In a study of young men who have sex with men, online sex-seeking behavior was associated with having a greater number of partners, but not consistently with unprotected anal sex.[1] Men who reported using the Internet—either exclusively or not—to meet sexual partners reported greater numbers of recent partners than those who met partners only offline. Men who met partners both online and offline were more likely than those who met partners only offline to have unprotected anal sex; however, the odds of reporting unprotected anal sex were similar for men who met partners only online and those who did so only offline.
The study was based on data from U.S. men who have sex with men, collected via an online survey advertised for three months in 2005 on a gay, lesbian, bisexual and transgender community Web site. Respondents answered questions about their social and demographic characteristics, Internet use, and sexual attitudes and behaviors. Researchers limited their analytic sample to the 770 men aged 18–24 who completed the survey and reported having had sex with men in the preceding three months; the sample was then divided into three groups, by whether the men had met their recent sexual partners only online, only offline or both online and offline. Analyses assessed whether number of sexual partners and unprotected anal intercourse were associated with online sex-seeking behavior.
On average, respondents were 21.5 years old; 76% had had anal intercourse in the past three months, and 36% had had unprotected anal sex during that period. A significantly greater proportion of men who had met partners both online and offline (86%) than of those in the online-only group (69%) or the offline-only group (63%) had recently had anal intercourse. Forty-three percent of men who had met partners both online and offline had recently had unprotected anal sex, a significantly greater proportion than for the online-only group and offline-only group (29% and 34%, respectively).
Overall, men had had a median of three male sex partners and two male anal sex partners in the past three months; those who had met partners both online and offline had had a significantly greater number of partners and anal sex partners (five and three, respectively) than those in the online-only (two and one, respectively) and offline-only (one each) groups. Men reported having had unprotected anal sex with about one-third of their anal sex partners; men in the offline-only group were unprotected with a greater proportion of their anal sex partners (49%) than were those in the other two groups (31% each).
At the bivariate level, increased number of male partners and unprotected anal sex were each associated with meeting partners both online and offline; the outcomes were also associated with spending more time online, spending more time online for sexual purposes and having sex after using drugs or alcohol. In multivariate analyses, the odds of having had multiple sex partners were significantly higher among men who had met partners both online and offline than among those in the online-only group (odds ratios, 3.4–58.4 in various comparisons); meeting partners both online and offline was also positively associated with having had had unprotected anal sex (1.6). Men in the offline-only group were less likely than those in the online-only group to have had multiple partners (0.4), but no more or less likely to have had unprotected anal sex. In addition, being drunk and being high during sex were positively associated with having had multiple partners (1.6 and 2.2, respectively) and having unprotected anal sex (1.4 and 1.6, respectively); using the Internet four or more hours per week for sexual purposes was associated with having had multiple partners (2.2–3.0), but not unprotected anal sex.
The authors note that because of their methodology, their sample may not represent all young men who have sex with men and who use the Internet. Even so, they believe that their findings "add to the growing evidence that the Internet facilitates meeting sexual partners without necessarily promoting unprotected anal intercourse." The authors suggest that future research should "recognize different subgroups of young [men who have sex with men] who use the Internet rather than dichotomizing Internet users and nonusers. They conclude that "there is a need and a demand for online health promotion and disease prevention services," and that such programs "should encourage young [men who have sex with men] who are at risk to reduce their numbers of sexual partners" and "decrease the frequency at which they engage in unprotected anal intercourse."
REFERENCE
1. Horvath KJ, Rosser S and Remafedi G, Sexual risk taking among young Internet-using men who have sex with men, American Journal of Public Health, 2008, 98(6):1059–1067.