title: The impact of meeting locations for men having sex with men on the risk for bacterial sexually transmitted infections: analyses from a cross-sectional online survey.
abstract: OBJECTIVE
  Opportunities for men having sex with men (MSM) to meet each other have very much improved by new communication technologies. Meeting venue-based characteristics can impact how many partners are met and how much sexual risk is taken. We analysed the association between physical and virtual venues and the risk for bacterial sexually transmitted infections (bSTIs) among participants in an MSM online survey.
  
  
  METHODS
  Data were collected during 2013/2014 with a survey targeting MSM living in Germany. The impact of the meeting place with the last non-steady anal sex partner on diagnosis with a bSTI in the previous year was analysed using bivariate and multivariate regression analysis, taking into account self-reported HIV status, serostatus communication, condom use, partner number, age and city size.
  
  
  RESULTS
  The study sample consisted of 8878 respondents (7799 not diagnosed with HIV; 1079 diagnosed with HIV). Meeting partners online was most common (62% HIV-/51% HIV+), followed by sex venues (11% HIV-/25% HIV+); other venues were each reported by 2-6% of the respondents. Venue-dependent proportions reporting bSTIs in the recent year were 2-4 folds higher among men diagnosed with HIV. In multivariate analysis, HIV status was the strongest predictor for bSTIs (OR=5.0; 95% CI 2.8 to 8.7). Compared with meeting partners online, sex (OR 1.6; 95% CI 1.0 to 2.5) and social venues (OR 1.9; 95% CI 1.4 to 2.6) were associated with increased bSTI risk for men not diagnosed with HIV, but the risk when meeting partners by smartphone apps was only of borderline significance (OR 1.5; 95% CI 0.9 to 2.3). For men diagnosed with HIV, bSTI risk increased for sex venues (OR 1.5; 95% CI 1.1 to 2.1), and was lower for non-gay/other venues (OR 0.2; 95% CI 0.1 to 0.5).
  
  
  CONCLUSIONS
  Venues are connected to social-behavioural facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment and prevention.
authors.affiliation: Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Marcus
authors.affiliation: Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: an der Heiden
authors.affiliation: Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gassowski
authors.affiliation: Department of Public Health, Free University, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kruspe
authors.affiliation: Department of Public Health, Free University, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Drewes
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: GENITOURINARY MEDICINE; SEXUAL MEDICINE