Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team’s response to various situations. Our recommendations direct researchers’ reflection on these considerations.

This study sought to study consumption patterns of gay-oriented sexually explicit media (SEM) by men who have sex with men (MSM); and to investigate a hypothesized relationship between gay SEM consumption and HIV risk behavior. Participants were 1391 MSM living in the US, recruited online to complete a SEM consumption and sexual risk survey. Almost all (98.5%) reported some gay SEM exposure over the last 90 days. While 41% reported a preference to watch actors perform anal sex without condoms (termed “bareback SEM”), 17% preferred to actors perform anal sex with condoms (termed “safer sex SEM”) and 42% reported no preference. Overall SEM consumption was not associated with HIV risk; however participants who watched more bareback SEM reported significantly greater odds of engaging in risk behavior. The results suggest that a preference for bareback SEM is associated with engaging in risk behavior. More research to understand how MSM develop and maintain preferences in viewing SEM, and to identify new ways to use SEM in HIV prevention, is recommended.

The aim of this paper is to examine whether transgender people's experiences of relationships are influenced by heteronormativity, the related concept of sexual legitimacy, and gender as a binary construct. Data from an Internet-based study of transgender people in the USA was used. Findings seem to indicate that participants were strongly influenced by heteronormative discourses. However, less rigid gender beliefs are associated with lower levels of internalised transphobia, which, in turn, are associated with higher levels of self-esteem. Transgender people can therefore find themselves in a double-bind where, on one hand, conforming to gender and sexual norms leads to validation by mainstream US. society, but could possibly entail diminished psychological well-being.

The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

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Researchers use protocols to screen for suspicious survey submissions in online studies. We evaluated how well a de-duplication and cross-validation process detected invalid entries. Data were from the Sexually Explicit Media Study, an Internet-based HIV prevention survey of men who have sex with men. Using our protocol, 146 (11.6 %) of 1254 entries were identified as invalid. Most indicated changes to the screening questionnaire to gain entry (n = 109, 74.7 %), matched other submissions’ payment profiles (n = 56, 41.8 %), or featured an IP address that was recorded previously (n = 43, 29.5 %). We found few demographic or behavioral differences between valid and invalid samples, however. Invalid submissions had lower odds of reporting HIV testing in the past year (OR 0.63), and higher odds of requesting no payment compared to check payments (OR 2.75). Thus, rates of HIV testing would have been underestimated if invalid submissions had not been removed, and payment may not be the only incentive for invalid participation.

The aim of the study was to evaluate the generalizability of the minority stress model on predicting depressive symptomatology among sexual minority men living outside of the United States. In addition, the role of resilience and its relationship between individual minority stressors and depressive symptomatology is examined. The study utilized online purposive sampling and focused on sexual minority men living in Brazil; participants’ (N = 388) ages ranged from 18 to 56 years (Mage = 25.31, SDage = 7.87, Mdnage = 23). Participants completed measures that assessed sociodemographics, minority stressors, resilience, and symptoms of depression. Results of a hierarchical regression indicated that, while accounting for sociodemographics, enacted stigma and internalized homonegativity independently predicted participants’ depressive symptomatology, whereas concealment of sexual identity did not. Further, to assess the role of resilience, while accounting for the effects of sociodemographics and minority stressors, results suggested that resilience significantly added to predicting depressive symptomatology and indicated that enacted stigma was the only minority stressor that significantly predicted depressive symptomatology. Lastly, when interactions between individual minority stressors and resilience were added to the model, results suggested that resilience moderated the relationship between concealment of sexual orientation and depressive symptomatology. The study’s findings highlight the importance of considering sociocultural context and resilience in evaluating minority stress and depressive symptomatology among sexual minorities. The authors discuss the implications of this study in the context of theory, research, clinical practice, and policy among sexual minority men.

The purpose of this study was to explore the relationship between perception of own appearance, Internet pornography consumption, preferences for pornographic actors' appearance, and sexual self-esteem in gay and bisexual men in Norway. An online survey of 477 gay and bisexual men showed that, despite the prevailing muscular and lean gay body ideal, many men with less ideal bodies also preferred to watch pornographic actors with body types similar to their own. Self-perceived attractiveness, having an ideal body type, and viewing Internet pornography in longer sessions each made a unique contribution to higher self-esteem as a sexual partner. Preferring to watch pornographic actors with ideal bodies was not related to sexual self-esteem. The findings underscore the importance for gay or bisexual men of both self-perceived attractiveness and being athletic or young and fit, for a positive self-evaluation of sexual performance and competence.