Epidemiology, Sexual Risk Behavior, and HIV Prevention Practices of Men who Have Sex with Men Using GRINDR in Los Angeles, California
01 Aug 2013-Journal of Urban Health-bulletin of The New York Academy of Medicine (Springer US)-Vol. 90, Iss: 4, pp 729-739
TL;DR: Men recruited via GRINDR were high risk for HIV acquisition or transmission and interested in clinical trial participation, suggesting potential for this method to be used for recruitment of YMSM to HIV prevention trials.
Abstract: Young men who have sex with men (YMSM) are at alarming risk for HIV acquisition, demonstrating the highest rates of incident infection of any age-risk group. GRINDR is a global positioning service-based social networking application popular with YMSM for sexual partnering. To assess the characteristics of YMSM who use GRINDR, we conducted a computer-assisted self-interview-based survey of 375 YMSM using GRINDR in metropolitan Los Angeles, recruited using the GRINDR platform. The median age was 25 (interquartile range, 22–27) years old, 42.4 % caucasian, 6.4 % African American, 33.6 % Latino, and 14.1 % Asian/Pacific Islander. Participants reported high rates of sexual partnering and unprotected anal intercourse (UAI). The majority (70 %) of those reporting unprotected anal intercourse reported low perception of HIV-acquisition risk. Of the participants, 83.1 % reported HIV testing within the past 12 months; 4.3 % had never been HIV tested. Of the participants, 4.5 % reported HIV-positive serostatus; 51.7 % indicated that they would be interested in participating in a future HIV prevention trial. Latinos were more likely than either caucasians or African Americans to endorse trial participation interest (odds ratio, 1.9; 95 % confidence interval [1.1–3.3]). HIV-positive test results were associated with increased number of anal sex partners in the past 3 months (adjusted odds ratio (AOR), 1.53 [0.97–2.40]), inconsistent inquiry about partners’ serostatus (AOR, 3.63 [1.37–9.64]), reporting the purpose for GRINDR use including “friendship” (AOR, 0.17 [0.03–1.06), and meeting a sexual partner in a bookstore in the past 3 months (AOR, 33.84 [0.99–1152]). Men recruited via GRINDR were high risk for HIV acquisition or transmission and interested in clinical trial participation, suggesting potential for this method to be used for recruitment of YMSM to HIV prevention trials.
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TL;DR: The historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013 are documented—including shifting technology as well as research methods to study gay andisexual men online.
Abstract: We document the historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013-including shifting technology as well as research methods to study gay and bisexual men online. Gay and bisexual men have rapidly taken to using the Internet for sexual purposes: for health information seeking, finding sex partners, dating, cybersex, and pornography. Men have adapted to the ever-evolving technological advances that have been made in connecting users to the Internet-from logging on via dial-up modem on a desktop computer to geo-social-sexual networking via handheld devices. In kind, researchers have adapted to the Internet to study gay and bisexual men. Studies have carefully considered the ethics, feasibility, and acceptability of using the Internet to conduct research and interventions. Much of this work has been grounded in models of disease prevention, largely as a result of the ongoing HIV/AIDS epidemic. The need to reduce HIV in this population has been a driving force to develop innovative research and Internet-based intervention methodologies. The Internet, and specifically mobile technology, is an environment gay and bisexual men are using for sexual purposes. These innovative technologies represent powerful resources for researchers to study and provide outreach.
260 citations
Cites background from "Epidemiology, Sexual Risk Behavior,..."
...The introduction of Grindr, a mobile-based global positioning system (GPS) app for ‘‘gay, bi, and curious guys looking for dating or friends’’ signaled the introduction of ‘‘gay sex’’ apps in the marketplace (Burrell et al., 2012; Landovitz et al., 2012; Rice et al., 2012)....
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TL;DR: Overall trends include use of new tools including social networking sites, provision of real-time assessment and feedback, gamification and virtual reality, and increasing attention to use of technology to address the care continuum.
