Background
Men who have sex with men (MSM), a group with high HIV incidence, may seek sexual partners through virtual (geosocial or dating apps) or in-person (bars or clubs) venues. Both types of venues facilitate partnerships among MSM and increase transmission of sexually transmitted infections and HIV. This analysis assessed if virtual and in-person sampling methods recruit MSM with different demographics and sexual behaviors.
Methods
We used data from seven US urban areas, which simultaneously used virtual and in-person recruitment to reach and interview MSM for CDC’s 2023 National HIV Behavioral Surveillance. We reported weighted percentages and 95% confidence intervals (CI) of MSM’s demographics and HIV sexual behaviors and compared them per recruitment type using Rao-Scott Chi-square tests. We calculated adjusted prevalence ratios (aPR) and 95% CI using multivariable logistic regression models with predicted margins to characterize the associations of recruitment type with MSM demographics and sexual behaviors. Statistical significance was determined by p<0.05.
Results
Among 2822 MSM, 386 (13.7%) were recruited virtually and 1203 (42.6%) had a college degree or higher education. A plurality, 1005 (35.8%) were Hispanic/Latino. Compared to MSM recruited in-person (IPR), those recruited virtually (VR) had the higher prevalence of: a college degree or higher education (62.1% VR, 95%CI [51.2-73.0] vs 40.8% IPR, 95%CI [36.2-45.5]), condomless anal or vaginal sex with a casual partner in the past 12 months (62.5% VR, 95%CI [55.5-69.4] vs 51.2% IPR, 95%CI [46.1-56.3]), and multiple (≥2) partners (90.9% VR, 95%CI [86.3-95.5] vs 74.2% IPR, 95%CI [69.8-78.6]) in the past 12 months (for all behaviors p<0.05). After controlling for region, having condomless sex (aPR=1.19, 95%CI [1.02-1.39]) and multiple partners in the past 12 months (aPR=1.23, 95%CI [1.14-1.32]) were higher among MSM recruited virtually (p<0.05). However, having a college degree or higher education was not significantly different between MSM recruited virtually and in-person (aPR=1.29, 95%CI [1.00-1.67], p>0.05).
Conclusions
MSM who were more likely to engage in behaviors associated with HIV were recruited virtually. Recruiting MSM in virtual and in-person spaces may both be needed to identify diverse HIV-related behaviors.