Seeking and engaging in internet sex: a survey of patients attending genitourinary medicine clinics in Plymouth and in London

Online sex-seeking among Chinese heterosexual men who seek care in sexually transmitted infections clinics: a cross-sectional study

Background

The Internet has become an important virtual venue for men who have sex with men to seek sexual partners, with a high potential threat to spread sexually transmitted infections (STIs). However, the online sex-seeking use and its risk causing STIs spread remain unclear among heterosexual men. We conducted a cross-sectional study to investigate the use of online sex-seeking venues and the related risky sex activities (e.g. condomless sex, quick sex) in STIs clinics in Guangdong, China.

Methods

These STIs clinics were involved in the Guangdong governmental sentinel network and we recruited heterosexual men (age >  = 18) between March and August 2018. Multivariable logistic regression models were used to identify the factors associated with online sex-seeking use and risky sex activities with online sex partners.

Results

191 of 2,154 participants (8.9%) ever sought sex online. Among users,16.8% met their partners in-person within 24 h, 31.4% engaged in condomless sex with their last online partner. Online sex-seeking was positively associated with a) Ever been diagnosed with STIs (aOR = 3.0, 95%CI:2.0–4.6), and b) Had casual sex in the last three months (aOR = 3.3, 95%CI 2.4–4.6). Condomless sex with the last online partner was negatively associated with the correct answer of “Having only one partner can reduce the risk to infect HIV” (aOR = 0.3, 95%CI:0.1–0.8).

Conclusion

In China, online sex-seeking and its related risky sexual activities are not rare among heterosexual men. Future prevention strategies to reduce STIs incidence should especially target heterosexual men engaging in online sex-seeking.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00903-5.

Is Online Partner-Seeking Associated with Increased Risk of Condomless Sex and Sexually Transmitted Infections Among Individuals Who Engage in Heterosexual Sex? A Systematic Narrative Review

Use of Internet websites and mobile applications to meet potential romantic and sexual partners is becoming increasingly popular. While the Internet might foster better communication and sexual negotiation between partners, it can also be a deceptive environment that instigates and accelerates sexual risk-taking. Given the complexities of the Internet, it is critical to examine the association between risky sexual behaviors (RSBs) and online partner-seeking. Five databases (i.e., Google Scholar, PubMed, PsycINFO, Web of Science, and Ovid Medline) were searched for articles published before September 10, 2017, that examined the association between online partner solicitation (either for romantic and/or sexual reasons) and RSBs. Studies were eligible for inclusion if they were empirical papers published in English-language peer-reviewed journals looking at samples of online partner seekers who practice heterosexual sex (with a comparison group) and reporting either condom use or sexually transmitted infections (STIs) status, which were the two primary outcomes. A total of 25 studies met the criteria to be included in our review. Results from this literature search do not indicate a clear association between online partner-seeking and condom use or STI status. Potential moderators (i.e., age, gender, reasons for online partner solicitation, duration of Internet correspondence, and Internet modalities) that should be included in future research were identified. Sexual health prevention efforts should address methods to negotiate safe practices between sexual partners and to encourage healthy non-virtual relationships, particularly among vulnerable populations.

'Men who use the Internet to seek sex with men': Rethinking sexuality in the transnational context of HIV prevention

MISM (i.e. men who use the Internet to seek sex with men) has emerged in public health literature as a population in need of HIV prevention. In this paper, we argue for the importance of rethinking the dominant notions of the MISM category to uncover its ethnocentric and heteronormative bias. To accomplish this, we conducted a historical, epistemological and transnational analysis of social sciences and health research literature (n = 146) published on MISM between 2000 and 2014. We critically unravel the normative underpinnings of 'westernised' knowledge upon which the MISM category is based. We argue that the essentialist approach of Western scholarship can homogenise MISM by narrowly referring to behavioural aspects of sexuality, thereby rendering multiple sexualities/desires invisible. Furthermore, we argue that a Eurocentric bias, which underlies the MISM category, may hinder our awareness of the transnational dynamics of sexual minority communities, identities, histories and cultures. We propose the conceptualisation of MISM as hybrid cultural subjects that go beyond transnational and social boundaries, and generate conclusions about the future of the MISM category for HIV prevention and health promotion.

Use of the Internet for Sexual Health Among Sexually Experienced Persons Aged 16 to 44 Years: Evidence from a Nationally Representative Survey of the British Population

Background

Those who go online regarding their sexual health are potential users of new Internet-based sexual health interventions. Understanding the size and characteristics of this population is important in informing intervention design and delivery.

Objective

We aimed to estimate the prevalence in Britain of recent use of the Internet for key sexual health reasons (for chlamydia testing, human immunodeficiency virus [HIV] testing, sexually transmitted infection [STI] treatment, condoms/contraceptives, and help/advice with one’s sex life) and to identify associated sociodemographic and behavioral factors.

Methods

Complex survey analysis of data from 8926 sexually experienced persons aged 16-44 years in a 2010-2012 probability survey of Britain’s resident population. Prevalence of recent (past year) use of Internet sources for key sexual health reasons was estimated. Factors associated with use of information/support websites were identified using logistic regression to calculate age-adjusted odds ratios (AORs).

