-structured interviews.33 Recording of semi-structured interviews.33 Questionnaire.33 Profile Questionnaire.33 Data Analysis34 Data entry, coding, and analysis34 Data Quality35 Reliability and validity. 35 Results 37 Participant Demographics 37 Table 1. Demographic Characteristics of Participants (N=20) 38 Dating Phone Apps & Dating Experiences 41 App description 41 Table 3. Participant Dating Phone Apps 43 Use of the apps 44 Figure 2. Dating Phone App Use Phases 46 Disclosure of information 46 Communicating, dating, and hooking-up 49 Dating phone app experiences in the IBM context 51 Figure 3. Summary of Dating Phone App Experiences in the IBM Context 53 Protective Sex Behaviors 54 HIV disclosure 54 Figure 4. HIV Disclosure within the IBM Context 60 Condom use. 60 Figure 5. Condom Use within the IBM Context 63 HIV Testing. 64 Figure 6. HIV Testing within the IBM Context 65 Knowledge & skills, environmental constraints, habits, and salience related to protective sex behaviors.65 Discussion 68 Integrated Behavioral Model: an appropriate model 68 Figure 7. Altered IBM: Participants' Perceptions 69 Dating Phone Apps & Dating Experiences 70 Dating phone apps, casual sex, multiple sex partners 70 Protective Sex Behaviors 71 HIV status disclosure & self-efficacy 71 Condom use norms & serosorting 72 HIV testing 74 Limitations 75 Future Directions & Conclusions 76 Bibliography 79 Appendix A 89 Appendix B 90 Appendix C 92 Appendix D 97 Appendix E 102 Appendix F 103 Appendix G 106 Appendix H 112 Appendix I 113

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	sex behaviors HIV men who have sex with men qualitative research young black MSM dating phone apps integrated behavioral model
Committee Chair / Thesis Advisor	Nehl, Eric J., Emory University
Committee Members	Hussen, Sophia A, Emory University Wong, Frank Y, Emory University
Partnering Agencies	Community-based non-profit organization (e.g., AID Atlanta) Hospital or other health care provider

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