Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 20, 2020
Date Accepted: Jun 3, 2020
Influence of social media on sexualized drug use and chemsex among men who have sex with men in Hong Kong: an observational prospective cohort study
ABSTRACT
Background:
Sexualized drug use (SDU, use of any psychoactive substance before/during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate its worsening HIV epidemic.
Objective:
This observational prospective cohort study investigated factors predicting occurrence of SDU within a 6-month follow-up period among a sample of Hong Kong MSM. We hypothesized that perceptions related to SDU would mediate the association between influence of social media/gay apps and SDU during the follow-up period.
Methods:
Participants were Hong Kong Chinese-speaking men who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) of them completed another the telephone survey six months later. Logistic regression models and path analysis were fit.
Results:
At Month 6, 6.9% (28/407) and 4.4% (18/407) reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (on PrEP, history of HIV and other sexually transmitted infections, anal intercourse with non-regular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period. They were: 1) positive attitudes toward SDU (AOR: 1.19, 95%CI: 1.05, 1.36), 2) perceived significant others would support them having SDU (AOR: 1.15, 95%CI: 1.01, 1.30), and 3) perceived behavioral control of refraining from SDU (AOR: 0.76, 95%CI: 0.59, 0.98). Exposure to information supporting SDU on social media/gay apps was also significantly associated with SDU (AOR: 1.11, 95%CI: 1.01, 1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through the TPB (β=0.04, B=0.002, 95%CI=0.001 to 0.01).
Conclusions:
Social media/gap apps may be a major source of influence on MSM’s perceptions and hence actual behaviors related to SDU.
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