NCT02248558.

Anti-gay stigma and harsh local environments in many low and middle-income countries (LMIC) encourage men who have sex with men (MSM) partner-seeking mobile application (gay app) use. To investigate the sexual risk profiles of gay app users and guide future HIV prevention programs, we conducted a cross-sectional online survey among 1,342 MSM in China examining associations between gay app use and sexual behaviors, including HIV and sexually transmitted disease (STD) testing. Compared to non-app users, app users were more likely to be younger, better educated, “out” about their sexual orientation, and single. They were also more likely to report multiple recent sex partners and HIV testing, but there was no difference in condomless sex between the two groups. Future research among MSM in LMIC is needed to characterize gay app use and explore its potential for future public health interventions.

Objectives 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 are associated with STI transmission. The goals of this study were to compare sexual behaviors between gay app users and non-users, and to describe sexual behaviors among gay app users in China. Methods In October 2014, we recruited MSM from three Chinese gay websites. Data on socio-demographics, sexual behaviors and gay app use were collected. Logistic regressions were used to compare gay app users to non-app users and to identify factors associated with condomless sex among gay app users. Results Of the 1,424 participants, most were less than 30 years old (77.5%), single (83.8%), and self-identified as gay (72.9%). Overall, 824 (57.9%) used gay apps for partner-seeking in the last six 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 to non-users, gay app users reported engaging in more condomless sex in the last six months (aOR=1.52, 95% CI 1.19–1.94) and more group sex (aOR=1.49, 95% CI 1.02–2.18). Negotiating about condom use before in-person meeting was positively associated with condom use with partners met through gay apps (aOR=1.83, 95% CI 1.29–2.60). Conclusion Gay apps are linked to risky sexual behaviors 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.