Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 24, 2025
Date Accepted: Sep 9, 2025
Associations between online casual sexual behavior and HIV–related risk behaviors among men who have sex with men in Southeast China: A cross–sectional study
ABSTRACT
Background:
With the popularity and convenience of the internet, an increasing number of MSMs are searching for sexual partners online. The effect of web-based casual sexual behavior on other risky behaivors was unclear.
Objective:
To determine the characteristics of casual sex partners on the internet and their relationship with human immunodeficiency virus (HIV)-related risky sexual behaviors.
Methods:
A cross-sectional study was conducted. We evaluated 751 men who have sex with men (MSM) and were enrolled in four community-based organizations using bathroom, bar, and gay applications. An online survey was conducted to collect information on demographic characteristics, casual sex partners, HIV-related risky behaviors, and HIV prevention.
Results:
Of the participants, 40.2% (302/751) reported finding sex partners online in the last 6 months; 60.7% had sex with online partners at a hotel/karaoke lounge/club. According to the multivariate logistic regression, compared with MSM who did not find partners online, those who found casual sexual partners online were more likely to report finding casual sexual partners offline (odds ratio [OR]=9.298, 95% confidence interval [CI]: 5.958–14.829), having sexual intercourse without condoms after drinking alcohol (OR=1.803, 95% CI: 1.038–3.133), and having sexual intercourse without condoms after using stimulants (OR=2.340, 95% CI: 1.317–4.156).
Conclusions:
Internet-based casual sexual behaviors are becoming increasingly prevalent. The hotel/karaoke lounge/club was the main place where online sexual behavior occurred. There were relationships between finding casual sexual partners online and finding casual sexual partners offline, not using condoms after drinking alcohol and after using stimulants. Future HIV-prevention approaches should emphasize behavioral interventions for MSM in dating applications.
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