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RESEARCH ARTICLE

Exploring the role of sex-seeking apps and websites in the social and sexual lives of gay, bisexual and other men who have sex with men: a cross-sectional study

Kiffer G. Card A B E , Nathan J. Lachowsky A D , Zishan Cui A , Susan Shurgold A , Maya Gislason B , Jamie I. Forrest C , Ashleigh J. Rich A C , David Moore A C , Eric Roth A D and Robert S. Hogg A B
+ Author Affiliations
- Author Affiliations

A B.C. Centre for Excellence in HIV/AIDS, 608–1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

B Simon Fraser University, 8888 University Drive, Vancouver, BC V5A 1S6, Canada.

C University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada.

D University of Victoria, 3800 Finnerty Road, Victoria, BC V8P 5C2, Canada.

E Corresponding author. Email: kcard@sfu.ca

Sexual Health 14(3) 229-237 https://doi.org/10.1071/SH16150
Submitted: 26 July 2016  Accepted: 27 October 2016   Published: 16 December 2016

Abstract

Background: The objective of this study was to explore the relationship between online sex-seeking, community/social attachment and sexual behaviour. Methods: Respondent-driven sampling was used to recruit 774 sexually active gay and bisexual men in Vancouver, Canada, aged ≥16 years. Multivariable logistic regression compared men who had used online sex-seeking apps/websites in the past 6 months (n = 586) with those who did not (n = 188). Results: Multivariable results showed that online sex seekers were more likely to be younger [adjusted odds ratio (aOR) = 0.95, 95% CI: (0.93–0.96)], college educated [aOR = 1.60, 95% CI: (1.07, 2.40)], have more Facebook friends [aOR = 1.07, 95% CI: (1.01, 1.13)], spend more social time with other gay men [aOR = 1.99, 95% CI: (1.33–2.97)], and were less likely to identify emotionally with the gay community [aOR = 0.93, 95% CI: (0.86–1.00)]. Further, they had displayed high sensation-seeking behaviour [aOR = 1.08, 95% CI: (1.03–1.13)], were more likely to engage in serodiscordant/unknown condomless anal sex [aOR = 2.34, 95% CI: (1.50–3.66)], use strategic positioning [aOR = 1.72, 95% CI: (1.08–2.74)], ask their partner’s HIV-status prior to sex [aOR = 2.06, 95% CI: (1.27–3.37)], and have ever been tested for HIV [aOR = 4.11, 95% CI: (2.04–8.29)]. Conclusion: These findings highlight the online and offline social behaviour exhibited by gay and bisexual men, pressing the need for pro-social interventions to promote safe-sex norms online. We conclude that both Internet and community-based prevention will help reach app/web users.

Additional keywords: community, gay men, HIV/AIDS, Internet, sexual health.


References

[1]  Seibt AC, Ross MW, Freeman A, Krepcho M, Hedrich A, McAlister A, Ferna’Ndez-Esquer ME. Relationship between safe sex and acculturation into the gay subculture. AIDS Care 1995; 7 85–8.
Relationship between safe sex and acculturation into the gay subculture.Crossref | GoogleScholarGoogle Scholar |

[2]  Meyer I. Minority stress and mental health in gay men. J Health Soc Behav 1995; 36 38–56.
Minority stress and mental health in gay men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3ls1KjsQ%3D%3D&md5=3db9731ccdc6c24c6aaa213cc6dd25feCAS |

[3]  Veinot TC, Meadowbrooke CC, Loveluck J, Hickok A, Bauermeister JA. How “community” matters for how people interact with information: mixed methods study of young men who have sex with other men. J Med Internet Res 2013; 15 e33
How “community” matters for how people interact with information: mixed methods study of young men who have sex with other men.Crossref | GoogleScholarGoogle Scholar |

[4]  Kertzner RM, Meyer IH, Frost DM, Stirratt MJ. Social and psychological well-being in lesbians, gay men, and bisexuals: the effects of race, gender, age, and sexual identity. Am J Orthopsychiatry 2009; 79 500–10.
Social and psychological well-being in lesbians, gay men, and bisexuals: the effects of race, gender, age, and sexual identity.Crossref | GoogleScholarGoogle Scholar |

[5]  Finneran C, Stephenson R. Social network composition and sexual risk-taking among gay and bisexual men in Atlanta, GA. AIDS Behav 2014; 18 59–68.
Social network composition and sexual risk-taking among gay and bisexual men in Atlanta, GA.Crossref | GoogleScholarGoogle Scholar |

