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Try out PMC Labs and tell us what you think. Learn More. Little research has focused on the associations between social media use and sexual behavior among Black MSM. Men spent an average of 34 hours per week on social media sites. Overall, users of social media and men who arranged sexual hookups online engaged in more risky behaviors than non-users and men who did not arrange sexual hookups online. However, partner-level data indicated that men engaged in fewer risky behaviors with partners met online compared to partners met in other ways such as at bars or through friends.
Possible reasons for these racial disparities in HIV incidence include higher levels of sexually transmitted infections STIs among Black MSM; lack of access to health care, housing, and HIV prevention services; poverty; discrimination; and homophobia 3 - 5. Although rates of high-risk sexual behavior are comparable for Black MSM and non-minority MSM, higher disease prevalence within Black MSM social networks, combined with racial homophily in sexual partnerships 6 , increase the probability of having HIV-infected partners.
In one exception, among Black MSM surveyed in the Boston area, using the Internet to meet sexual partners in the 12 months was associated with higher rates of UAI However, as described above, most research on social media use and risky behavior has been conducted with either predominantly White samples, or with more diverse samples that still do not specifically report on Black MSM.
Given the racial disparity in HIV infections, this represents a ificant gap in the research. This gap has become more important in recent years due to increasing mobile phone connectivity among Black Americans. Therefore, specifically examining associations between social media use and risky sexual behavior among racial minority MSM is greatly needed.
A second limitation of research is reliance on global measures of sexual risk as opposed to partner-level analysis. In a study of predominantly white MSM, retrospective survey data showed an association between online partner seeking and engaging in UAI, a greater of partners, and lack of discussions regarding sexual history In contrast, daily diary monitoring within the same study indicated more condom use with partners met online compared to those met in other venues. Therefore, in the current study we examine both global measures of social media use and partner-level analysis of risk, with specific attention to comparing sexual behaviors with partners met online and partners met in other ways, such as at bars or through friends.
Lack of discussion of HIV status before intercourse has also been suggested as a factor potentially contributing to racial disparities in HIV infection, which may be especially important when meeting partners online. Although this study recruited participants through social media sites, it did not examine whether partners were met online or not. In another study of MSM, however, greater communication with potential sexual partners regarding sexual preferences and HIV status was noted for online partners compared to offline partners Also, discussing one's preference for using condoms was associated with less frequent UAI, regardless of whether the partner was met online or offline.
Given the racial disparity in HIV incidence, additional research is needed to understand the relationship between sexual risk behavior and use of social media among Black MSM. In particular, research is needed to determine levels of high-risk sexual behavior with sexual partners met online versus partners met in other ways. Also, the potential of using social media for discussions of serostatus and condom use to mitigate any risks inherent in online sexual partner seeking could provide a useful direction for potential interventions.
The current study was conducted to 1 describe how Black MSM in three cities use social media, including arranging sexual hookups; 2 assess global associations between social media use and high-risk sexual behavior; 3 directly compare sexual behavior practices with partners met online versus partners who were met in other ways such as at bars or through friends; and 4 examine reports of online discussions of serostatus and condom use and the potential associations of these discussions with the men's subsequent sexual behavior.
Inclusion criteria included self-identifying as a Black or African-American man, being 18 years of age or older, and reporting sex with another man in the past year. Participants were on average 32 years old. Institutional review boards at each participating institution approved the study protocol. Additional venues included university campuses, churches, and community organizations providing services to Black MSM.
Participants were recruited through a combination of direct approach by project staff, brochures and recruitment cards, and referrals by friends or acquaintances. Potential participants called a dedicated phone , were screened for eligibility, and were scheduled for assessments. After providing informed consent, participants individually completed anonymous paper-and-pencil surveys in private rooms in site offices.
Participants were also asked their HIV status. For each site, participants were asked if they used the site, for how many hours they used the site in a typical week, and how many times have they arranged a sexual hookup in the past 3 months through that site. Online communication with potential sexual partners was assessed for participants who reported arranging one or more online hookups in the three months.
