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Dating App Use Among Rural Men Who Have Sex with Men and Its Relationship to HIV Prevention and Risk Behaviors: a Mixed- Methods Analysis University of Kentucky UKnowledge Center for Health Equity Transformation Faculty Publications Health Equity Transformation 6-2-2021 Dating App Use among Rural Men Who Have Sex with Men and Its Relationship to HIV Prevention and Risk Behaviors: A Mixed- Methods Analysis Lauren Bineau University of Georgia Danielle Lambert University of Georgia Natalia Truszczynski University of Georgia Nathan Hansen University of Georgia Carolyn Lauckner University of Kentucky, [email protected] Follow this and additional works at: https://uknowledge.uky.edu/chet_facpub Part of the Communication Technology and New Media Commons, Gender and Sexuality Commons, and the Public Health Commons Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Repository Citation Bineau, Lauren; Lambert, Danielle; Truszczynski, Natalia; Hansen, Nathan; and Lauckner, Carolyn, "Dating App Use among Rural Men Who Have Sex with Men and Its Relationship to HIV Prevention and Risk Behaviors: A Mixed-Methods Analysis" (2021). Center for Health Equity Transformation Faculty Publications. 1. https://uknowledge.uky.edu/chet_facpub/1 This Article is brought to you for free and open access by the Health Equity Transformation at UKnowledge. It has been accepted for inclusion in Center for Health Equity Transformation Faculty Publications by an authorized administrator of UKnowledge. For more information, please contact [email protected]. Dating App Use among Rural Men Who Have Sex with Men and Its Relationship to HIV Prevention and Risk Behaviors: A Mixed-Methods Analysis Digital Object Identifier (DOI) https://doi.org/10.22605/RRH6556 Notes/Citation Information Published in Rural and Remote Health, v. 21, issue 2, 6556. This work is licensed under a Creative Commons Attribution 4.0 International Licence. This article is available at UKnowledge: https://uknowledge.uky.edu/chet_facpub/1 Rural and Remote Health rrh.org.au James Cook University ISSN 1445-6354 ORIGINAL RESEARCH - AUTHORS Lauren Bineau1 MPH, Research Assistant Danielle Lambert2 PhD, Postdoctoral Fellow Natalia Truszczynski3 PhD, Research Associate Nathan Hansen4 PhD, Professor Carolyn Lauckner5 PhD, Assistant Professor * CORRESPONDENCE *Dr Carolyn Lauckner [email protected] AFFILIATIONS 1, 4 Department of Health Promotion and Behavior, University of Georgia, Athens, GA 30602, USA 2 Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA 3 Department of Health Promotion and Behavior, University of Georgia, Athens, GA 30602, USA. Present address: School of Medicine, University of Colorado, Aurora, CO 80045, USA 5 Department of Health Promotion and Behavior, University of Georgia, Athens, GA 30602, USA. Present address: Center for Health Equity Transformation, University of Kentucky, Lexington, KY 40536, USA PUBLISHED 2 June 2021 Volume 21 Issue 2 HISTORY RECEIVED: 2 December 2020 REVISED: 25 March 2021 ACCEPTED: 29 March 2021 CITATION Bineau L, Lambert D, Truszczynski N, Hansen N, Lauckner C. Dating app use among rural men who have sex with men and its relationship to HIV prevention and risk behaviors: a mixed-methods analysis. Rural and Remote Health 2021; 21: 6556. https://doi.org /10.22605/RRH6556 This work is licensed under a Creative Commons Attribution 4.0 International Licence ABSTRACT: Introduction: Men who have sex with men (MSM) in rural areas resources. Given the growing usage of mobile dating apps among have limited access to HIV prevention and education the wider MSM population, this research sought to explore their use among MSM in rural areas and their potential for delivering number of sexual partners. Three-quarters of participants had HIV prevention information. heard of PrEP, but only 7% had ever received a prescription for it Methods: Participants were recruited from different areas of the and less than one-third reported that it would be easy to get PrEP rural Southern USA. This mixed-methods study consisted of an if they wanted it. Dating app users were more likely than non-app online survey (n=85) and follow-up qualitative phone interviews users to have more positive attitudes toward taking PrEP and with 20 survey respondents. The survey assessed dating app use, interest in taking PrEP. In qualitative interviews, respondents sexual behaviors, and pre-exposure prophylaxis (PrEP) awareness, expressed support for integrating HIV prevention information into usage, and attitudes among MSM in the rural, Southern USA. dating apps. Interviews explored perceptions of dating apps and their potential Conclusion: Dating app usage is high among rural MSM. value as a source of health and HIV prevention information. Individuals who use these apps have more sexual partners and also Results: Among survey respondents, 74% had used a dating app, are more interested in PrEP for HIV prevention, suggesting that with Grindr being the most frequently used app. Of individuals this is an ideal group to target for PrEP education and who were in a relationship, 41% had met their current partner interventions. This could be especially beneficial