Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 29, 2020
Date Accepted: Jun 15, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
New challenges associated with Internet-related sexual behaviors: A cross-sectional study of the characteristics and risk factors of men who have sex with men in Zhejiang Province, China
ABSTRACT
Background:
Finding casual sex partners on the Internet has been considered as a new challenge for HIV transmission among men who have sex with men (MSM).
Objective:
To identify the characteristics and risk factors of men who have sex with men (MSM) finding casual sex partners on the Internet for a new challenge regarding HIV transmission.
Methods:
This was a cross-sectional study. Participants were enrolled by four community-based organizations (CBOs) through bathroom, bar and gay applications. Online survey was conducted to collected information on finding casual sex partners, HIV knowledge, HIV-risk behaviors.
Results:
Among 767 participants, 310(40.4%) reported ever finding causal sex partners on the Internet. Factors associated with finding casual sex partners online in multivariate logistic regression analysis included watching pornographic videos on the Internet more than once per week (adjusted odds ratio (aOR) = 1.881, 95% CI: 1.201–2.948), discussing “hooking-up online” with friends (aOR = 4.018, 95%CI: 2.910–5.548), and perceiving that the likelihood of HIV infection in online casual sex partners was “very high” (aOR = 2.034, 95%CI: 1.441–2.873) or “high/medium/low” (aOR = 2.548, 95% CI: 1.524–4.259). Among the 310 participants who reported finding casual sex partners online, 30.2% reported having unprotected sex with casual sex partners met online in the past 6 months. In multivariate logistic regression analysis, knowing the HIV infection status of online casual sex partners was significantly associated with a decreased risk of inconsistent condom use (aOR = 0.327, 95% CI: 0.167–0.642).
Conclusions:
Internet-based casual sexual behavior is becoming more prevalent, and the rate of unprotected sex among MSM in Zhejiang Province is high. Future HIV prevention approaches should emphasize the importance for MSM of proactively determining the HIV infection status of potential online casual sex partners.
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