Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 24, 2022
Open Peer Review Period: Mar 24, 2022 - May 19, 2022
Date Accepted: Apr 25, 2022
Date Submitted to PubMed: Aug 26, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Engagement with HIV and COVID-19 prevention within a geosocial networking app: a tale of two pandemics
ABSTRACT
Background:
Geosocial networking (GSN) apps play a pivotal role in catalyzing sexual partnering, especially among men who have sex with men (MSM).
Objective:
To quantify the United States (US) prevalence and disparities in disclosure of pre-exposure prophylaxis (PrEP) use and COVID-19 vaccination among GSN app users, mostly MSM.
Methods:
We randomly sampled online Grindr profiles from the top 50 metropolitan areas as well as the 50 most rural counties in the US by population. Grindr provides an option to disclose current PrEP use (HIV positive, HIV negative, or HIV negative with PrEP use). We analyzed the free text in all profiles and recorded any mention of COVID-19 vaccination, which is passively reported. We performed multivariable logistic regression to assess independent associations with PrEP disclosure and COVID-19 vaccination. We used imputation analyses to test the robustness of the results.
Results:
We evaluated 1,889 urban and 384 rural profiles. Mean age among urban profiles was 32.9 years (SD 9.6); mean age among rural profiles was 33.5 years (SD 12.1), p=0.41. Among the urban profiles, 16% reported being vaccinated against COVID-19 and 23% reported PrEP use compared to 10% and 8% in rural profiles, respectively (p<0.01). Reporting COVID-19 vaccination (adjusted OR 1.7, 95%CI 1.2-2.4), living in an urban center (aOR 3.2, 95%CI 1.8-5.7), and showing a face picture as part of the Grindr profile (aOR 4.0, 95%CI 2.3-7.0) were positively associated with PrEP disclosure. Self-identified Black and Latino users were less likely to report PrEP use (aOR 0.6, 95%CI 0.4-0.9 and aOR 0.5, 95%CI 0.4-0.9, respectively). Reporting PrEP use (aOR 1.7, 95%CI 1.2-2.4), living in an urban center (aOR 2.5, 95%CI 1.4-4.5), ‘discreet’ status (aOR 1.6, 95%CI 1.0-2.5), and showing a face picture (aOR 2.7, 95%CI 1.5-4.8) were positively associated with reporting COVID-19 vaccination on the profile. Users in the southern US were less likely than users in the northeast to report COVID-19 vaccination (aOR 0.6, 95%CI 0.3-0.9).
Conclusions:
Variations in PrEP disclosure are associated with race, whereas COVID-19 vaccination disclosure is associated with geographic area. However, rural GSN users were less likely to report both PrEP use and COVID-19 vaccination. We demonstrate a need to expand health preventative services in the rural US for sexual minorities. GSN platforms may be ideal for deployment of preventative interventions to improve access for this difficult to reach population. Clinical Trial: n/a
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.