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Geosocial networking applications e. Of these, most reported having oral Of those who reported having anal sex, Relative to those who used only non-MSM-specific apps, MSM-specific app users reported more sex partners and condomless anal sex partners, greater perceived risk of HIV, more engagement in sexual health services, and greater odds of HIV testing.
Geosocial networking applications are widely used by adult men who have sex with men MSM in the United States to meet partners for sex and dating. Moreover, some studies indicate MSM are less likely to use condoms with partners met via hookup apps, 11 though evidence for this is equivocal.
Indeed, studies of adolescent sexual behavior and internet use indicate that relative to heterosexual youth, gay adolescents are more likely to report online partner seeking 1920 and unprotected sex with a partner met online, 19 and these behavior patterns may generalize to MSM-specific hookup apps. Finally, hookup app use poses legal risks if AMSM are under the legal age of consent in their state and have adult partners.
To date, no empirical studies have examined hookup app usage patterns among AMSM. Reasons for this lack of research may include the fact that studies on MSM app use often recruit participants from the apps, whose terms of service require users to be over 18, as well as actual and perceived barriers among researchers to conducting research on sexual behavior in sexual minority adolescents. This study sought to describe patterns of hookup app use among AMSM and examine relationships between their hookup app use and HIV risk and preventive behaviors.
As part of a larger study, 24 — 26 AMSM aged 14—17 were recruited from December to February through paid Facebook advertisements to complete an online survey on ethical issues in adolescent HIV prevention research. Clicking on the advertisement directed the individual to a brief eligibility survey.
Eligible individuals reviewed an online consent form and were automatically routed to the survey upon confirming consent.
Participants completed items assessing age, race and ethnicity, birth-ased sex, gender identity, sexual orientation, and sexual orientation disclosure i. Items included of lifetime anal sex partners, of lifetime condomless anal sex CAS partners, and frequency of substance and alcohol use before sex in the past 12 months.
Two other items assessed whether participants had ever been tested for HIV in their lifetime and whether they had been tested for STIs in the past year. For analysis, participants were grouped based on whether they endorsed using any MSM-hookup apps MSM-app usersusing exclusively sites or apps other than MSM-hookup apps other-app usersand using no apps non-users.
Participants who did not report using an MSM-specific app did not receive any other questions about app use and continued to other parts of the survey. MSM-app users were routed to additional items asking for more detail on how they had used the MSM-specific mobile apps e. Those who endorsed meeting a man from an MSM-specific app in person were asked what types of sexual acts, if any, they had engaged in with those men.
Finally, those who reported having had anal sex with a partner met from an app were asked about the frequency of sex and condom use with those partners. Among MSM-app users, we similarly assessed group differences between those who had anal sex with a partner met from an app and those who had not. The type of regression was matched to the dependent variable structure: negative binomial for counts, linear for continuous, and logistic for binary outcomes. Finally, we conducted the same multivariable analyses with having had anal sex with a partner met from an MSM-specific app as the independent variable.
Participant characteristics are presented in Table 1.
Hookup app use, sexual behavior, and sexual health among adolescent men who have sex with men in the united states
Most participants identified as male Thirty-five percent of participants reported ever having an HIV test, and Outcomes did not differ by geographic location or urbanicity. App use and sexual behaviors are also presented in Table 1. Over half of participants endorsed using Grindr Over half of participants endorsed using general social media to meet other male partners Of the forty participants Overall, Of the AMSM who reported ever using any apps or websites to meet male partners, the vast majority Of the AMSM who reported using one of the four listed MSM-specific apps, the most frequently endorsed reason for using the apps was to meet men in person for sex Curiosity was mentioned by three participants in the subsequent free-response item.
MSM-app users also reported having a variety of relationships with men met from the apps, including hookups Regardless of relationship type, a majority of MSM-app users reported engaging in oral sex Finally, of the 64 who reported having had anal sex, most had anal sex with the partners more than once Group differences among all participants by their level of app engagement i.
Regarding demographic characteristics, MSM-app users were slightly older, and a larger percentage had exclusively male sex partners relative to other-app users and non-users. Non-users reported the greatest proportion of lifetime HIV testing Non-users were not statistically similar to either MSM-app or other-app users and were excluded from further analyses.
