Abstract
BackgroundMen who have sex with men (MSM) frequently seek partners through mobile apps (geosocial networking [GSN] apps). However, it is unclear whether GSN apps’ use is associated with the increase in HIV incidence among MSM.ObjectiveThe aim of this study was to clarify the characteristics of GSN apps’ users and to determine the association and putative mechanisms between GSN apps’ use behavior and HIV incidence.MethodsWe conducted an 18-month prospective cohort study of MSM in Shenyang, China, and the participants were surveyed every 3 months from March 2015 to December 2016. An in-person interview collected information on sociodemographics, GSN apps’ use, recreational drug use, and sexual behaviors. In addition, blood was drawn to test for HIV and syphilis. We used a multivariable Cox regression model to determine possible predictors for increased HIV incidence.ResultsOf the enrolled 686 HIV-negative MSM, 431 (431/686, 62.8%) were GSN apps’ users. Compared with GSN apps’ nonusers, GSN apps’ users were younger; had an earlier age of sexual debut; and in the past 3 months, were more likely to have used recreational drugs, more likely to have had 5 or more casual partners (CPs), more likely to have had group sex with males, and more likely to have had condomless anal intercourse (CAI) with male steady partners (SPs). In addition, 59.4% (256/431) of the GSN apps’ users were willing to accept HIV and AIDS prevention information push services through GSN apps. In total, 19 MSM seroconverted to HIV during the follow-up period; the HIV incidence density rate was 8.5 (95% CI 5.0-13.5) per 100 person-years (PY) among GSN apps’ users and 2.0 (95% CI 0.4-5.8) per 100 PY among nonusers. New HIV infections were independently associated with ever using GSN apps to seek male sexual partners (P=.04) and in the past 3 months, using recreational drugs (P=.048), having group sex with males (P=.01), and having CAI with male CPs (P=.02).ConclusionsGSN apps’ use is associated with higher HIV incidence and may be mediated through recreational drug use and having multiple CPs. Researchers must develop an intervention propagated through GSN apps to reach this high-risk population to mitigate the HIV epidemic in the MSM community.
Highlights
BackgroundMen who have sex with men (MSM) are disproportionately affected by HIV [1,2,3]
A total of 761 MSM who had no prior positive HIV test were screened for HIV, of which 9.1% (69/761) individuals were detected as HIV-positive and excluded from this study
A total of 686 eligible HIV-negative MSM were included in this prospective cohort study, of which 431 (431/686, 62.8%) self-identified as geosocial networking (GSN) apps’ users and 255 (255/686, 37.2%) as nonusers (Figure 1)
Summary
BackgroundMen who have sex with men (MSM) are disproportionately affected by HIV [1,2,3]. With the current popularity of smartphones, tablets, or computers with geosocial networking (GSN) abilities, a large number of GSN apps have been developed and are widely used by MSM. These GSN apps have revolutionized social communication and how MSM seek casual partners (CPs) or multiple sexual partners [6,7,8,9,10]. Men who have sex with men (MSM) frequently seek partners through mobile apps (geosocial networking [GSN] apps) It is unclear whether GSN apps’ use is associated with the increase in HIV incidence among MSM
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