Background: Online platforms such as social networking and internet dating sites offer access to large groups to engage new sex partners and potentially increased risk for STIs. We will examine risk factors and behaviors associated with last partner identification through Social Networking Sites (SNS).
Methods: HIV+ individuals within the U.S. Military HIV Natural History Study (NHS) were administered a risk behavior survey (RBS) between 9/14-2/15 and screened every 6 months for STIs (syphilis, gonorrhea, Chlamydia, HSV2, HBV). Incident STIs were defined by a positive test within one year of survey, preceded by a negative test. STIs were considered prevalent if positive tests >1yr before RBS or prevalent STI within one year of RBS. Potential confounding variables were assessed and controlled by multivariate analysis.
Results: 1094 male participants with complete last partner data were included (41%% white, 43% African-American, 16% Hispanic/Other, 53.3% active-duty, 31.4% married at survey). 40.0% reported using SNS to meet last partner. SNS use was associated with last sex with a male, non-steady partner without a condom, being single, younger age, active-duty, inconsistent condom use, alcohol use, and ≥1 new sex partners in the last 3 months. 26.9% SNS users had an incident STI compared to 15.9% of non-SNS and increased risk of STI (OR=1.96; P=<.001). Multivariate analysis among SNS users shows last sex MSM (OR=4.5; P<0.05), younger age (OR=0.975; P=0.02), ≥5 new sex partners (OR=4.8; P<.0001) were associated with incident STI. SNS users were more likely to screen positive for prevalent Chlamydia (21%), gonorrhea (16%), and syphilis (26%) at higher frequencies than non-SNS users (13%, 7.5%, and 20.4% respectively).
Conclusions: High rates of prevalent STIs among our population indicates that SNS users engage in high risk behaviors and continue to engage in risky behaviors facilitated by SNS use resulting in incident STIs. Interventions should aim to reduce STIs among SNS users.