Associate Professor Johns Hopkins School of Medicine Hyattsville, Maryland, United States
Background: Geosocial networking applications (GSN apps) are important tools for HIV/sexually transmitted infection (STI) prevention among men who have sex with men (MSM). Strategies for identifying high transmission and acquisition among GSN app users are needed for prioritizing public health response. Community viral load (CVL) is associated with HIV transmission and can be used to identify populations with risk factors for HIV acquisition. We sought to determine user profile characteristics and utilization patterns associated with GSN app use in high CVL census tracts (CT).
Methods: We used routine HIV surveillance data from in-care individuals and their viral loads at point of diagnosis to estimate CVL in 200 CTs across Baltimore City. CTs were ordered based on CVL and categorized into quantiles from high to low. We then assessed a sample of GSN app user profiles collected October-December 2017 to explore the association between profile characteristics, app utilization times, and use in high CVL CTs using bivariate and multivariable generalized ordered logistic regression models.
Results: Data on 813 GSN app users were collected. Users ranged from 18-65 years (mean=34.1, standard deviation [SD]=9.7), 35.7% Black, 43.9% HIV-negative, 42.0% in high CVL CTs, and 55.5% daytime use and 51.8% weekend use. MSM with profiles listing versatile sex positions had greater odds of app use in high/medium CVL CTs (adjusted odds ratio [AOR] 2.37, 95% CI 1.14, 4.92). Users seeking a friendship/relationship (AOR 0.44, 95% CI 0.23,0.83) compared with those looking for casual sex, had lower odds of app use in high/medium (vs. low) CVL CTs. Black users had greater odds of app use in high CVL CTs (AOR 1.38, 95% CI 1.01, 1.89).
Conclusion: GSN app user profiles of people who report versatile sexual positions and Black MSM may benefit from online HIV prevention messages to reduce HIV transmission in high and medium CVL areas.