They were asked how often they told the person their HIV status, asked the other person's HIV status, and raised the issue of condoms or safer sex with partners on social media sites. Sexual behavior was assessed by asking participants detailed questions about up to five of their most recent male partners in the past three months. Separately for each partner and beginning with the most recent, participants described their relationship with each partner main, committed, and steady; regular, but not main and committed; casual hookup; or a partner with whom gifts, money, or drugs were exchanged.
Some analyses for this study were conducted with all partners, and some included only casual partners, or partners characterized as a casual hookup. Participants were asked how they met the partner introduced through friends; met in a club, bar, party, hangout or other place; met online; or met in some other way.
Additional, aggregated data on sexual behavior was collected where applicable on all partners beyond the five most recent, although contextual information on partner type and how they met was not collected beyond the first five partners. Demographic differences between users and non-users of social media were assessed using analysis of variance for continuous variables, and Pearson Chi Square tests for categorical variables. Global associations between social media use and risky sexual behavior were assessed using several methods. Different analyses used either a dichotomous dependent variable that indicated whether they engaged in any UAI in the 3 months with that partner, the percentage of AI occasions in which a condom was not used, or total of UAI occasions.
Two main social media independent variables were examined: whether participants were users or non-user of social media, and whether they used social media specifically for sexual hookups or not. We employed Kruskal Wallace tests of non-parametric data to examine associations of these independent variables with the of UAI occasions with all partner types and UAI occasions with casual partners. Additional Kruskal Wallace tests examined the associations for arranging hookups online with total s of sexual partners and unprotected intercourse partners in the past 3 months.
For all ificant univariate analyses, we conducted generalized linear models GLM , controlling for demographic background covariates on which ificant differences between social media users and non-users were found. For dichotomous outcomes, the data were fit to logistic regression models. For counts of intercourse occasions and partners, we analyzed the data using Poisson regression. A second group of analyses compared the percentage of AI occasions that were unprotected for partners met online versus those met in other ways.
For this comparison, a Wilcoxon Rank Test for paired non-parametric data was performed. Critical values of the asymptotic Z statistic were evaluated to determine whether observed differences in frequencies of risk behavior were statistically ificant for all partners and for casual hookup partners. This analysis was done only among participants who had arranged a sexual hookup online and had UAI with sexual partners met online. ificance was determined by Mann-Whitney U-tests of dichotomous groups for non-parametric data.
Most men in the sample Of those who reported arranging a hookup, Users of social media were more likely to have engaged in UAI in the 3 months compared to non-users However, there were no differences between users and non-users of social media in either engaging in UAI with casual partners Associations between having arranged a hookup online and high-risk sexual behavior are presented in Table 3.
Men who arranged sexual hookups were more likely to report UAI with casual partners Differences between those who arranged hookups and those who did not remained ificant in generalized linear models controlling for age, income, currently attending school, currently working, and HIV-positive status.
We next compared occurrences of high-risk sexual behavior with partners who were met online versus partners who were met in other ways. Participants reported meeting online a mean of 0. Finally, we examined use of social media sites for serostatus discussion or discussion of condom use with online partners and their associations with high-risk sexual behaviors. These analyses were restricted to partners met online only, and examined only global associations, as use of social media sites for these discussions were collected overall, not as partner-specific measures.
There was a trend towards a difference between those men who reported always raising the issue of condoms or safe sex with online hookup partners compared to those who never or sometimes did so. Black MSM in this sample are intensive users of social media and those men who are using social media engaged in more risky sexual behaviors overall than those who are not. Controlling for demographic differences between social media users and non-users did not change the pattern of associations between social media use and sexual risk.
Black MSM in this sample frequently used social media to arrange sexual hookups and those who did reported a higher of sexual hookups. Men who used social media for arranging sexual hookups also were more likely to engage in risky sexual behaviors with casual partners, had more partners, and had more partners with whom they had engaged in UAI than those who did not.
The findings suggest that social media use is associated with increased overall levels of sexual risk in Black MSM, consistent with the findings from studies with predominantly non-minority MSM. In seemingly contradictory , the percentage of AI occasions that were unprotected was lower with partners met online than with partners met in other ways. However, men who arranged sexual hookups online also reported more partners overall and more partners with whom they had had UAI.
Thus, men who use social media sites for sexual partner-seeking may be engaging in more risky behaviors overall, but for these men having sex with partners met online is not inherently more risky than with partners met in other ways.
