School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.
Front Public Health. 2023 Feb 8;11:1063993. doi: 10.3389/fpubh.2023.1063993. eCollection 2023.
Men who have sex with men (MSM) are increasingly using geosocial networking (GSN) mobile applications (apps) to socialize in the community. Our study aimed to compare sexual behaviors between app-using MSM (app users) and non-app-using MSM (non-app users), and evaluate the association between app use and sexually transmitted infections (STIs).
Eligible MSM were recruited from January to August 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was collected about socio-demographic characteristics, sexual behaviors and app use. Blood samples were collected to test for HIV and syphilis. Rectal swabs taken by nurses and urine samples taken by participants themselves were collected to test for gonorrhea and chlamydia. Anogenital warts were checked by a clinician. Chi square tests and logistic regression were used to compare the prevalence of STIs and the characteristics between app users and non-app users.
A total of 572 MSM were included in our analysis, 59.9, 25.7, and 23.4% MSM were recruited from Guangzhou, Shenzhen, and Wuxi, respectively. The majority of participants were 20-29 years old (61.7%). 89.0% of MSM had ever used at least one GSN app, and 63.8% MSM had anal intercourse (AI) partners found apps. Among app users, 62.7% spent <30 min on apps per day on average in the past 6 months. Compared with non-app users, app users were more likely to have an education level of college and above [adjusted OR (AOR) 3.36, 95% confidence interval (CI) 1.65-7.03], have regular sex partners (2.40, 1.16-5.19), have two or more casual sex partners (2-5: 2.90, 1.21-6.90; ≥6: 13.91, 3.13-82.90), have condomless anal intercourse (CAI) with casual sex partners in the past 6 months (2.50, 1.28-5.04), do not know their last sex partners' HIV status (2.16, 1.13-4.21), have tested for HIV in the past year (2.09, 1.07-4.09) and be circumcised (4.07, 1.29-18.42). Prevalence of HIV (8.3 vs. 7.9%, = 0.93), syphilis (6.9 vs. 11.1%, = 0.34), gonorrhea (5.1 vs. 6.3%, = 0.90), chlamydia (18.5 vs. 12.7%, = 0.36), and anogenital warts (4.9 vs. 4.8%, = 1.00) were similar between app users and non-app users.
GSN app users were more likely to have high-risk sexual behaviors, but the prevalence of HIV and other STIs were similar to non-app users. Longitudinal studies comparing the incidence of HIV/STIs between long-term app users and non-app users may be necessary to clarify the impact of app use on HIV/STIs risk.
男男性行为者（MSM）越来越多地使用基于地理位置的社交网络（GSN）移动应用程序（apps）在社区中进行社交活动。我们的研究旨在比较使用和不使用应用程序的 MSM（app 用户和 non-app 用户）之间的性行为，并评估应用程序使用与性传播感染（STIs）之间的关联。
2017 年 1 月至 8 月，在广州、深圳和无锡三个大都市地区招募符合条件的 MSM。通过平板电脑自填式问卷收集社会人口统计学特征、性行为和应用程序使用情况。采集血液样本检测 HIV 和梅毒。由护士采集直肠拭子和参与者自行采集尿液样本检测淋病和衣原体。由临床医生检查肛门生殖器疣。使用卡方检验和 logistic 回归比较 STIs 的患病率以及 app 用户和 non-app 用户之间的特征。
共纳入 572 名 MSM 进行分析，分别有 59.9%、25.7%和 23.4%的 MSM 来自广州、深圳和无锡。大多数参与者年龄在 20-29 岁（61.7%）。89.0%的 MSM 曾至少使用过一种 GSN 应用程序，63.8%的 MSM 通过应用程序找到了肛交（AI）伙伴。在 app 用户中，62.7%的人在过去 6 个月中平均每天在应用程序上花费<30 分钟。与非 app 用户相比，app 用户更有可能具有大学及以上学历（调整后的 OR [AOR] 3.36，95%置信区间 [CI] 1.65-7.03），有规律的性伴侣（2.40，1.16-5.19），有两个或更多的临时性伴侣（2-5：2.90，1.21-6.90；≥6：13.91，3.13-82.90），在过去 6 个月内与临时性伴侣发生过无保护肛交（CAI）（2.50，1.28-5.04），不知道他们的最后一次性伴侣的 HIV 状况（2.16，1.13-4.21），在过去一年中进行过 HIV 检测（2.09，1.07-4.09）和接受过割礼（4.07，1.29-18.42）。HIV（8.3%与 7.9%， = 0.93）、梅毒（6.9%与 11.1%， = 0.34）、淋病（5.1%与 6.3%， = 0.90）、衣原体（18.5%与 12.7%， = 0.36）和肛门生殖器疣（4.9%与 4.8%， = 1.00）在 app 用户和 non-app 用户之间的发生率相似。
GSN app 用户更有可能发生高危性行为，但 HIV 和其他 STIs 的患病率与非 app 用户相似。为了阐明应用程序使用对 HIV/STIs 风险的影响，可能有必要对长期使用 app 的用户和非 app 用户的 HIV/STIs 发病率进行纵向比较研究。
