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Understanding the Impact of Smartphone Applications on STI/HIV Prevention Among Men Who Have Sex with Men in the EU/EEA

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Understanding the Impact of Smartphone Applications on STI/HIV Prevention Among Men Who Have Sex with Men in the EU/EEA TECHNICAL REPORT Understanding the impact of smartphone applications on STI/HIV prevention among men who have sex with men in the EU/EEA www.ecdc.europa.eu ECDC TECHNICAL REPORT Understanding the impact of smartphone applications on STI/HIV prevention among men who have sex with men in the EU/EEA This report was commissioned by the European Centre for Disease Prevention and Control (ECDC), led and managed by Teymur Noori with technical input from Andrew J Amato-Gauci, Gianfranco Spiteri and Anastasia Pharris. The first draft of this report was produced by Cary James and Justin Harbottle, Terrence Higgins Trust (THT). ECDC and THT would like to thank all those who contributed to the stakeholder survey and in-depth interviews that are the foundation of this report. These are: Isabell Eibl (Aids Hilfe Wien, Austria); Daniela Rojas Castro (AIDE, France); Aida Kurtovic (Partnerships in Health, Bosnia and Herzegovina); Veaceslav Mulear (GENDERDOC-M, Moldova); Ricardo Fuertes (CheckpointLX, Portugal); Tomasz Malkuszewski (Social AIDS Committee, Poland); Djurica Stankov (AIDS Support Center, Serbia); Lella Cosmaro (Fondazione LILA Milano ONLU, Italy); Giulio Maria Corbelli (Plus onlus, Italy); Paolo Gorgoni (Plus onlus/HIV activist); Zoran Dominković (Iskorak, Croatia); Miran Šolinc (Department Magnus, Slovenia); Loreta Stoniene (Demetra, Lithuania); Tristan Rehbold, Pablo Corbalan (manCheck, Germany); Safia Soltani (Ex Aequo, Belgium); Frank M. Amor (FH JOANNEUM University of Applied Sciences, Austria); Dirk Sander (Deutsche AIDS- Hilfe, Germany); Fiona Larkan (Centre of Global Health, Trinity College, Ireland); Silke Klumb (Deutsche AIDS-Hilfe, Germany); Anastassia Peterson, Latsin Alijev (Estonian Network of People Living with HIV, Estonia); Magdalena Ankiersztejn-Bartczak (CEO, Foundation of Social Education, Poland); Cédric FIEVET (Agent de terrain/chargé de missions, Belgium); Patt Maclusker (Yorkshire MESMAC, United Kingdom); Sam Whalley (LGBT Foundation, United Kingdom); Ben Tooke (Terrence Higgins Trust, United Kingdom). ECDC would also like to thank the following members of the expert group for their significant and valuable input: Cary James, Tom Boyt (Terrence Higgins Trust, United Kingdom); Francois Pichon (The Danish AIDS Foundation, Denmark); Daniela Rojas-Castro, Fred Bladou (AIDES, France); Tamás Bereczky (European AIDS Treatment Group, Hungary); Dirk Sander (Deutsche AIDS-Hilfe, Germany); Vicky Gilbart (Public Health England, United Kingdom); Adam Bourne (London School of Hygiene & Tropical Medicine, United Kingdom); Félix Pérez (HISPANOSIDA, Spain); Zoran Dominković (Iskorak, Croatia); Miran Šolinc (SKUC Association, Slovenia); Massimo Mirandola (Verona University Hospital, Italy); Ulrich Marcus (Robert Koch Institute, Germany); Koenraad Vermey (Soa Aids Nederland, Netherlands); Chantal den Daas (National Institute for Public Health and the Environment, Netherlands); Lucile Bluzat (Institut national de prévention et d'éducation pour la santé, France); Thomas Ronti (Observatoire du sida et des sexualités, Belgium);Nikos Dedes (Positive Voice, Greece); Kathy Attawell (Public Health Consultant); Axel Schmidt (London School of Hygiene & Tropical Medicine, United Kingdom); Kane Race (University of Sydney, Australia); Jennifer Hecht (San Francisco AIDS Foundation, USA); David Purcell (Centers for Disease Control and Prevention, USA); Nicklas Dennermalm, Filip Garcia, Carolina Orre (The Swedish Federation for Lesbian, Gay, Bisexual and Transgender Rights); Alessandro Pirona (The European Monitoring Centre for Drugs and Drug Addiction); Kristina Ingemarsdotter Persson (Public Health Agency of Sweden). Declarations of interest were received from the contractor and all the experts who participated in the expert group in accordance with ECDC’s Independence Policy and no conflict was identified. Suggested citation: European Centre for Disease Prevention and Control. Understanding the impact of smartphone applications on STI/HIV prevention among men who have sex with men in the EU/EEA. Stockholm: ECDC; 2015. Stockholm, September 2015 ISBN 978-92-9193-673-1 doi 10.2900/908148 Catalogue number TQ-04-15-635-EN-N © European Centre for Disease Prevention and Control, 2015 Reproduction is authorised, provided the source is acknowledged ii TECHNICAL REPORT Understanding the impact of smartphone apps on STI/HIV prevention among MSM in the EU/EEA Contents Abbreviations ............................................................................................................................................... iv Glossary ....................................................................................................................................................... iv Introduction .................................................................................................................................................. 