William C. Goedel

Geosocial-Networking App Usage Patterns of Gay, Bisexual, and Other Men Who Have Sex With Men: Survey Among Users of Grindr, A Mobile Dating App.

Background Geosocial-networking apps like Grindr have been used increasingly among men who have sex with men (MSM) to meet anonymous partners. These mobile dating apps employ global positioning system technology to facilitate connections with other users based on their current location. These new technologies have generated quicker and easier modes for men who have sex with men to meet potential partners based on attraction and physical proximity. Objective The aim of this study is to describe geosocial-networking app use and recent sexual behaviors of MSM in the Atlanta metropolitan statistical area. Methods Our sample was recruited from Grindr, the most commonly used of these mobile apps among MSM, using broadcast advertising. Advertisements were displayed over the course of a 72-hour period and participants were directed to a Web-based survey. Results In total, 604 men clicked through the advertisement, and 92 users completed the survey. One-third (38.0%) of the men reported using these mobile apps to meet new sexual partners, and one-fifth (18.5%) used them to “kill time” when bored. Men reporting currently being in a relationship were less likely to report using these mobile apps to meet other MSM to date or to find a boyfriend or romantic partner, but more likely to report using these mobile apps to meet other MSM to have sex, X 2 24=12.1, P=.016. Respondents had current accounts on 3.11 mobile apps (SD 1.84) on average, with Grindr being the most common (100%), followed by Scruff (52.5%), and Jack’d (45.7%). Most men were most active in the late night (40.2%), and on weekdays (64.1%). Each day, on average, men reported opening these mobile apps 8.38 times (SD 8.10) and spent 1.31 hours (SD 1.15) on these mobile apps. The age respondents began using these mobile apps was associated with the age at their first instance of insertive anal sex (r80=.527, P<.001) and receptive anal sex (r76=.527, P<.001). Conclusions These findings suggest that MSM use multiple mobile apps and spend significant time on them. For these reasons, HIV prevention interventions could be delivered on these mobile apps.

HIV Risk Behaviors, Perceptions, and Testing and Preexposure Prophylaxis (PrEP) Awareness/Use in Grindr-Using Men Who Have Sex With Men in Atlanta, Georgia

&NA; Geosocial‐networking smartphone applications such as Grindr can help men who have sex with men (MSM) meet sexual partners. Given the high incidence of HIV in the Deep South, the purpose of our study was to assess HIV risk and preexposure prophylaxis (PrEP) awareness and use in a sample of HIV‐uninfected, Grindr‐using MSM residing in Atlanta, Georgia (n = 84). Most (n = 71; 84.6%) reported being somewhat or very concerned about becoming HIV infected. Most (n = 74; 88.1%) had been tested for HIV in their lifetimes. About three fourths (n = 65; 77.4%) were aware of PrEP, but only 11.9% currently used the medication. HIV continues to disproportionately impact MSM and represents a significant source of concern. As the number of new infections continues to rise, it is important to decrease risks associated with acquisition and transmission of HIV by increasing rates of HIV testing and the use of biobehavioral interventions such as PrEP.

Feasibility and Acceptability of Global Positioning System (GPS) Methods to Study the Spatial Contexts of Substance Use and Sexual Risk Behaviors among Young Men Who Have Sex with Men in New York City: A P18 Cohort Sub-Study.

Background No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population. Methods Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre- and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre- and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics. Results Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days. Conclusions Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors.

Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men

OBJECTIVES The purpose of this study was to evaluate the prevalence of poor sleep health (ie, poor sleep quality and short sleep duration) in a sample of men who have sex with men (MSM). In addition, this study examined whether poor sleep health was associated with depressive symptoms, substance use, and sexual risk behaviors in this sample. DESIGN Cross-sectional survey. PARTICIPANTS Broadcast advertisements were placed on a popular smartphone application for MSM in January 2016 to recruit users in the London metropolitan area (n=202) to complete a Web-based survey, which included validated measures of sleep quality and duration. MEASUREMENTS Poor sleep quality was defined based on self-report as very or fairly bad. Short sleep duration was defined as less than 7 hours each night. Regression models were used to assess associations between sleep variables and self-reported depressive symptoms, substance use, and sexual risk behaviors. RESULTS About one-third (34.6%) of the respondents reported poor sleep quality and almost half (43.6%) reported sleeping less than 7 hours every night. Several poor sleep health variables were independently associated with depressive symptoms, substance use (eg, use of alcohol or marijuana), and condomless anal intercourse. For example, typical nightly sleep duration of less than 7 hours was associated with condomless receptive anal intercourse with a higher number of sexual partners (incidence rate ratio, 2.65; 95% confidence interval: 1.63-4.30; P<.001). CONCLUSION Sleep health promotion interventions should be developed for MSM, which may promote positive mental health as well as reduce substance use and sexual risk behaviors in this population.

