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      Relationship between gay app use and HIV testing among men who have sex with men in Shenzhen, China: a serial cross-sectional study

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          Abstract

          Objectives

          To investigate the relationship between gay app use and HIV testing among men who have sex with men (MSM).

          Design

          Serial cross-sectional study.

          Setting

          A newly well-developed city in China.

          Participants

          4935 MSM were recruited through offline sampling methods from 2015 to 2017.

          Primary and secondary outcomes

          The primary outcome is the difference in HIV testing between app and non-app users.

          Results

          2872 (58.2%) and 2159 (43.7%) participated MSM had been tested for HIV within lifetime and the past year, respectively. Compared with non-app-using MSM, app-using MSM had a significantly higher prevalence of HIV testing within lifetime (adjusted OR (AOR): 1.48, 95% CI 1.27 to 1.72) and the past year (AOR: 1.36, 95% CI 1.18 to 1.57). App-using MSM were more likely to take an HIV test at the Centers for Disease Control and Prevention (AOR: 1.48, 95% CI 1.24 to 1.76) and community-based organisations (AOR: 1.71, 95% CI 1.44 to 2.03), but less often at gay venues (AOR: 0.49, 95% CI 0.37 to 0.63). Meanwhile, app-using MSM were more likely to take self-testing (AOR: 1.61, 95% CI 1.21 to 2.14). Predictors of HIV testing in the past year were: having an education level of college or higher (AOR: 1.29, 95% CI 1.01 to 1.65), being self-identified as a homosexual (AOR: 1.23, 95% CI 1.02 to 1.46), being recruited through clinic-based sampling (AOR: 1.30, 95% CI 1.06 to 1.60), using gay app (AOR: 1.49, 95% CI 1.21 to 1.83), engaging in group sex (AOR: 1.64, 95% CI 1.23 to 2.19), having received HIV-related service (AOR: 5.49, 95% CI 4.57 to 6.60), having a high level of HIV-related knowledge (AOR: 1.33, 95% CI 1.10 to 1.61) and high-risk perception (AOR: 2.95, 95% CI 1.40 to 6.23).

          Conclusions

          Gay app use was significantly associated with increased HIV testing among MSM hard to reach by traditional outreach. Therefore, it is imperative to expand HIV testing among non-app-using MSM. Continued efforts, innovative strategies and increased resource are highly needed to realise the first ‘90’ target.

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          Most cited references20

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          Characteristics of Men Who Have Sex With Men Who Use Smartphone Geosocial Networking Applications and Implications for HIV Interventions: A Systematic Review and Meta-Analysis.

          Huachun Zou, Song Fan (2017)
          Men who have sex with men (MSM) are increasingly using geosocial networking (GSN) mobile applications (apps) designed for MSM to socialize and seek sex partners. We systematically reviewed studies on the characteristics of app-using MSM and the potential feasibility of app-based HIV interventions. Existing studies provided limited parameters to compare characteristics and sexual behaviors between app-using and non-app-using MSM. Available data showed that: compared to non-app-using MSM, app-using MSM tended to be younger, identified as White (in the US and Australia), have higher educational level, report higher incomes, and had a higher rate of engagement in risky sexual behaviors and STIs. Compared to non-app-using MSM, app-using MSM were more likely to have tested for HIV in lifetime (Pooled odds ratio = 2.1, 95 % confidence interval: 1.7-2.6) and have similar HIV prevalence. Up to 676 MSM were recruited in 1 day via apps. In the current literature, there was a lack of (1) comparable parameters to measure sexual risk; (2) large longitudinal studies to clarify behavioral changes and HIV/STI incidence over time, comparing app-using and non-app-using MSM; (3) studies to examine the feasibility and efficacy of using apps to promote HIV testing among MSM; and (4) studies on similar topics from countries other than the US, Australia, and China. MSM GSN apps should be utilized in future HIV prevention and control endeavors. Researchers and health providers should collaborate with GSN app developers on these endeavors.
          Article 0 comments Cited 72 times – based on 0 reviews     Review now
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            Social Networking Smartphone Applications and Sexual Health Outcomes among Men Who Have Sex with Men