[6]  Peterson JL, Rothenberg R, Kraft JM, Beeker C, Trotter R. Perceived condom norms and HIV risks among social and sexual networks of young African American men who have sex with men. Health Educ Res 2009; 24 119–27.
Perceived condom norms and HIV risks among social and sexual networks of young African American men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1M%2Fls1CmtQ%3D%3D&md5=e0cf3a90560b6d7a7e851c3c13f187f7CAS |

[7]  Frye V, Koblin B, Chin J, Beard J, Blaney S, Halkitis P, Vlahov D, Galea S. Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav 2010; 14 974–85.
Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis.Crossref | GoogleScholarGoogle Scholar |

[8]  Nimmons D, Folkman S. Other-sensitive motivation for safer sex among gay men: expanding paradigms for HIV prevention. AIDS Behav 1999; 3 313–24.
Other-sensitive motivation for safer sex among gay men: expanding paradigms for HIV prevention.Crossref | GoogleScholarGoogle Scholar |

[9]  Nimmons D. In this together. J Psychol Human Sex 1998; 10 75–87.
In this together.Crossref | GoogleScholarGoogle Scholar |

[10]  Luhtanen R, Crocker J. Self-esteem and intergroup comparisons: toward a theory of collective self-esteem. In Suls J, Wills TA, editors. Social comparison: contemporary theory and research. Hillsdale: Lawrence Erlbaum Associates, Inc; 1991. pp. 211–34.

[11]  Ashmore RD, Deaux K, McLaughlin-Volpe T. An organizing framework for collective identity: articulation and significance of multidimensionality. Psychol Bull 2004; 130 80–114.
An organizing framework for collective identity: articulation and significance of multidimensionality.Crossref | GoogleScholarGoogle Scholar |

[12]  Frost DM, Meyer IH. Measuring community connectedness among diverse sexual minority populations. J Sex Res 2012; 49 36–49.
Measuring community connectedness among diverse sexual minority populations.Crossref | GoogleScholarGoogle Scholar |

[13]  Putnam RD. Bowling alone: the collapse and revival of American community. 1 edn. New York: Simon and Schuster; 2001.

[14]  Simon Rosser BR, West W, Weinmeyer R. Are gay communities dying or just in transition? Results from an international consultation examining possible structural change in gay communities. AIDS Care 2008; 20 588–95.
Are gay communities dying or just in transition? Results from an international consultation examining possible structural change in gay communities.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1czit12gtA%3D%3D&md5=3dd6170e52ed71e475200532965a9687CAS |

[15]  Rowe MS, Dowsett GW. Sex, love, friendship, belonging and place: is there a role for “Gay Community” in HIV prevention today? Cult Health Sex 2008; 10 329–44.
Sex, love, friendship, belonging and place: is there a role for “Gay Community” in HIV prevention today?Crossref | GoogleScholarGoogle Scholar |

[16]  Ghaziani A. There goes the gayborhood? Princeton: Princeton University Press; 2014.

[17]  Lea T, de Wit J, Reynolds R. “Post-gay” yet? the relevance of the lesbian and gay scene to same-sex attracted young people in contemporary Australia. J Homosex 2015; 62 1264–85.
“Post-gay” yet? the relevance of the lesbian and gay scene to same-sex attracted young people in contemporary Australia.Crossref | GoogleScholarGoogle Scholar |

[18]  Holt M. Gay men and ambivalence about “gay community”: from gay community attachment to personal communities. Cult Health Sex 2011; 13 857–71.
Gay men and ambivalence about “gay community”: from gay community attachment to personal communities.Crossref | GoogleScholarGoogle Scholar |

[19]  Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men’s use of the Internet: research from the 1990s through 2013. J Sex Res 2014; 51 390–409.
Gay and bisexual men’s use of the Internet: research from the 1990s through 2013.Crossref | GoogleScholarGoogle Scholar |

[20]  Lewnard JA, Berrang-Ford L. Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies. Sex Transm Infect 2014; 90 290–6.
Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies.Crossref | GoogleScholarGoogle Scholar |

[21]  Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. J Med Internet Res 2014; 16 e134
eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[22]  Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res 2010; 12 e4

[23]  Taggart T, Grewe ME, Conserve DF, Gliwa C, Roman Isler M. Social media and HIV: a systematic review of uses of social media in HIV communication. J Med Internet Res 2016; 17 e248

