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Advances in smartphones and their applications (apps) over the past decade have revolutionized the way that people—particularly gay, bisexual and other men who have sex with men (MSM)—find sex partners.
As part of a study of screening for HIV and sexually transmitted infections (STIs), scientists at the University of California at San Diego (UCSD) also reviewed the use of the popular hookup Grindr by some of the participants, the vast majority of whom were MSM. In this 1,256-person study, those people who tested negative for HIV and who were not already taking HIV pre-exposure prophylaxis (PrEP) were offered it.
In an article in press in the journal Clinical Infectious Diseases, the scientists report that Grindr users disclosed having more male partners, having more engagement in condomless sex and testing positive for STIs at higher rates than non-Grindr users. However, Grindr users were significantly more likely to initiate PrEP. As a result, Grindr users had fewer diagnoses of HIV infection.
The scientists suggested that “Grindr may provide a useful platform to promote HIV and STI testing and increase PrEP uptake.”
Scientists at UCSD enrolled adult MSM and transgender women for this study. Participants completed surveys regarding HIV risk behaviour. They were then offered HIV screening using HIV antibody tests. People who tested negative for these antibodies had their blood screened using assays that checked for HIV’s genetic material.
STI screening was done for chlamydia and gonorrhea using urine samples and swabs from the rectum and throat. Screening for syphilis was done using standard blood tests.
Participants who tested positive for HIV or STIs were offered immediate initiation of PrEP (a pill containing fixed doses of two anti-HIV drugs: tenofovir DF + FTC, sold as Truvada), taken once daily, at no cost.
The average profile of participants upon entry to the study was as follows:
Scientists divided 1,256 participants into the following two groups:
According to the scientists:
The scientists made the following statements:
“Given the higher risk behaviour and greater acceptance of PrEP among Grindr users, PrEP promotional messages and linkage to care on the Grindr platform could enhance PrEP uptake, as well as increase testing for HIV and STIs. The surge of dating apps and their association with high risk sex offers unique opportunities for broad delivery of prevention messages. Grindr may provide a real opportunity to reach those at risk and substantially increase PrEP awareness and uptake.”
The scientists noted that “Grindr commercially offers banner ads, which can convey an HIV prevention message … targeted toward specific regions that [is also] tailored to specific PrEP providers.” However, the scientists also stated that “a more personalized delivery of prevention messages, [for example] via advertisement on profile pictures of selected opinion leaders, may be more effective than banner ads for delivering prevention messages to Grindr users.”
The UCSD scientists are beginning to grapple with an important idea: Some people in the 21st century who are at risk for HIV and other STIs use apps to find sexual partners. Interventions associated with those apps can be used help to educate people about ways to enhance their sexual health, to encourage testing for HIV and STIs, and, in the scientists’ words, “to engage them to start PrEP.”
The scientists noted that future studies could investigate the use of other apps, as well as the use of on-demand rather than daily PrEP, “and incorporate objective measures of PrEP use to help establish if [engagement with] Grindr also translates into higher adherence.”
The current study was limited to one app—Grindr. However, there are other apps that the scientists mentioned, such as Hornet and Scruff, that could also be investigated for use as possible sexual health platforms.
Resources
Researchers use social media to increase HIV testing among men – CATIE News
Pre-exposure prophylaxis (PrEP) resources and tools: An online collection for service providers – CATIE
PrEP resources for clients – CATIE
Is PrEP Right for Me? – CATIE
Sexual Health and Safer Sex – CATIE
Canadian guidelines on sexually transmitted infections – Public Health Agency of Canada
Pre-exposure prophylaxis (PrEP) for HIV prevention in Canada – Darrell Tan, MD
—Sean R. Hosein
REFERENCE:
Hoenigl M, Little MD, Grelotti D, et al. Grindr users take more risks, but are more open to HIV pre-exposure prophylaxis: Could this dating app provide a platform for HIV prevention outreach? Clinical Infectious Diseases. 2019; in press.