1 Background ................................................................................................................................................... 1 Aims and objectives ....................................................................................................................................... 3 Methods ........................................................................................................................................................ 3 Results .......................................................................................................................................................... 5 MSM spaces and HIV prevention ................................................................................................................ 5 Changing spaces – websites and smartphone apps ...................................................................................... 6 Smartphone app and website preference and popularity ............................................................................... 7 HIV prevention online – smartphone apps and websites ............................................................................... 8 Advertising services, campaigns and recruiting to research: push messages and banner adverts ...................... 8 Hypotheses ................................................................................................................................................. 14 Hypothesis 1: ‘I believe that smartphone applications have increased partner numbers and frequency of partner change among MSM.’ .............................................................................................................................. 14 Hypothesis 2: ‘I believe that smartphone applications provide new opportunities for MSM to communicate, meet and form non-sexual connections.’ ........................................................................................................... 16 Hypothesis 3: ‘I believe that the short nature of conversations on smartphone applications can have an impact on successful negotiation of sex or sexual health practices.’ ....................................................................... 18 Hypothesis 4: ‘I believe that smartphone applications facilitate the mixing of sexual networks which may have previously been separated by age, identity or sexual practices.’ .................................................................. 19 Hypothesis 5: ‘I believe smartphone applications facilitate the organisation of private sex parties involving recreational drug use.’ ............................................................................................................................. 22 Hypothesis 6: ‘I believe that smartphone applications influence MSM tourism within Europe, functioning as a common way for MSM travelling to a new country to meet other MSM in that location.’ ................................ 24 Hypothesis 7: ‘I believe that online platforms, and increasingly smartphone applications, will often be the first point of contact for young MSM with other MSM or MSM culture.’................................................................ 26 Conclusions ................................................................................................................................................. 28 References .................................................................................................................................................. 29 Appendix 1. Literature review........................................................................................................................ 30 Appendix 2. Popularity of MSM spaces by country ........................................................................................... 40 Appendix 3. Importance of MSM spaces for HIV prevention by country ............................................................. 41 Appendix 4. Popularity of online spaces by country ......................................................................................... 42 Figures Figure 1. Popularity of MSM space by smartphone and website classification. ...................................................... 7 Figure 1. Websites and apps: differences in popularity between the market leaders and the competition ............. 20 iii Understanding the impact of smartphone apps on STI/HIV prevention among MSM in the EU/EEA TECHNICAL REPORT Abbreviations BME Black and minority ethnic EU European Union G or GBL gamma-Butyrolactone GPS Global positioning system HIV Human immunodeficiency virus LGBT Lesbian, gay, bisexual and transgender MSM Men
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