for MSM in rural online. Using a dating app was associated with having a greater areas, as most have difficulty accessing PrEP and PrEP education. Keywords: dating applications, HIV/AIDS, mHealth, MSM, PrEP, sexual risk, USA. FULL ARTICLE: Introduction MSM in rural areas are less likely to be tested for HIV, receive condoms, or have information about and access to PrEP6 . A recent Men who have sex with men (MSM) are disproportionately study found that one out of eight MSM who were eligible for PrEP affected by HIV/AIDS and, as of 2018, account for more than two- lived more than 30 minutes from a PrEP provider (in a ‘PrEP thirds of all new HIV diagnoses in the USA1 . The most common desert’), with the odds of living in a PrEP desert significantly way MSM acquire HIV is through unprotected anal sex, which increased for those living in the South and in non-metropolitan includes not using condoms or prevention medications like pre- areas7 . Qualitative research has found that rural MSM report exposure prophylaxis (PrEP)1 . PrEP is a medication containing multiple barriers to accessing PrEP, including stigma and reduced tenofovir and emtricitabine that a HIV-negative person can take access to LGBT-sensitive medical care8 . daily to significantly reduce their chances of acquiring HIV. When PrEP is taken consistently, it is up to 99% effective and is even Furthermore, HIV funding and prevention efforts have largely more effective in combination with condoms2 . Improving focused on urban areas due to a higher prevalence of HIV. education surrounding the utilization of PrEP among key However, MSM in rural areas are still significantly affected by HIV populations affected by HIV could significantly decrease the and have less access to HIV services as areas become more remote number of new infections. Despite continued technological and isolated4 . There are fewer services in rural areas because it is advances and new medications available to increase HIV not as cost effective for organizations to operate in a lower-density prevention measures, there are still numerous barriers to acquiring area, increasing the need for technology-based service delivery4. these preventative medications. A few of these barriers, particularly Telehealth, the idea of delivering medical services or prevention for MSM in rural areas, include lack of knowledge about the information by technology, has become more feasible in recent availability of PrEP, concerns about insurance coverage, lack of years as internet speeds and connectivity have improved in rural providers in their area, transportation issues, and areas and MSM are relying more on technology to build their stigma/homophobia surrounding accessing HIV-related services3 . social networks4,5,9 . MSM living in rural areas have suggested that online methods of health outreach are preferred10 . Experiences of MSM in rural areas Dating application use The experiences of MSM living in rural areas are different than those living in more urban areas, particularly for those who identify In recent years, an increasing number of people have turned to as gay, bisexual, or transgender, as rural areas are less likely to internet-based dating websites or applications (apps) to meet have supportive, same-gender-loving communities and lesbian, potential sexual partners, find friendships, and pursue romantic gay, bisexual, and transgender (LGBT)-friendly social spaces4 . For relationships. Recent research has found that 30% of all US adults, non-heterosexual MSM, not having LGBT-supportive communities and over 50% of those who have never been married, have used can lead to internalized stigma, loneliness, fear of being ‘outed’ by an online dating site or app11 . The growth in dating app usage has friends and family and the pressure to adopt heterosexual norms4. coincided with an increase in positive attitudes toward online Additionally, the lack of comprehensive sexual health education in dating and a decrease in the previously associated stigma. As rural areas limits the ability for LGBT-identifying MSM to receive many as 80% of Americans believe online or app-based dating is a sexual health information that directly pertains to them, as it is good way to meet people and 61% feel it is easier and more frequently focused only on sexual behaviors between cis-gender efficient than meeting someone through in-person methods12 . men and women5 . When compared with MSM in urban areas, One group that has received considerable research attention What is the frequency and use of dating apps among MSM specific to dating app usage is MSM, who were early adopters of in rural areas? using the internet to find partners13 . A 2014 study reported that What perceptions do MSM in rural areas have of dating MSM accessed dating apps nearly 22 times per week while their apps? non-MSM counterparts accessed them eight times per What is the relationship between dating app use and sexual week14 . More recently, one study found that 78% of MSM reported behaviors? at least some use of dating apps, while over 55% were frequent What is the relationship between dating app use and PrEP users15 .
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