Abstract: eHealth, mHealth and “Web 20” social media strategies can effectively reach and engage key populations in HIV prevention across the testing, treatment, and care continuum To assess how these tools are currently being used within the field of HIV prevention and care, we systematically reviewed recent (2013–2014) published literature, conference abstracts, and funded research Our searches identified 23 published intervention studies and 32 funded projects underway In this synthesis we describe the technology modes applied and the stages of the HIV care cascade addressed, including both primary and secondary prevention activities Overall trends include use of new tools including social networking sites, provision of real-time assessment and feedback, gamification and virtual reality While there has been increasing attention to use of technology to address the care continuum, gaps remain around linkage to care, retention in care, and initiation of antiretroviral therapy
248 citations
TL;DR: It is concluded that sexual health clinic MSM attendees who are meeting on GSN apps are at greater risk for gonorrhoea and chlamydia than MSM Attendance who meet in-person or on the internet.
Abstract: Background Geosocial networking applications (GSN apps) used for meeting sexual partners have become increasingly popular with men who have sex with men (MSM) since 2009. The current study aimed to determine if self-identified HIV-negative, MSM clinic attendees who used GSN apps have an increased incidence of sexually transmitted infections (STI) compared to self-identified HIV-negative, MSM attendees who met sexual partners via in-person venues, such as bars or clubs or through MSM-specific hook-up websites. Methods Data were collected between August 2011 and January 2013 on all self-identified HIV-negative, MSM clients visiting the L.A. Gay & Lesbian Center for STI screening. A total of 7184 individuals tested for STIs and self-reported behaviours on drug use and social networking methods to meet sexual partners. Multivariate logistic regression models were used to analyse the results. Results Individuals who used GSN apps for meeting sexual partners had greater odds of testing positive for gonorrhoea (OR: 1.25; 95% CI 1.06 to 1.48) and for chlamydia (OR: 1.37; 95% CI 1.13 to 1.65) compared to individuals who met partners through in-person methods only. There were no significant differences in syphilis and HIV incidence between those who met partners via in-person venues only, on the internet or through GSN apps. Conclusions The present study concludes that sexual health clinic MSM attendees who are meeting on GSN apps are at greater risk for gonorrhoea and chlamydia than MSM attendees who meet in-person or on the internet. Future interventions should explore the use of these novel technologies for testing promotion, prevention and education.
213 citations
TL;DR: In this article, Bauman argued that the solidity and security once provided by life-long partnerships has been ‘liquefied’ by rampant individualisation and technological change.
Abstract: In Liquid Love Zygmunt Bauman argued that the solidity and security once provided by life-long partnerships has been ‘liquefied’ by rampant individualisation and technological change. He believes i...
182 citations
Cites background from "Epidemiology, Sexual Risk Behavior,..."
...Moreover, much of the literature has focused on risk and sexual health matters (Landovitz et al., 2012; Prestage et al., 2015; Rice et al., 2012), and comes more from a psychological or health studies perspective than a sociological paradigm....
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TL;DR: Development and testing of smartphone apps for HIV prevention delivery has the potential to engage young men who have sex with men in HIV prevention programming, which can be tailored based on use patterns and motivations for use.
Abstract: Young men who have sex with men (YMSM) are increasingly using mobile smartphone applications (“apps”), such as Grindr, to meet sex partners. A probability sample of 195 Grindr-using YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone-based HIV prevention for YMSM. The number one reason for using Grindr (29 %) was to meet “hook ups.” Among those participants who used both Grindr and online dating sites, a statistically significantly greater percentage used online dating sites for “hook ups” (42 %) compared to Grindr (30 %). Seventy percent of YMSM expressed a willingness to participate in a smartphone app-based HIV prevention program. Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use.
179 citations
Cites background from "Epidemiology, Sexual Risk Behavior,..."
...[41] also documented that among HIV-positive Grindr users in their study, 52 % indicated that they would be willing to participate in a future HIV prevention trial....
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...[41] found that 60 % of Grindr-using MSM used the application for sexual partnering and 70 % of users who engaged in UAI considered themselves to be at low risk of contracting HIV....
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...Geosocial networking apps (also referred to as ‘‘cruising apps’’ or ‘‘hook up apps’’) targeting MSM, such as Grindr, have emerged as a new digital technology through which YMSM are meeting sex partners [41, 42]....
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References
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Journal Article•
TL;DR: The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in health-care settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States.