            Justin Lehmiller, Michael Ioerger (2014)
            Several smartphone applications (apps) designed to help men who have sex with men (MSM) find casual sexual partners have appeared on the market recently. Apps of this nature have the potential to impact sexual health and behavior by providing constant access to a large supply of available partners. In this study, the sexual health history, behavior, and personality of MSM who use these apps was compared to MSM who meet partners in other ways. A sample of 110 adult MSM was recruited online to complete a cross-sectional survey. All participants were either single or involved in a non-exclusive romantic relationship. There were no statistically significant differences between app users and non-users in frequency of insertive or receptive anal sex without a condom. However, app users reported significantly more sexual partners and had a higher prevalence of ever being diagnosed with an STI than did non-users. App users did not differ from non-users on any demographic or personality variables (including erotophilia, sensation seeking, and self-control); however, when adjusting lifetime total sex partners for those met specifically through apps, app users still had significantly more partners. This pattern of results suggests that app users may be more sexually active in general. More work is needed to fully understand the association between this emerging technology and potential sexual health risks.
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              Point-of-care testing for sexually transmitted infections: recent advances and implications for disease control.

              Joseph Tucker, Cedric Bien, Rosanna Peeling (2013)
              Sexually transmitted infections (STIs) remain a major global public health issue, with more than 448 million incident bacterial infections each year. We review recent advances in STI point-of-care (POC) testing and implications for STI prevention and control. Accurate immunochromatographic assays to detect HIV, hepatitis C virus (HCV) and syphilis antibodies have made home or supervised self-testing possible. Several studies have demonstrated feasibility and excellent test characteristics for HIV, HCV and syphilis POC tests. Rapid oral HIV tests are now available for purchase at retail sites across the United States. Combined HIV and syphilis tests using a single finger prick blood sample are under evaluation. Oral POC STI tests with comparable performance to blood-based POC tests are available for self-testing. POC tests can expand screening, improve syndromic management and reduce loss to follow up. POC STI tests have the potential to facilitate prompt treatment and partner services. POC STI tests create opportunities for new social and financial models of community-based testing services. Increasing equity and access to testing will create challenges in linkage to care, quality assurance, partner services and surveillance. These important developments warrant research to understand appropriate contexts for implementation.
              Article 0 comments Cited 51 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2019
                Publication date (Electronic): 24 August 2019
                Volume: 9
                Issue: 8
                Electronic Location Identifier: e028933
                Affiliations
                [1 ] departmentDepartment of AIDS Control and Prevention , Shenzhen Center for Disease Control and Prevention , Shenzhen, China
                [2 ] departmentTongji Medical College , Huazhong University of Science and Technology , Wuhan, China
                Author notes
                [Correspondence to ] Dr Jinquan Cheng; cjinquan@ 123456szcdc.net
                Article
                Publisher ID: bmjopen-2019-028933
                DOI: 10.1136/bmjopen-2019-028933
                PMC ID: 6721534
                PubMed ID: 31446409
                SO-VID: 44dae50f-bd7f-4fa3-8720-36418dca1a29
                Copyright © © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 04 January 2019
                Date revision received : 05 July 2019
                Date accepted : 10 July 2019
                Funding
                Funded by: San-Ming Project of Medicine in Shenzhen;
                Award ID: SZSM201811007
                Funded by: Shenzhen Municipal Technological Project;
                Award ID: JCYJ20170306160440762
                Funded by: National Science and Technology Major Project of the Ministry of Science and Technology of China;
                Award ID: 2018ZX10715004
                Categories
                Subject: Epidemiology
                Subject: Research
                Subject: 1506
                Subject: 1692
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                ScienceOpen disciplines: Medicine
                Keywords: hiv testing,gay app,testing approach,msm
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: hiv testing, gay app, testing approach, msm

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