Network Influences on HIV Risk Behaviors of Gay, Bisexual and Other Men Who Have Sex with Men Using Geosocial Networking Applications

Introduction: HIV remains a pressing public health issue among gay, bisexual, and other men who have sex with men (MSM). While efforts to prevent HIV transmission in this population have typically focused on individual-level behaviors, such as consistent condom use and regular HIV testing, recent evidence has demonstrated the importance of contextual factors on HIV risk, including where MSM meet sex partners. Geosocial networking applications (GSN apps) have become increasingly popular among MSM. However, it unclear to what extent MSM who use GSN apps integrate app users into their social networks and how similar or different sexual health norms are among GSN app-met social network members compared to those met elsewhere.

Methods: A probability sample of GSN app using MSM (N=295) were recruited in Los Angeles, California. Utilizing the geo-location feature of a popular GSN app, eligible and potential participants were randomly selected to receive a text message via the app providing information about the study. Interested participants received a link and unique log-in code to an anonymous, online survey, which took approximately 20-30 minutes to complete. Participants who indicated their consent were surveyed about demographic characteristics, GSN app use, their five closest social network members, and three primary sexual behavior outcomes (i.e., number of recent sex partners, UAI at last sex, and UAI with last GSN app-met partner). Statistically significant variables at the bivariate level and theoretically important covariates were included in multivariate regression models for each of the three outcomes.

Results: Approximately 20% of participants included a GSN app-met individual as one of their top five closest social network members. Those with a GSN app-met network member had more recent (past 30-day) sexual partners (B=1.21, p<0.05), were nearly twice as likely to have engaged in unprotected anal intercourse (UAI) with their last sexual partner (AOR=2.02, p<0.05), and were nearly four times as likely to have engaged in UAI with their last GSN app-met sexual partner (AOR=3.98, p<0.001). In multivariate analyses, including a GSN app-met partner in one’s network was the strongest predictor of having more recent sex partners and having engaged in UAI at last sex and with last GSN app-met partner after adjusting for all other covariates.

Conclusion: To date, this study is the first to examine social network characteristics of GSN app-using MSM and demonstrates the importance of considering network variables in the analysis of risk behaviors among this population. Additionally, network-based interventions delivered via GSN apps may be useful in preventing the spread of HIV among MSM.