title: Virtual versus physical channel for sex networking in men having sex with men of sauna customers in the City of Hong Kong.
abstract: BACKGROUND
  Advances in communication technology may affect networking pattern, thereby influencing the dynamics of sex partnership. The aim of the study is to explore the impacts of partner sourcing through internet and related channels on exposure risk to sexually transmitted infections (STI) including HIV.
  
  
  METHODS
  Using venue-based sampling, a cross-sectional questionnaire survey was conducted at saunas frequented by men having sex with men (MSM) in Hong Kong. Comparison was made between MSM sourcing partners through physical venues alone versus concomitant users of physical and virtual channels, the latter referring to internet and smart-phone applications, using bivariate logistic regression.
  
  
  RESULTS
  Over a 7-week study period, 299 MSM were recruited from 9 saunas. Three main types of sex partners were distinguished: steady (46.8%), regular (26.4%) and casual (96.0%) partners. Users of sauna (n = 78) were compared with concomitant users of saunas and virtual channels (n = 179) for partner sourcing. Sauna-visiting virtual channel users were younger and inclined to use selected physical venues for sourcing partners. Smart-phone users (n = 90) were not different from other internet-users in terms of age, education level and single/mixed self-identified body appearance. Classifying respondents into high risk and low risk MSM by their frequency of condom use, concomitant use of both sauna and virtual channels accounted for a higher proportion in the high risk category (71.6% vs. 58.2%, OR = 1.81, p<0.05). In virtual channel users, partner sourcing through smart-phone was not associated with a higher practice of unprotected sex.
  
  
  CONCLUSIONS
  MSM sauna customers commonly use virtual channels for sex partner sourcing. Unprotected sex is more prevalent in sauna customers who use virtual channel for sex partner sourcing. While the popularity of smart-phone is rising, its use is not associated with increased behavioural risk for HIV/STI transmission.
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. sslee@cuhk.edu.hk
authors.forename: Shui-Shan
authors.initials: SS
authors.lastname: Lee
authors.forename: Agnes N S
authors.initials: AN
authors.lastname: Lam
authors.forename: Chi-Kei
authors.initials: CK
authors.lastname: Lee
authors.forename: Ngai-Sze
authors.initials: NS
authors.lastname: Wong
mesh_terms: D003142:Communication; D015658:HIV Infections / Q000635:transmission*; D018451:Homosexuality, Male; D006723:Hong Kong; D006801:Humans; D020407:Internet; D008297:Male; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D060756:Social Networking; D029002:Steam Bath / Q000706:statistics & numerical data*