Open AccessThe Effect of Using Geosocial Networking Apps on the HIV Incidence Rate Among Men Who Have Sex With Men: Eighteen-Month Prospective Cohort Study in Shenyang, China
Author(s) -
Junjie Xu,
Huan Yu,
Weiming Tang,
Sequoia I. Leuba,
Jing Zhang,
Xiang Mao,
Hongyi Wang,
Wenqing Geng,
Yongjun Jiang,
Hong Shang
Publication year - 2018
Publication title -
jmir. journal of medical internet research/journal of medical internet research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.446
H-Index - 142
eISSN - 1439-4456
pISSN - 1438-8871
DOI - 10.2196/11303
Subject(s) - men who have sex with men , medicine , demography , incidence (geometry) , recreational drug use , casual , cohort , prospective cohort study , human immunodeficiency virus (hiv) , syphilis , family medicine , physics , sociology , optics , materials science , composite material
Background Men who have sex with men (MSM) frequently seek partners through mobile apps (geosocial networking [GSN] apps). However, it is unclear whether GSN apps’ use is associated with the increase in HIV incidence among MSM. Objective The aim of this study was to clarify the characteristics of GSN apps’ users and to determine the association and putative mechanisms between GSN apps’ use behavior and HIV incidence. Methods We conducted an 18-month prospective cohort study of MSM in Shenyang, China, and the participants were surveyed every 3 months from March 2015 to December 2016. An in-person interview collected information on sociodemographics, GSN apps’ use, recreational drug use, and sexual behaviors. In addition, blood was drawn to test for HIV and syphilis. We used a multivariable Cox regression model to determine possible predictors for increased HIV incidence. Results Of the enrolled 686 HIV-negative MSM, 431 (431/686, 62.8%) were GSN apps’ users. Compared with GSN apps’ nonusers, GSN apps’ users were younger; had an earlier age of sexual debut; and in the past 3 months, were more likely to have used recreational drugs, more likely to have had 5 or more casual partners (CPs), more likely to have had group sex with males, and more likely to have had condomless anal intercourse (CAI) with male steady partners (SPs). In addition, 59.4% (256/431) of the GSN apps’ users were willing to accept HIV and AIDS prevention information push services through GSN apps. In total, 19 MSM seroconverted to HIV during the follow-up period; the HIV incidence density rate was 8.5 (95% CI 5.0-13.5) per 100 person-years (PY) among GSN apps’ users and 2.0 (95% CI 0.4-5.8) per 100 PY among nonusers. New HIV infections were independently associated with ever using GSN apps to seek male sexual partners ( P =.04) and in the past 3 months, using recreational drugs ( P =.048), having group sex with males ( P =.01), and having CAI with male CPs ( P =.02). Conclusions GSN apps’ use is associated with higher HIV incidence and may be mediated through recreational drug use and having multiple CPs. Researchers must develop an intervention propagated through GSN apps to reach this high-risk population to mitigate the HIV epidemic in the MSM community.