Abstract: These recommendations for human immunodeficiency virus (HIV) testing are intended for all health-care providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance abuse treatment clinics, public health clinics, community clinics, correctional health-care facilities, and primary care settings. The recommendations address HIV testing in health-care settings only. They do not modify existing guidelines concerning HIV counseling, testing, and referral for persons at high risk for HIV who seek or receive HIV testing in nonclinical settings (e.g., community-based organizations, outreach settings, or mobile vans). The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in health-care settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States. These revised recommendations update previous recommendations for HIV testing in health-care settings and for screening of pregnant women (CDC. Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings. MMWR 1993;42[No. RR-2]:1-10; CDC. Revised guidelines for HIV counseling, testing, and referral. MMWR 2001;50[No. RR-19]:1-62; and CDC. Revised recommendations for HIV screening of pregnant women. MMWR 2001;50[No. RR-19]:63-85). Major revisions from previously published guidelines are as follows: For patients in all health-care settings HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening). Persons at high risk for HIV infection should be screened for HIV at least annually. Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings. For pregnant women HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women. HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening). Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.
2,958 citations
03 Feb 2010
TL;DR: Pew Research Center report series that looks at the values, attitudes and experiences of America's next generation: the Millennials as mentioned in this paper found that since 2006, blogging has dropped among teens and young adults while simultaneously rising among older adults.
Abstract: This publication is part of a Pew Research Center report series that looks at the values, attitudes and experiences of America's next generation: the Millennials. Find out how today's teens and twentysomethings are reshaping the nation at: Since 2006, blogging has dropped among teens and young adults while simultaneously rising among older adults. As the tools and technology embedded in social networking sites change, and use of the sites continues to grow, youth may be exchanging 'macro‐blogging' for microblogging with status updates. Blogging has declined in popularity among both teens and young adults since 2006. Blog commenting has also dropped among teens. 14% of online teens now say they blog, down from 28% of teen internet users in 2006. This decline is also reflected in the lower incidence of teen commenting on blogs within social networking websites; 52% of teen social network users report commenting on friends' blogs, down from the 76% who did so in 2006. By comparison, the prevalence of blogging within the overall adult internet population has remained steady in recent years. Pew Internet surveys since 2005 have consistently found that roughly one in ten online adults maintain a personal online journal or blog. While blogging among adults as a whole has remained steady, the prevalence of blogging within specific age groups has changed dramatically in recent years. Specifically, a sharp decline in blogging by young adults has been tempered by a corresponding increase in blogging among older adults. In December 2007, 24% of online 18‐29 year olds reported blogging, compared with 7% of those thirty and older. By 2009, just 15% of internet users ages 18‐29 maintain a blog—a nine percentage point drop in two years. However, 11% of internet users ages thirty and older now maintain a personal blog. Both teen and adult use of social networking sites has risen significantly, yet there are shifts and some drops in the proportion of teens using several social networking site features. 73% of wired American teens now use social networking websites, a significant increase from previous surveys. Just over half of online teens (55%) used social networking sites in November 2006 and 65% did so in February 2008. As the teen social networking population has increased, the popularity of some sites' features has shifted. Compared with SNS activity in February 2008, a smaller proportion of teens in mid‐ 2009 were …
1,849 citations
TL;DR: The spectrum of engagement in care for HIV-infected individuals in the United States is reviewed and this information is applied to help understand the magnitude of the challenges that pooragement in care will pose to test-and-treat strategies for HIV prevention.
Abstract: For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies. We review the spectrum of engagement in care for HIVinfected individuals in the United States and apply this information to help understand the magnitude of the challenges that poor engagement in care will pose to test-and-treat strategies for HIV prevention.
1,746 citations
"Epidemiology, Sexual Risk Behavior,..." refers background in this paper
...Additional potential applications of such GPSbased apps include the delivery of HIV testing and prevention messaging aimed at reducing HIV incidence.(18)...
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03 Feb 2010
TL;DR: A sharp decline in blogging by young adults has been tempered by a corresponding increase in blogging among older adults, and there are shifts and some drops in the proportion of teens using several social networking site features.
