Geosocial networking app use is correlated with increased high-risk sexual behaviors and prevalence of HIV among Chinese men who have sex with men university students: A mixed offline and online cross-sectional survey (Preprint)

BACKGROUND The HIV infection prevalence is increasing rapidly among Chinese men who have sex with men (MSM) university students, and there is limited research on the association of mobile geosocial networking (GSN) apps use and HIV-related high-risk sexual behaviour and HIV prevalence among MSM university students. OBJECTIVE To provide evidence for tailored HIV intervention programs we conducted this study to examine the association between use of GSN apps and HIV-related behaviors and HIV prevalence among Chinese MSM attending university. METHODS Chinese MSM university students were recruited using mixed recruitment methods from 2017 to 2019. Data on sociodemographic, sexual behaviours, use of GSN apps, and eligibility for pre-exposure prophylaxis (PrEP) was collected. Participants were tested for HIV and syphilis, and positive cases were confirmed by laboratory testing. RESULTS We recruited 771 MSM university students: 76.3% (n=588) online and 23.7% (n=183) offline. Among all participants, the HIV prevalence was 3.5% (n=27), and 67.4% (n=520) were eligible for PrEP. GSN app users (81.2%, n=626) vs. GSN app nonusers (18.8%, n=145) were more likely to have used recreational drugs, have multiple male sexual partners, have casual sex, and have been tested for HIV in the past six months (all P < 0.05). After adjusting for age, residence, education, and recruitment method, GSN app users had an increased odds of HIV infection compared to GSN app nonusers (aOR=8.1 [95% CI: 1.05, 62.33]). CONCLUSIONS MSM university students who used GSN apps more frequently engaged in HIV-related high-risk sexual behaviours and had a higher prevalence of HIV infection compared to GSN app nonusers. GSN app platforms can reach Chinese MSM university students and should be used to promote HIV testing and implement sexual behavioural risk reduction interventions or PrEP.