A Study of Intimate Partner Violence, Substance Abuse, and Sexual Risk Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in a Sample of Geosocial-Networking Smartphone Application Users

Geosocial-networking smartphone applications (“apps”) are widely used by gay, bisexual, and other men who have sex with men (MSM) and facilitate connections between users based on proximity and attraction. MSM have sexual encounters and relationships of varying degrees of emotional and physical intimacy with app-met individuals, potentially placing them at risk for intimate partner violence (IPV). The purpose of the current study was to utilize a geosocial-networking application to investigate relationships between experiences of IPV victimization as it relates to substance use and sexual risk behaviors in a sample of MSM. Participants (n = 175) were recruited by means of broadcast advertisements on an application widely used by MSM (Grindr) to seek sexual partners. Multivariable regression models were fit to examine associations between IPV, substance abuse, and sexual risk behaviors. Lifetime experiences of IPV victimization were common, where 37.7% of respondents reported having experienced at least one form of IPV. While a marginally significant positive association between IPV and substance abuse was detected in multivariable models (p = .095), individual forms of IPV were strongly associated with substance abuse. For example, sexual IPV victimization was associated with an increase in substance abuse in the preceding month (p = .004). Experiences of IPV victimization were associated with higher numbers of partners for both condomless receptive and insertive anal intercourse (p < .05). Given the relatively high prevalence of IPV victimization and its associations with substance abuse and sexual risk behaviors, these findings suggest that IPV screening and prevention programs may reduce substance abuse and sexual risk behaviors in this population.

Behavior- and Partner-Based HIV Risk Perception and Sexual Risk Behaviors in Men Who Have Sex with Men (MSM) Who Use Geosocial-Networking Smartphone Applications in New York City

Men who have sex with men (MSM) in the USA continue to be impacted disproportionately by HIV. MSM represent only 2 % of the male population in the USA, yet comprised 66.7 % of all new HIV infections diagnosed in 2014. As of 2014, there were an estimated 119,550 people living with HIV in New York City, where 72.6 % were male and 2718 new HIV diagnoses, where 80.7 % were male. In New York City, MSM represent 53.3 % of all males living with HIV and 73.8 % of all new HIV diagnoses among males. HIV is transmitted predominantly through sexual activity and its spread from individual to individual is affected by choices of partners, sexual behaviors, and condom use. Sexually active persons can reduce their risks of acquiring HIV by choosing a partner who has recently tested negative for HIV, by choosing sexual behaviors that are less likely to transmit HIV infection, and by choosing to use condoms or pre-exposure prophylaxis (PrEP). In gauging risk, MSM often make assumptions regarding HIV status based on stereotypes about HIV-positive people, but these assumptions may frequently be inaccurate. Sexual encounters between MSM, especially those that are facilitated by the use of geosocial-networking smartphone applications, may occur quickly with little discussion of each partner’s HIV status or sexual history beforehand, so users may rely on incorrect perceptions of what types of people are HIV-positive to make decisions regarding their sexual practices with their potential partners. Because these applications utilize global positioning system (GPS) technologies to connect users based on proximity and attraction, they have generated easier ways for MSM to meet casual sex partners. The use of these applications among MSM to meet sexual partners is pervasive, particularly in urban epicenters like New York City.

Contextual factors in geosocial-networking smartphone application use and engagement in condomless anal intercourse among gay, bisexual, and other men who have sex with men who use Grindr.

