JMIR Publications

ABSTRACT

Background:

Men who have sex with men (MSM) residing outside of large urban areas are under-represented in research about online partner-seeking and sexual behaviors related to transmission of human immunodeficiency virus (HIV).

Objective:

We aimed to determine associations between the use of the Internet or geosocial networking applications (“apps”) to meet partners for sex and/or dating and sexual behaviors among MSM residing in small and midsized towns in Kentucky.

Methods:

Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18-34, who had recently (past 6 months) engaged in anal sex with another man, and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of app use for partner-seeking and HIV-related sexual behaviors.

Results:

Most participants (72%) reported using apps to seek partners for sex and/or dating. Two thirds (66%) had used apps to meet partners for sex and over half (54%) had used apps to meet partners for dating. Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report app use (aOR=0.22, 95%CI=0.07-0.68 and aOR=0.25, 95%CI=0.10-0.66). Increased number of insertive and receptive anal sex partners, and substance use before/during sex were associated with higher odds of app use (aOR=1.31, 95%CI=1.11-1.55; aOR=1.20, 95%CI=1.05-1.39; and aOR=2.50, 95%CI=1.41-4.44, respectively).

Conclusions:

Among app-using MSM who reside outside of large urban areas, HIV risk reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drugs use before or during sex. Non-app-using MSM are in need of continued outreach to reduce condomless anal sex.