While these global differences between social media users and non-users are not explained by demographic differences between groups, it is possible that social media users may be higher in sensation seeking, sexual adventurousness, or other individual difference variables that were not measured in the current study.
Regardless, by directly comparing sexual risk behaviors within partnerships initiated online to partnerships initiated through other venues, these fill a gap in the research and suggest the need for more sophisticated hypotheses and analyses to better understand the role that social media use plays in sexual behavior among racial minority MSM. research suggests that use of social media for sexual partner-seeking may allow for discussions of serostatus and safer sex, presumably leading to lower levels of high-risk sexual behaviors. Our do not support this hypothesis, but indicate the need for future research to pursue this line of inquiry further.
Using social media sites to discuss serostatus was not associated with sexual risk in this sample and there was only a marginal effect of discussions of condom use with reported high-risk sexual behavior. Yet caution should be taken in drawing any conclusions from these . First, our sample size for these analyses was limited to only those who used social media sites to arrange sexual hookups, greatly reducing statistical power to detect ificant differences.
Additionally, some participants who reported that they always raised the issue of condoms or safe sex may actually indicate to potential partners that they do not want to use condoms and discussions of condom use may depend on whether discussions of serostatus also occurred. Finally, participants may have still discussed condom use and serostatus in person, which was not captured with our measures. These suggest several avenues for future research. First, the majority of men who arranged sexual hookups online reported using both hookup-focused sites and generic sites such as Facebook.
Further research is needed to understand how partner-seeking behaviors differ among social media sites, especially given the non-anonymous nature of generic sites such as Facebook, and the effect of site type on subsequent sexual behaviors. Second, further research is needed to compare perceived riskiness of unprotected sex with partners met online and partners met in other ways, and how risk perceptions affect sexual risk behavior with these partners over time.
Men may perceive partners met online as inherently more risky than those met in other ways, which would explain the lower levels of high-risk sexual behavior found in these encounters. However, relationships initiated online may develop into long-term or committed relationships in which risk perceptions change, and in which condom use becomes less likely. Indeed, in this sample, only half of online partners were characterized as casual hookups, but we did not have the statistical power to directly compare reports of behaviors with casual partners met online and main partners met online.
Partner-level investigations of online discussions of serostatus and condom use are therefore warranted. Limitations of the current research include modest sample sizes for some of the subgroup analyses, and the study's cross-sectional de. None of the ificant findings provide evidence for a causal effect of social media use or online sexual partner-seeking on risky sexual behavior. Longitudinal research is needed to clarify the direction of causal effects.
Additionally, data may be affected by social desirability bias, especially considering that surveys were completed using pen and paper rather than Automated Computer Assisted Self Interviewing ACASI techniques that tend to yield higher reports of sensitive behaviors. Finally, our sample represents individuals who were willing to participate in a research study and complete measures of their sexual behavior, and may therefore miss perspectives of Black MSM who are less comfortable with disclosing their sexual orientation or reporting on intimate personal behaviors.
A more nuanced and sophisticated understanding of the associations between social media use and risky sexual behavior, especially among racial and sexual minority groups, is needed to capitalize upon the potential for harnessing social media for interventions to reduce sexual risk and HIV transmission. Our corroborate a shrinking digital divide given the heavy use of social media in general and for partner-seeking among Black MSM. Intervention efforts utilizing social media technology are feasible, and interventions to mitigate the riskiness of online partner-seeking are appropriate among racial minority MSM.
This research represents a further step towards understanding how social media is currently used within sexual relationships among Black MSM, in order to inform the preparation of social media interventions and evaluate their efficacy in reducing high-risk sexual behavior. Finally, we'd like to thank the study participants. National Center for Biotechnology Information , U. AIDS Behav. Author manuscript; available in PMC Jun 1. Michelle R. Broaddus , a Wayne J. DiFranceisco , a Jeffrey A. Kelly , a Janet S. Lawrence , b Yuri A. Amirkhanian , a and Julia D. Dickson-Gomez a. Wayne J.
Jeffrey A. Janet S. Yuri A. Julia D. Author information Copyright and information Disclaimer. Corresponding Author: Michelle R. Summit Ave. Milwaukee, WI Ph: Fax: ude.Sex meet black and Portland
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