[24]  Melendez-Torres GJ, Nye E, Bonell C. Internet sex-seeking is inconsistently linked with sexual risk in men who have sex with men: systematic review of within-subjects comparisons. Sex Health 2015; 12 183–7.
| 1:STN:280:DC%2BC2MjhtFOjsQ%3D%3D&md5=2cc5575d84c96b38ad4f7824acd8be0fCAS |

[25]  Liau A, Millett G, Marks G. Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sex Transm Dis 2006; 33 576–84.
Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[26]  Zablotska IB, Holt M, Prestage G. Changes in gay men’s participation in gay community life: implications for HIV surveillance and research. AIDS Behav 2012; 16 669–75.
Changes in gay men’s participation in gay community life: implications for HIV surveillance and research.Crossref | GoogleScholarGoogle Scholar |

[27]  Holt M, Rawstorne P, Wilkinson J, Worth H, Bittman M, Kippax S. HIV testing, gay community involvement and internet use: social and behavioural correlates of HIV testing among Australian men who have sex with men. AIDS Behav 2012; 16 13–22.
HIV testing, gay community involvement and internet use: social and behavioural correlates of HIV testing among Australian men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC387jt1GjtQ%3D%3D&md5=fb566b81ca5e76a1e8a191ce31898298CAS |

[28]  Ross MW, Tikkanen R, Berg RC. Gay community involvement: its interrelationships and associations with Internet use and HIV risk behaviors in Swedish men who have sex with men. J Homosex 2014; 61 323–33.
Gay community involvement: its interrelationships and associations with Internet use and HIV risk behaviors in Swedish men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[29]  Shilo G, Mor Z. Seeking sex online: social and sexual risk factors among adolescent and young gay and bisexual men. Sex Health 2015; 12 217–23.
Seeking sex online: social and sexual risk factors among adolescent and young gay and bisexual men.Crossref | GoogleScholarGoogle Scholar |

[30]  McPherson M, Smith-Lovin L, Brashears ME. Social isolation in America: changes in core discussion networks over two decades. Am Sociol Rev 2006; 71 353–75.
Social isolation in America: changes in core discussion networks over two decades.Crossref | GoogleScholarGoogle Scholar |

[31]  Kaufman M, Cornish F, Zimmerman RS, Johnson BT. Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach. J Acquir Immune Defic Syndr 2014; 66 S250–8.
Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach.Crossref | GoogleScholarGoogle Scholar |

[32]  Bronfenbrenner U. Developmental ecology through space and time: a future perspective. In Moen P, Elder GH, Lüscher K, editors. Examining lives in context: perspectives on the ecology of human development. Washington, DC: American Psychological Association; 1995. pp. 619–47.

[33]  Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health 2013; 13 482
Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics.Crossref | GoogleScholarGoogle Scholar |

[34]  Lachowsky NJ, Lal A, Forrest JI, Card KG, Cui Z, Sereda P, Rich A, Raymond HF, Roth EA, Moore DM, Hogg RS. Including online-recruited seeds: a respondent-driven sample of men who have sex with men. J Med Internet Res 2016; 18 e51
Including online-recruited seeds: a respondent-driven sample of men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[35]  Forrest JI, Lachowsky NJ, Lal A, Cui Z, Sereda P, Raymond HF, Ogilvie G, Roth EA, Moore D, Hogg RS. Factors associated with productive recruiting in a respondent-driven sample of men who have sex with men in Vancouver, Canada. J Urban Health Bull N Y Acad Med 2016; 93 379–87.
Factors associated with productive recruiting in a respondent-driven sample of men who have sex with men in Vancouver, Canada.Crossref | GoogleScholarGoogle Scholar |

[36]  LeBeau RT, Jellison WA. Why get involved? Exploring gay and bisexual men’s experience of the gay community. J Homosex 2009; 56 56–76.
Why get involved? Exploring gay and bisexual men’s experience of the gay community.Crossref | GoogleScholarGoogle Scholar |

[37]  O’Dell BL, Rosser BRS, Miner MH, Jacoby SM. HIV prevention altruism and sexual risk behavior in HIV-positive men who have sex with men. AIDS Behav 2008; 12 713–20.
HIV prevention altruism and sexual risk behavior in HIV-positive men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[38]  Kalichman SC, Rompa D. Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior. J Pers Assess 1995; 65 586–601.
Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK287ptFWruw%3D%3D&md5=f9c462d8f37c459bb716ff27fe015aaaCAS |

[39]  Grosskopf NA, Harris JK, Wallace BC, Nanin JE. Online sex-seeking behaviors of men who have sex with men in New York City. Am J Men Health 2011; 5 378–85.
Online sex-seeking behaviors of men who have sex with men in New York City.Crossref | GoogleScholarGoogle Scholar |

[40]  Voltz E, Wejnert C, Cameron C, Spiller M, Barash V, Degani I, et al. Respondent-Driven Sampling Analysis Tool (RDSAT). Ithaca, NY: Cornell University; 2012.