Background Geosocial-networking smartphone applications (apps) have been used increasingly by men who have sex with men (MSM) to meet new sexual partners. The purpose of this study was to examine associations between contexts of app use (e.g. using apps when drinking) and condomless anal intercourse among a sample of MSM who use these apps. METHODS MSM (n=174) in New York City were recruited through Grindr, a geosocial-networking app popular among MSM, using broadcast advertisements asking MSM to complete an Internet-based survey about their app use and sexual behaviours. Log-binomial regression models were fit to assess the association between each of the six app-use contexts (e.g. using apps when lonely, when drinking) and engagement in condomless insertive and receptive anal intercourse with one or more partners in the past 3 months. RESULTS Engagement in condomless receptive and insertive anal intercourse with one or more partners in the preceding 3 months was common (39.7% and 43.1% respectively) and was associated with several app-use contexts. For example, significant associations (P<0.05) were observed between alcohol and other drug use when using these apps and engagement in condomless receptive and insertive anal intercourse. CONCLUSION Given that 57.5% of respondents had engaged in condomless anal intercourse in the preceding 3 months and the associations of app-use contexts with condomless sexual behaviours, these findings suggest that reductions in substance use may lead to safer sexual practices among MSM who use apps to meet sexual partners.

Correlates of Engagement in Group Sex Events Among Men Who Have Sex with Men in London Who Use Geosocial-Networking Smartphone Applications

Men who have sex with men (MSM) who attend group sex events (GSEs) tend to also engage in high-risk sexual behaviors and substance use that may place them at additional increased risk for becoming infected with HIV. These sorts of events may be facilitated by the use of geosocial-networking smartphone applications, where MSM may have access to a large virtual pool of potential partners. The purpose of the current study was to examine the prevalence of recent engagement in GSEs and its demographic and behavioral correlates among a sample of MSM (n = 202). Log-binomial models were fit to assess correlates of engagement in GSEs in the preceding three months. Overall, 42.6% had engaged in a GSE in the preceding three months. In multivariable models, the use of inhalant nitrites (PR: 2.239; 95% CI: 1.119, 4.848; p = .024) and methamphetamine (PR: 7.601; 95% CI: 2.340, 24.691; p = .001) were associated with recent engagement in GSEs. Given the high prevalence of these potentially high-risk behaviors, future research should be conducted to examine the concurrent use of substance use and condom use at the GSEs to develop appropriate risk reduction interventions.

Serodiscussion, Perceived Seroconcordance, and Sexual Risk Behaviors among Dyads of Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in London

Serodiscussion—the mutual discussion of HIV statuses between sexual partners—can be viewed as an essential prerequisite for risk-reduction behaviors among men who have sex with men (MSM). The current study aimed to assess the prevalence of serodiscussion with one’s most recent sexual partner and its association with sexual behaviors with these partners. Broadcast advertisements were placed on a geosocial-networking smartphone application, encouraging users to complete an online survey. A total of 200 MSM completed the survey. Serodiscussion occurred in 43.5% of dyads, and it was most common in dyads where both partners were reported to be HIV positive, χ2(5) = 60.3, P < .001. Serodiscussion was associated with engagement in both condomless insertive, χ2(1) = 3.847, P = .046, and receptive anal intercourse, χ2(1) = 6.5, P = .011. However, there were no significant differences in how recently a respondent was tested for HIV, representing potentially high-risk scenarios.

Associations Between Perceived Weight Status, Body Dissatisfaction, and Self-Objectification on Sexual Sensation Seeking and Sexual Risk Behaviors Among Men Who Have Sex with Men Using Grindr.

ABSTRACT To date, various dimensions of body image and their associations with condom use have not been studied among men who have sex with men (MSM) who use geosocial-networking smartphone applications (“apps”) to meet new sexual partners. The purpose of the current study was to evaluate associations between weight perception, body dissatisfaction, and self-objectification with sexual behaviors among a sample of MSM (N = 92) recruited from Grindr, an app popular among MSM, to complete an online survey. Obese participants scored significantly higher on measures of body dissatisfaction and lower on measures of sexual sensation seeking. Decreased propensities to seek sexual sensations were associated with fewer sexual partners. By assessing associations between dimensions of body dissatisfaction and sexual risk behaviors, this study adds support to a theory of syndemics among MSM, which suggests that synergistically related biological, psychological, social, and behavioral factors disproportionately affect health and health-related behaviors in this population.