Results

Recent Internet use for chlamydia/HIV testing or STI treatment (combined) was very low (men: 0.31%; women: 0.16%), whereas 2.35% of men and 0.51% of women reported obtaining condoms/contraceptives online. Additionally, 4.49% of men and 4.57% of women reported recent use of information/support websites for advice/help with their sex lives. Prevalence declined with age (men 16-24 years: 7.7%; 35-44 years: 1.84%, P<.001; women 16-24 years: 7.8%; 35-44 years: 1.84%, P<.001). Use of information/support websites was strongly associated with men’s higher socioeconomic status (managerial/professional vs semiroutine/routine: AOR 1.93, 95% CI 1.27-2.93, P<.001). Despite no overall association with area-level deprivation, those in densely populated urban areas were more likely to report use of information/support websites than those living in rural areas (men: AOR 3.38, 95% CI 1.68-6.77, P<.001; women: AOR 2.51, 95% CI 1.34-4.70, P<.001). No statistically significant association was observed with number of sex partners reported after age adjustment, but use was more common among men reporting same-sex partners (last 5 years: AOR 2.44, 95% CI 1.27-4.70), women reporting sex with multiple partners without condoms (last year: AOR 1.90, 95% CI 1.11-3.26), and, among both sexes, reporting seeking sex online (last year, men: AOR 1.80, 95% CI 1.16-2.79; women: AOR 3.00, 95% CI 1.76-5.13). No association was observed with reporting STI diagnosis/es (last 5 years) or (after age adjustment) recent use of any STI service or non-Internet sexual health seeking.

Conclusions

A minority in Britain used the Internet for the sexual health reasons examined. Use of information/support websites was reported by those at greater STI risk, including younger people, indicating that demand for online STI services, and Internet-based sexual health interventions in general, may increase over time in this and subsequent cohorts. However, the impact on health inequalities needs addressing during design and evaluation of online sexual health interventions so that they maximize public health benefit.

Evaluating the Internet as a sexually transmitted disease risk environment for teens: findings from the communication, health, and teens study

BACKGROUND

Few studies have examined the association between sexual health risks and online sex-seeking among teenagers. The purpose of this study was to assess the associations between meeting sex partners online and a range of sexual risk behaviors and outcomes among adolescents.

METHODS

Participants aged 13 to 19 years were recruited from a publicly funded teen clinic in Florida. After obtaining informed consent/assent, 273 participants completed an audio computer-assisted self-interview that included questions on demographics, sexual behavior, sexually transmitted disease (STD) history, and online sex-seeking behaviors and experiences. Participants also provided urine samples for chlamydia and gonorrhea testing. Data were analyzed using logistic regression to identify the association between having an online sex partner and sexual behaviors/outcomes.

RESULTS

After adjusting for significant bivariate correlates, teens reporting online sex partners were more likely to be male, be multiracial, have a history of same-sex sexual activity, report a higher number of vaginal sex partners, and report a lower age at first vaginal sex. However, teens with online sex partners were no more likely to have ever had an STD or a current biological STD.

CONCLUSIONS

This study is one of the first to correlate biological STD results to online sexual partnering data in a youth population. Although meeting a sex partner online was not associated with past or current STDs, it was associated with other sexual risk behaviors. Future research is needed to examine the complex nature of online sexual partnering among adolescents and to develop intervention approaches.

Sexually transmitted infections in men who have sex with men

Homosexuality is a global human phenomenon. Although the American Psychiatric Association removed homosexuality from its list of disorders more than 35years ago, homophobia among physicians is still widely prevalent. Men who have sex with men (MSM) form a relatively new epidemiological risk group for STI. To perform correct management, clinicians evaluating men with male-male sex contacts for STI related complaints or STI screening must obtain a thorough sexual history. Emerging STI like lymphogranuloma venereum, hepatitis C, and multidrug resistant N. gonorrhea strains have been described first in MSM. STI related proctitis often occur in MSM. Within the MSM population, HIV positive patients form a special group affected by STI related diseases, such as anal carcinoma and neurosyphilis. The final part of this review concludes with recommendations to reduce the STI burden in MSM.

Internet and email use among STD clinic patients

BACKGROUND

Little data exist on Internet and email use among STD clinic patients for research and clinical care communication.

METHODS

An anonymous cross-sectional survey of STD clinic patients aged >/=18 years in Seattle, WA, March 13 to 22, 2006.

RESULTS

Of 489 study period patients, 251 (51%) completed the questionnaire. Participants had a median age of 30 (range 18-66) years and were 69% male, 56% white, 19% black, 9% Hispanic, and 7% Asian/Pacific Islander. Of all participants, 75% had some postsecondary education but half reported an annual income of <US$15,000. Of 251 participants, 200 (80%) reported using the Internet from a private location at least once a week, 190 (76%) had their own email that they check at least 3 times a week, and 144 (57%) were willing to receive an email reminding them to come back for a follow-up appointment if diagnosed with an STD. Men who have sex with men were more likely than women and heterosexual men to be regular Internet and email users (92% vs. 70%, P = 0.001) and to have met a sex partner over the Internet during the past year (69% vs. 11%, P <0.001). Higher educational level and income, but not age or gender, were also associated with Internet and email use, as was racial/ethnic background (86% of whites, 48% of blacks, 73% of Hispanics, 100% of Asians/Pacific Islanders, and 57% of others, P <0.001).

CONCLUSIONS

Internet and email use are common and acceptable to many STD clinic patients for research and clinical purposes.