[41]  Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol 1993; 138 923–36.
| 1:STN:280:DyaK2c%2FnvV2mug%3D%3D&md5=c30737add7a69400dcab6f9b3a184232CAS |

[42]  Lima VD, Geller J, Bangsberg DR, Patterson TL, Daniel M, Kerr T, Montaner JSG, Hogg RS. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS 2007; 21 1175–83.
The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART.Crossref | GoogleScholarGoogle Scholar |

[43]  Dohoo IR, Martin SW, Stryhn H. Methods in epidemiologic research. 2012. Available online at: https://www.islandscholar.ca/islandora/object/ir%3A8372/ [verified 20 September 2016].

[44]  Tikkanen R, Ross MW. Technological tearoom trade: characteristics of Swedish men visiting gay Internet chat rooms. AIDS Educ 2003; 15 122–32.
Technological tearoom trade: characteristics of Swedish men visiting gay Internet chat rooms.Crossref | GoogleScholarGoogle Scholar |

[45]  Hampton K, Goulet LS, Her EJ, Rainie L. Social isolation and new technology. Pew Research Center: Internet, Science & Tech; 2009. Available online at: http://www.pewinternet.org/2009/11/04/social-isolation-and-new-technology/ [verified 19 September 2016].

[46]  Downing MJ. Using the internet in pursuit of public sexual encounters is frequency of use associated with risk behavior among MSM? Am J Men Health 2012; 6 18–27.
Using the internet in pursuit of public sexual encounters is frequency of use associated with risk behavior among MSM?Crossref | GoogleScholarGoogle Scholar |

[47]  Finlayson T. Effects of stigma, sense of community, and self-esteem on the HIV sexual risk behaviors of African American and Latino men who have sex with men. Psychol Diss. 2007 Jun Available online at: http://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1029&context=psych_diss [verified 11 June 2016].

[48]  White D, Stephenson R. Identity formation, outness and sexual risk among gay and bisexual men. Am J Men Health 2014; 8 98–109.
Identity formation, outness and sexual risk among gay and bisexual men.Crossref | GoogleScholarGoogle Scholar |

[49]  Simon W, Gagnon JH. Sexual scripts: permanence and change. Arch Sex Behav 1986; 15 97–120.
Sexual scripts: permanence and change.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL283ktFertQ%3D%3D&md5=033bf2c875b5d47b3d8e47935a5a6d3dCAS |

[50]  Fishbein M, Ajzen I. Predicting and changing behavior: the reasoned action approach. 1st edn. New York: Psychology Press; 2009.

[51]  Young SD, Holloway I, Jaganath D, Rice E, Westmoreland D, Coates T. Project HOPE: online social network changes in an HIV prevention randomized controlled trial for African American and Latino men who have sex with men. Am J Public Health 2014; 104 1707–12.
Project HOPE: online social network changes in an HIV prevention randomized controlled trial for African American and Latino men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[52]  Berry M, Raymond HF, Kellogg T, McFarland W. The Internet, HIV serosorting and transmission risk among men who have sex with men, San Francisco. AIDS 2008; 22 787–9.
The Internet, HIV serosorting and transmission risk among men who have sex with men, San Francisco.Crossref | GoogleScholarGoogle Scholar |

[53]  Beymer MR, Weiss RE, Bolan RK, Rudy ET, Bourque LB, Rodriguez JP, Morisky DE. Sex on-demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles County. Sex Transm Infect 2014; 90 567–72.
Sex on-demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles County.Crossref | GoogleScholarGoogle Scholar |

[54]  Vallabhaneni S, Li X, Vittinghoff E, Donnell D, Pilcher CD, Buchbinder SP. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men. PLoS One 2012; 7 e45718
Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhsFWgsb7F&md5=b50483ac507b55c7e10f927b87757b86CAS |

[55]  Wang K, Brown K, Shen S-Y, Tucker J. Social network-based interventions to promote condom use: a systematic review. AIDS Behav 2011; 15 1298–308.
Social network-based interventions to promote condom use: a systematic review.Crossref | GoogleScholarGoogle Scholar |