Every Saturday, The CSPH highlights news or recent research in the field of human sexuality. This week we’re venturing into the world of technology, using Grindr–a popular phone app that allows its users, primarily men who have sex with men, to see other users who are geographically close to their current location–to learn about young men who have sex with men (YMSM). In the US, this population has the highest number of new HIV diagnoses compared to any other group, and it is the only group that has seen an increase in diagnoses in recent years. The number of newly diagnosed HIV is especially high for young African American and Latino men who have sex with men (MSM). Therefore learning as much as possible about this group’s sexual behaviors and HIV prevention practices can provide important information to guide interventions and future research.
Demographics and Methodology
The researchers used Grindr to recruit 375 YMSM in the metro Los Angeles area with a median age of 25 years old, and the majority of participants were either Caucasian or Latino. Nearly all of the participants had sex with a male in the past year. For those who had sex with a female, all but one also had sex with a man. All participants had to be at least 18 (self-reported) and using Grindr on their phones. Repeat participation was prevented and screened for using databases of coded Grindr profiles.
Participants were recruited from various venues within and around Los Angeles that were identified as being popular with YMSM. Research assistants would visit a randomly selected venue, find a safe area to conduct the study, log on to Grindr using their personal profile, and message users who self-identified as between 18 and 29 years old. Individuals already in the study or who had refused to participate were not re-contacted and anyone deemed intoxicated, altered, or otherwise unable to understand the research information sheet and give proper consent were not enrolled. “Walk-on” participants—those who followed their friends to the researchers—were allowed to participate so long as they met the inclusion criteria.
Following this screening, participants completed a computer-assisted self-interview (CASI) on a tablet. They answered a total of 37 questions, including ones modified from the National HIV Behavioral Surveillance System (NHBS) and validated Grindr-focused questions. The questions were divided into the following nine categories: Demographics, HIV Testing Behavior, Sexually Transmitted Disease History, Sexual Risk Behavior, Drug/Alcohol Use, HIV-Related Attitudes/Beliefs, Prevention Strategies, Clinical Trial Participation, and Grindr use.
What Did They Find?
More than 80% of participants had been tested for HIV in the past year, though only a small percentage of these reported a positive serostatus. Of those individuals who did not report being tested, all but one had engaged in anal sex in the prior year. With regards to STIs, there were some reports of prior diagnosis of gonorrhea, chlamydia, or syphilis (all less than 20% of participants).
Despite relatively low numbers of diagnosed STIs, participants were engaging in numerous risky sexual behaviors. The average number of reported sex partners in the past year was ten, nearly half reported having any unprotected anal intercourse (UAI), and more than one third reported having unprotected receptive anal intercourse (URAI). These risky behaviors were more common in Caucasian males than African Americans or Latinos. Perhaps this is related to the fact that nearly three quarters of individuals engaging in UAI or URAI believed—erroneously and dangerously—that their risk for contracting HIV was “unlikely” or “very unlikely.”
More than half of the participants did not always ask sex partners about their HIV status, although the researchers did not collect data about the reasons for this lack of inquiry. However, they did hypothesize that it could be due to the relative anonymity of their partners, many of whom were met via Grindr, sex or dating websites, bars, and dance clubs. On the other hand, it could also be due to the fact that nearly half reported using alcohol and/or drugs at the time of intercourse.
Strengths and Weaknesses
This study utilized the marvels of modern technology to not only recruit, but also survey its participants. As the world becomes more and more connected, it is important to engage these new technologies as viable avenues for research, information dissemination, and prevention strategies. Additionally, though the study was relatively small, the sample demographics were similar to those in greater Los Angeles, making the results fairly generalizable to YMSM in this area.
Though the use of Grindr and YMSM-frequented venues for recruitment was novel and interesting, it does lend itself to one major flaw: the exclusion of those who a) do not use the app; b) are not close to the researchers location-wise; and/or c) don’t visit such venues. There may be something significantly different among these various groups that could have an impact on how future research and interventions are done. At the end of the day, the benefits of recruiting in this manner certainly outweigh the associated limitations. This is because it is important for the health of YMSM that they begin utilizing safer sex practices (e.g. consistent use of protection and decreased sex while under the influence) to decrease HIV in their sexual networks.
Young men who have sex with men are a very vulnerable population for HIV infection, and this study provides further evidence that they are engaging in multiple high risk sexual behaviors that could lead to a positive serostatus. Though these findings seem grim, they provide strong support for the idea that this group is an excellent target for HIV prevention studies and interventions. Furthermore, Grindr was shown to be a viable option for finding and recruiting YMSM for such work. This is supported by its use, and the use of similar programs, in other STI prevention and screening studies. Though this research is neither perfect nor complete, at the end of the day, apps like Grindr may be one answer to reaching those in the most need of health education and/or services.
Landovitz, R. J., Tseng, C., Weissman, M., Haymer, M., Mendenhall, B., Rogers, K., … Shoptaw, S. (2012). Epidemiology, sexual risk behavior, and HIV prevention practices of men who have sex with men using Grindr in Los Angeles, California. Journal of Urban Health, doi:10.1007/s11524-012-9766-7.