1,344 citations
"Epidemiology, Sexual Risk Behavior,..." refers background in this paper
...African Americans outpace Caucasian and English-speaking Latino counterparts in mobile internet usage.(4,5) Young MSM are technologically savvy(6) and have adopted Internet-based services to facilitate sexual partnering....
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TL;DR: Overall, HIV incidence in the United States was relatively stable 2006–2009; however, among young MSM, particularly black/African American MSM, incidence increased and expanded, improved, and targeted prevention is necessary to reduce HIV incidence.
Abstract: Background
The estimated number of new HIV infections in the United States reflects the leading edge of the epidemic. Previously, CDC estimated HIV incidence in the United States in 2006 as 56,300 (95% CI: 48,200–64,500). We updated the 2006 estimate and calculated incidence for 2007–2009 using improved methodology.
Methodology
We estimated incidence using incidence surveillance data from 16 states and 2 cities and a modification of our previously described stratified extrapolation method based on a sample survey approach with multiple imputation, stratification, and extrapolation to account for missing data and heterogeneity of HIV testing behavior among population groups.
Principal Findings
Estimated HIV incidence among persons aged 13 years and older was 48,600 (95% CI: 42,400–54,700) in 2006, 56,000 (95% CI: 49,100–62,900) in 2007, 47,800 (95% CI: 41,800–53,800) in 2008 and 48,100 (95% CI: 42,200–54,000) in 2009. From 2006 to 2009 incidence did not change significantly overall or among specific race/ethnicity or risk groups. However, there was a 21% (95% CI:1.9%–39.8%; p = 0.017) increase in incidence for people aged 13–29 years, driven by a 34% (95% CI: 8.4%–60.4%) increase in young men who have sex with men (MSM). There was a 48% increase among young black/African American MSM (12.3%–83.0%; p<0.001). Among people aged 13–29, only MSM experienced significant increases in incidence, and among 13–29 year-old MSM, incidence increased significantly among young, black/African American MSM. In 2009, MSM accounted for 61% of new infections, heterosexual contact 27%, injection drug use (IDU) 9%, and MSM/IDU 3%.
Conclusions/Significance
Overall, HIV incidence in the United States was relatively stable 2006–2009; however, among young MSM, particularly black/African American MSM, incidence increased. HIV continues to be a major public health burden, disproportionately affecting several populations in the United States, especially MSM and racial and ethnic minorities. Expanded, improved, and targeted prevention is necessary to reduce HIV incidence.
1,001 citations
"Epidemiology, Sexual Risk Behavior,..." refers background in this paper
...GRINDR and other Internet sites and social networking applications offer advertising space for sale to both commercial interests and academic research; we are aware of groups using GRINDR and other non-GPS-based sex-focused websites successfully for recruitment and survey of MSM.10 Our findings show that such apps/sites are feasible as direct recruitment tools for study participation and facilitation of epidemiologic and behavioral surveillance of this difficult-to-access population....
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...Although the GRINDR sample did not acquire any biologic specimens for HIV or STI testing, self-reports of HIV-positive serostatus almost universally underestimate the true seroprevalence rate16 attributable primarily to occult and undiagnosed HIV infection and secondarily to the persistent stigma associated with reporting an HIVpositive diagnosis among MSM.17 Participants demonstrated a high rate of ongoing transmission-associated risk behavior, indicating that the sample is an excellent target for recruitment for and ultimate deployment of HIV prevention studies and interventions, respectively....
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...MSM are over 40 times more likely to be HIV-infected than the general population.1 Young MSM (YMSM) age 13–29 have the highest HIV incidence rate of any age-risk population segment and represent the only risk group with an increase in incidence from 2006 to 2009 and disproportionately so for young African American and Latino MSM.2 In Los Angeles County, MSM represent 84 % of newly diagnosed HIV infections.3 In the USA, 93 % of young adults own a cell phone; 65 % of young adults access the Internet via their cell phones....
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...Young MSM (YMSM) age 13–29 have the highest HIV incidence rate of any age-risk population segment and represent the only risk group with an increase in incidence from 2006 to 2009 and disproportionately so for young African American and Latino MSM.(2) In Los Angeles County, MSM represent 84 % of newly diagnosed HIV infections....
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...Prevention-focused studies have found it challenging to recruit YMSM....
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