Geosocial networking applications can be a useful tool for studying larger cohorts in HIV research and evaluating health interventions

Dating apps have changed patterns of sexual behavior in most demographic groups, with potential consequences for the risk of transmission of HIV and STIs. A study recently published in Infectious diseases of poverty used a geosocial networking app for gay men to assess the incidence of HIV among users. Beyond the fight against HIV, these applications could potentially play an important role in promoting overall health and well-being.

Networking app can help build and maintain larger study cohorts

To estimate the incidence of HIV, it is recommended to conduct a prospective cohort study, but it is difficult to build and maintain cohorts among people living with HIV in China due to fear of stigma, discrimination and perceived lack of confidentiality, which has likely exacerbated the HIV epidemic.

In recent years, the extensive use of geosocial networking (GSN) applications to find social and sexual partners has changed patterns of sexual behavior in most demographic groups, including men who have sex with men (MSM ). The shift from location-led networking to an internet-driven network has resulted in an increased likelihood of casual sex. However, the influence of risky sexual behavior on the incidence of HIV caused by this change has not been clearly established. To better understand the role of GSN applications in influencing these behaviors, we used a popular networking application to conduct our study.

How did we use the app to estimate the incidence of HIV among its users?

We built an open cohort among MSM via an app with 40 million users worldwide, which included an HIV survey and test booking functionality. Users who wanted to be tested for HIV filled out a questionnaire and booked a test through the app. Those who tested positive were referred to the appropriate Center for Disease Control (CDC) for confirmatory testing.

During the study period, participants who voluntarily booked two or more HIV tests through the app and completed the online survey were considered to be individuals receiving a full follow-up visit. . Participants who had only undergone one HIV test through the app were considered lost to follow-up in this study.

The HIV cohort and seroconversion

During the 18-month study period, we recruited 6952 HIV-negative men into the cohort and identified 37 HIV seroconversions among 1,937 HIV-negative people who reported at least two episodes of HIV testing. The total observed person-time was 1,065 person-years. The estimated HIV incidence rate was 3.47 per 100 person-years (95% CI 2.37-4.57).

Incidence of HIV among app users.

We found that in the six months before their last follow-up, 37.2% of participants reported having two or more sex partners, 4.5% reported having HIV-positive sex partners, while 48.3% were unaware of the HIV status of their sexual partners, and those who never or occasionally used condoms during anal sex accounted for 35.8%.

We found that it was not socio-demographic characteristics, but sexual behaviors that were associated with HIV seroconversion. Having more than five sexual partners as well as partners living with HIV were the main risk factors for seroconversion. Regular condom use and exclusive insertion during anal intercourse were protective factors against HIV seroconversion. In China, the incidence of HIV among app users was still high despite the implementation of multiple interventions to reduce transmission.

In recent years, social media applications have been increasingly integrated into public health interventions. With the intensive use of dating apps, more and more interventions and health education are carried out through these apps and as a result, health resources are more accessible to users. In light of this, smartphone apps could potentially play an important role in promoting health and wellness beyond HIV control.

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