Gay mobile apps and the evolving virtual risk environment: a cross-sectional online survey among men who have sex with men in China.
OBJECTIVE
The expansion of gay sex-seeking application (gay app) use among men who have sex with men (MSM) may create new virtual risk environments that facilitate STI transmission. The goals of this study were to compare sexual behaviours between gay app users and non-users, and to describe sexual behaviours among gay app users in China.


METHODS
In October 2014, we recruited MSM from three Chinese gay websites. Data on sociodemographics, sexual behaviours and gay app use were collected. Logistic regressions were used to compare gay app users with non-app users and to identify factors associated with condomless sex among gay app users.


RESULTS
Of the 1424 participants, most were <30 years old (77.5%), single (83.8%) and self-identified as gay (72.9%). Overall, 824 (57.9%) had used gay apps for partner-seeking in the last 6 months. Among gay app users, 36.4% met their last partner within 24 hours of first message exchange through gay apps, and 59.0% negotiated condom use before in-person meeting. Compared with non-users, gay app users reported engaging in more condomless sex in the last 6 months (adjusted OR (aOR) =1.52, 95% CI 1.19 to 1.94) and more group sex (aOR =1.49, 95% CI 1.02 to 2.18). Negotiating condom use before in-person meeting was positively associated with condom use with partners met through gay apps (aOR =1.83, 95% CI 1.29 to 2.60).


CONCLUSIONS
Gay apps are linked to risky sexual behaviours and may foster a virtual risk environment for STI transmission among Chinese MSM. App-based interventions could target young gay man and facilitate condom negotiation.
University of North Carolina Project-China, Guangzhou, China.|Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|SESH Global, Guangzhou, China.|School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Weiming
W
Tang
University of North Carolina Project-China, Guangzhou, China.|Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|School of Medicine, University of California, San Francisco, San Francisco California, USA.
John
J
Best
University of North Carolina Project-China, Guangzhou, China.|Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|SESH Global, Guangzhou, China.
Ye
Y
Zhang
Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|SESH Global, Guangzhou, China.
Feng-Ying
FY
Liu
University of North Carolina Project-China, Guangzhou, China.|SESH Global, Guangzhou, China.
Lai Sze
LS
Tso
Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|SESH Global, Guangzhou, China.
Shujie
S
Huang
Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China.|SESH Global, Guangzhou, China.
Bin
B
Yang
Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, San Francisco, San Francisco California, USA.
Chongyi
C
Wei
University of North Carolina Project-China, Guangzhou, China.|SESH Global, Guangzhou, China.|School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Joseph D
JD
Tucker
CHINA; GAY MEN; HIV; SEXUAL BEHAVIOUR