Factors Associated With Online Sex Partners Among Gay, Bisexual and Other Men Who Have Sex With Men: Results From a National Survey

Abstract

Background: Associations between online sex seeking and increased risk for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) among men who have sex with men (MSM) typically rely on convenience samples. We examined Internet and mobile app use for finding sex partners among a nationally representative sample of MSM. Methods:We analyzed 2011 to 2017 data from the National Survey of Family Growth, a nationally representative sample of the civilian, non-institutionalized US population (15-44 years). The analytic sample was comprised of men who reported 1 or more same-sex partners in the past year. We also assessed associations between online sex-seeking and STI risk, sexual health care behaviors, and condom use.Results: Of 13,320 male respondents, 442 (3.0%) reported sex with a man in the past year, of whom 215 (46.3%) had met a partner online. Between MSM who met partners online and those who did not, we found no differences by age, education, race/ethnicity or socioeconomic status. Men who have sex with men with online partners were more likely to identify as gay (68.4% vs 49.5%, P = 0.0124). They also reported more sex partners overall (M = 3.04 vs 1.60, P < 0.0001), and multiple insertive (46.3% vs 8.5%, P < 0.0001) and receptive (33.2% vs 15.4%, P = 0.0055) anal sex partners, in the past year. They were also more likely to receive sexual risk assessments (56.0% vs 40.4%, P = 0.0129), STI testing (57.4% vs 35.3%, P = 0.0002), and STI treatment (17.8% vs 8.7%, P = 0.0152) in the past year. We found no differences in condom use. Conclusions:Men who have sex with men who report using online sources to find sex partners are more likely than other MSM to report behaviors that increase risk for STI/HIV but are also more likely to engage in behaviors that may mitigate further transmission, such as STI testing.

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

“…This finding is important given that some HIV care providers have negative perceptions of MSM who report online partner seeking, and who are assumed to engage in increased sexual risk behaviors, without acknowledgment that it may also be associated with protective behaviors [ 83 ]. This study’s findings and those of others [ 9 , 67 , 81 , 82 , 84 , 85 ] demonstrating the association of online partner seeking not only with sexual risk but also with protective behaviors is important to help HIV care providers understand the nuances of online partner seeking and thereby have more open conversations about online partner seeking with their clients. Past studies show equivocal results about the relationship between online partner seeking and condomless sex, with some studies among MSM from rural areas or large cities showing higher odds [ 30 , 31 , 86 , 87 ], whereas others report lower odds [ 10 - 12 ] or no associations [ 85 , 88 ].…”

“…This study’s findings and those of others [ 9 , 67 , 81 , 82 , 84 , 85 ] demonstrating the association of online partner seeking not only with sexual risk but also with protective behaviors is important to help HIV care providers understand the nuances of online partner seeking and thereby have more open conversations about online partner seeking with their clients. Past studies show equivocal results about the relationship between online partner seeking and condomless sex, with some studies among MSM from rural areas or large cities showing higher odds [ 30 , 31 , 86 , 87 ], whereas others report lower odds [ 10 - 12 ] or no associations [ 85 , 88 ]. Our results revealed lower odds for online partner seeking among those who reported recent condomless insertive and receptive anal sex.…”

“…Evidence shows that MSM who seek partners online are more likely to report HIV [ 9 ] or STI [ 85 ] testing and willingness to use PrEP [ 84 , 89 ]. Consistent with previous research, we observed more (although not statistically significantly) HIV testing among users and nonusers of online tools in unadjusted analyses.…”

Gay Dating App Users Support and Utilize Sexual Health Features on Apps

“…Numerous studies, as compiled in one meta-analysis, have explored HIV and sexually transmitted infection (STI) transmission risk among app-using MSM [8]. There is some evidence that MSM who use apps to meet partners are more likely to engage in condomless anal sex, have a higher number of sex partners and experience higher incidence of STIs, such as gonorrhea and chlamydia, as compared to those who meet partners in-person exclusively [9,10]. Other studies are more equivocal and have found that meeting partners online is not predictive of sexual risk behaviors [11][12][13][14].…”

Online partner seeking and high-risk behaviour in men who have sex with men and male-to-female transgendered people in Mumbai, India: Implications for prevention strategies

“…A meta-analysis found that sexual encounters that were initiated online were more likely to have unprotected anal intercourse, whereas recent studies have found that app-users were more likely to have sexually transmitted infections (gonorrhea, chlamydia, and syphilis) [8][9][10]. In addition, though MSM who find their partners online are more likely to engage in risky behaviours, they are also more likely to have regular sexual risk assessments and treatment for sexually transmitted infections [11][12][13].…”