Group differences among MSM-app users by whether or not they had sex with a partner met from the apps are presented in Table 3. MSM-app users who had anal sex with a partner met from the apps were slightly Ladies seeking sex Puckett Mississippi, reported a greater of male sex partners and male CAS partners, and were more likely to report having an HIV test in their lifetime and an STI test in the past year relative to those who did not have anal sex with a partner met from the apps.
After ing for demographic variables, MSM-app use was associated with having twice as many male sex partners as well as twice as many male CAS partners. MSM-app use was also associated with greater perceived risk of HIV, more engagement in sexual health services, and 2.
In the parallel regression models among MSM-app users Table 5having had anal sex with a partner met through an MSM-app was associated with almost three times the of male sex partners and 3. Anal sex with a partner met from an MSM-specific app was also ificantly associated with 2. While participants in our study most frequently reported using MSM-specific apps to meet partners for sex, a majority also endorsed nonsexual purposes.
These reasons for use echo findings among adult samples. The motivations behind the selection of media may be nuanced: Holloway and colleagues 4 reported that among MSM aged 18—24, Grindr, Facebook, and dating sites were more likely used for making new friends, connecting with existing friends, and meeting people for sex, respectively. Future research among AMSM should examine whether they also make such distinctions.
Regardless, participants in our sample reported using MSM-apps largely because they felt they lacked access to other MSM nearby, which has been voiced by other samples of sexual minority youth. AMSM have a smaller pool of potential partners relative to their heterosexual peers due to the smaller size of the sexual minority community, as well as the relative lack of sexual minority male peers who are out in any given school, where youth tend to meet partners. MSM-apps provide a forum to meet sex partners quickly and easily and communicate specific risk-related desires e.
Adolescents may be relatively inexperienced at understanding and negotiating such communication, leading to offline outcomes in which sexual risk may be expected. Regardless of the reasoning behind the increased risk, the data suggest that AMSM may be aware of their Ladies seeking sex Puckett Mississippi behavior and utilize sexual health services accordingly. Similar to findings from adult samples, 31 youth who used MSM-specific apps reported greater odds of HIV testing and more use of sexual health services compared to peers who only used other apps.
Increased testing and use of sexual health services could be linked to the fact that sexual health outreach is increasingly common on MSM-specific apps, and the fact that user profiles often describe sexual health information such as last HIV testing date and PrEP use. As our suggest that underage MSM-app use is not uncommon, strategies that increase the safety of both adolescent and legal adult users are needed.
AMSM hookup app users may post personal information and share sexually explicit pictures of themselves, but youth could be prosecuted for sexting pictures of themselves to potential partners. Adult users, who may knowingly or unknowingly interact with AMSM online, may risk greater legal consequences should their interactions escalate to sexual contact offline. Finally, AMSM who meet adult partners online could be at higher risk of sexual victimization and HIV infection associated with age-discrepant sexual relationships. Our study was not without limitations. First, we used a cross-sectional de with a moderately-sized sample of AMSM, which precludes our drawing causal links and hinders our ability to generalize to larger populations.
Third, we recruited participants primarily from Facebook and Instagram, and it is possible these youth may differ from those recruited from MSM-apps or the community. Fourth, our measures may have been a limiting factor.
Nevertheless, these provide an initial glance into a phenomenon that warrants future research. To the former, MSM-apps could be a forum through which to educate young users about HIV risk behaviors and sexual health responsibilities e. However, this must be preceded by education about navigating online interactions, dating, and sex to protect themselves from negative encounters that may stem from such venues.
As the internet and connected technologies evolve further, continued attention to how young people adopt new media is critical. This study examined and demonstrated normative use of MSM-specific geosocial networking applications among adolescent men who have sex with men, which has ethical, legal, and sexual health considerations.
This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose.
The study sponsor was not involved in study de, collection, analysis, or interpretation of data, the writing of this report, or the decision to submit this manuscript for publication. Kathryn Macapagal, David Moskowitz, Dennis Li, and Andres Carrion wrote the first draft of the manuscript and were not given honoraria to produce this manuscript.
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