1. What are you into? The role of social networking platforms in HIV risk behavior Darren Whitfield, MSW, Doctoral Student University of Denver, Graduate School of Social Work Gay and Lesbian Medical Association Conference September 20, 2013

2. Presentation Objective By the end of the presentation, learners will be able to:  Describe the prevalence of using mobile applications and the Internet for finding sexual partners among MSM.  Understand future directions for research to inform HIV prevention efforts.  Discuss the implications of an increasingly mobile community on HIV prevention efforts.

3. HIV Infection Rates for Men Who Have Sex with Men (MSM) (Centers for Disease Control and Prevention [CDC], 2012)

4. Prevalence of Unprotected Anal Intercourse (UAI)  The primary mode of HIV infections for MSM is UAI.  Few studies provide a composite of the prevalence of UAI among MSM. 2  A study of San Franciscan MSM found that 4.8% of MSM had UAI in the last six months. 3  Studies suggest that younger men (ages 18 – 24), men with lower income, and men with less education are more likely to engage in UAI. 3

5. “Hooking Up”  In the late 80’s and 90’s MSM found sexual partners using “traditional” venues. 4,5,6  In recent years, more MSM find sexual partners using the Internet. 7,8,9,10  In a meta analysis, 40% of MSM stated they found sexual partners online. 11  The Internet is an effective mechanism for finding sexual partners. 12,13,14  Social network sites make it easier for MSM to narrow partner selection to isolate potential mates. 4,11,15, 16

6. UAI and Internet Partners  Studies suggest that MSM who find sexual partners online are more likely to engage in UAI. 9,10,11,13  One study suggest that HIV positive MSM are twice as likely to engage in UAI with online partners versus offline sexual partners. 9  Other studies have determined that MSM who find sexual partners are no more likely to engage in UAI compared to individuals who use other venues to find sexual partners. 16,17, 18

7. The Role of Mobile Apps  Mobile phones have become the primary mode of information consumption and social interaction. 19  62% of smartphone users use their mobile phones for obtaining news and interacting with their social networks. 20  For young adults (age 18 – 29), 56% use geo-location mobile apps to obtain information or connect with peers. 21  In 2012, mobile apps utilization surpassed using a mobile browsers. 22

9. Mobile Apps and MSM  For MSM, mobile apps provide an opportunity for individuals to find people of similar interest in their specific geographic location. 21  Mobile apps make it easier to find sexual partners with the convenience of close proximity. 21

10. Research Question  How do MSM current find sexual partners?  Is there a difference in the percentage of MSM who have UAI by mode of finding sexual partners?

11. Methods  Gathered participants in Colorado National HIV Behavioral Surveillance Survey (NHBS) based on responses to the following questions:  In the last year have you had anal sex with a man?  Do you have unprotected or protected anal sex?  How they found their sexual partners?  Total sample size = 546

13. Results

16. Key Findings  UAI Findings  Contrary to previous studies that suggest that MSM of color engage in higher risk behavior, our study suggest that white MSM were more likely to engage in UAI.  Younger MSM were more likely to engage in UAI compared to older MSM (40+ years of age).  MSM were more likely to engage in UAI as the number of sexual partners increased.

17. Key Findings  Venue specific UAI  Our findings do not support previous studies findings that a higher percentage of MSM are more likely to engage in UAI with sexual partners they meet “online”.  MSM between ages 30 -40 were more likely to engage in UAI with a partner they met using a mobile app.  Overall, there was difference in the occurrence of UAI and venue. People were no more likely to engage in UAI regardless of finding their sexual partners “online” or through a mobile app.

18. Implication  There is a need for targeted HIV prevention interventions using different venues for MSM. It is important to think about what different venues offer and tailor messages to there different communities.  Geo-specific messages about HIV prevention, may increase the effectiveness of the intervention.  More research needs to be conducted to understand the impact of generational attitudes on HIV prevention (first – decade, second decade, third decade).

19. Acknowledgements Dr. N. Eugene Walls NHBS Interviewers NHBS participants