Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States.
Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States.
J Med Internet Res. 2022 Sep 22;24(9):e38244. doi: 10.2196/38244.
Geosocial networking (GSN) apps play a pivotal role in catalyzing sexual partnering, especially among men who have sex with men.
To quantify the prevalence and disparities in disclosure of pre-exposure prophylaxis (PrEP) use and COVID-19 vaccination among GSN app users, mostly men who have sex with men, in the United States.
Web-based Grindr profiles from the top 50 metropolitan areas as well as the 50 most rural counties in the United States by population were randomly sampled. Grindr provides an option to disclose current PrEP use (HIV positive, HIV negative, or HIV negative with PrEP use). The free text in all profiles was analyzed, and any mention of COVID-19 vaccination was recorded. Multivariable logistic regression to assess independent associations with PrEP disclosure and COVID-19 vaccination was performed. Imputation analyses were used to test the robustness of the results.
We evaluated 1889 urban and 384 rural profiles. Mean age among urban profiles was 32.9 (SD 9.6) years; mean age among rural profiles was 33.5 (SD 12.1) years (P=.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=.002 and P<.001, respectively). Reporting COVID-19 vaccination (adjusted odds ratio [aOR] 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), having a "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 their profile. Users in the southern United States were less likely to report COVID-19 vaccination status than those in the northeast United States (aOR 0.6, 95% CI 0.3-0.9).
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. The data demonstrate a need to expand health preventative services in the rural United States for sexual minorities. GSN platforms may be ideal for deployment of preventative interventions to improve access for this difficult-to-reach population.
社交地理位置网络（GSN）应用在促进性伴侣关系方面发挥了关键作用，尤其是在男男性行为者中。
在美国，定量评估 GSN 应用用户（主要是男男性行为者）中报告使用暴露前预防（PrEP）和 COVID-19 疫苗接种的流行率和差异。
从美国人口最多的前 50 个大都市区和人口最多的 50 个农村县的 Grindr 在线资料中随机抽取样本。Grindr 提供了一个选项，可以披露当前 PrEP 的使用情况（HIV 阳性、HIV 阴性或 HIV 阴性但使用 PrEP）。分析所有资料中的自由文本，并记录任何提及 COVID-19 疫苗接种的内容。使用多变量逻辑回归来评估与 PrEP 披露和 COVID-19 疫苗接种独立相关的因素。使用插补分析来测试结果的稳健性。
我们评估了 1889 个城市和 384 个农村资料。城市资料中平均年龄为 32.9（标准差 9.6）岁；农村资料中平均年龄为 33.5（标准差 12.1）岁（P=.41）。在城市资料中，16%的人报告接种了 COVID-19 疫苗，23%的人报告使用了 PrEP，而农村资料中的这一比例分别为 10%和 8%（P=.002 和 P<.001）。报告 COVID-19 疫苗接种（调整后的优势比 [aOR] 1.7，95%置信区间 [CI] 1.2-2.4）、居住在城市中心（aOR 3.2，95%CI 1.8-5.7）和在 Grindr 资料中展示面部照片（aOR 4.0，95%CI 2.3-7.0）与 PrEP 披露呈正相关。自我认定为黑人或拉丁裔的用户更不可能报告使用 PrEP（aOR 0.6，95%CI 0.4-0.9 和 aOR 0.5，95%CI 0.4-0.9）。报告使用 PrEP（aOR 1.7，95%CI 1.2-2.4）、居住在城市中心（aOR 2.5，95%CI 1.4-4.5）、状态为“谨慎”（aOR 1.6，95%CI 1.0-2.5）和展示面部照片（aOR 2.7，95%CI 1.5-4.8）与报告 COVID-19 疫苗接种状态呈正相关。与美国东北部相比，美国南部的用户更不可能报告 COVID-19 疫苗接种状态（aOR 0.6，95%CI 0.3-0.9）。
PrEP 披露的差异与种族有关，而 COVID-19 疫苗接种披露的差异与地理位置有关。然而，农村 GSN 用户更不可能报告 PrEP 使用和 COVID-19 疫苗接种。这些数据表明，美国农村地区需要扩大性少数群体的预防性服务。GSN 平台可能是为这一难以接触到的人群提供预防性干预措施的理想选择。
