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Gay mobile apps and the evolving virtual risk environment: a cross-sectional online survey among men who have sex with men in China
  1. Weiming Tang1,2,3,4,
  2. John Best1,2,5,
  3. Ye Zhang1,2,3,
  4. Feng-ying Liu2,3,
  5. Lai Sze Tso1,3,
  6. Shujie Huang2,3,
  7. Bin Yang2,3,
  8. Chongyi Wei6,
  9. Joseph D Tucker1,3,4
  1. 1University of North Carolina Project-China, Guangzhou, China
  2. 2Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
  3. 3SESH Global, Guangzhou, China
  4. 4School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  5. 5School of Medicine, University of California, San Francisco, San Francisco California, USA
  6. 6Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, San Francisco, San Francisco California, USA
  1. Correspondence to Dr Joseph D Tucker, University of North Carolina Chapel Hill Project-China, No. 2 Lujing Road, Guangzhou 510095, China; jdtucker{at}


Objectives The expansion of gay sex-seeking application (gay app) use among men who have sex with men (MSM) may create new virtual risk environments that facilitate STI transmission. The goals of this study were to compare sexual behaviours between gay app users and non-users, and to describe sexual behaviours among gay app users in China.

Methods In October 2014, we recruited MSM from three Chinese gay websites. Data on sociodemographics, sexual behaviours and gay app use were collected. Logistic regressions were used to compare gay app users with non-app users and to identify factors associated with condomless sex among gay app users.

Results Of the 1424 participants, most were <30 years old (77.5%), single (83.8%) and self-identified as gay (72.9%). Overall, 824 (57.9%) had used gay apps for partner-seeking in the last 6 months. Among gay app users, 36.4% met their last partner within 24 hours of first message exchange through gay apps, and 59.0% negotiated condom use before in-person meeting. Compared with non-users, gay app users reported engaging in more condomless sex in the last 6 months (adjusted OR (aOR) =1.52, 95% CI 1.19 to 1.94) and more group sex (aOR =1.49, 95% CI 1.02 to 2.18). Negotiating condom use before in-person meeting was positively associated with condom use with partners met through gay apps (aOR =1.83, 95% CI 1.29 to 2.60).

Conclusions Gay apps are linked to risky sexual behaviours and may foster a virtual risk environment for STI transmission among Chinese MSM. App-based interventions could target young gay man and facilitate condom negotiation.

  • HIV

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  • WT and JB contributed equally and are co-first authors.

  • Handling editor Jackie A Cassell

  • Contributors WT and JB participated in all stages and wrote the manuscript, YZ and F-yL helped collect the data; LST, SH, BY, CW and JDT helped design the study and reviewed the manuscript.

  • Funding JDT and CW are receiving grants (NIAID 1R01AI114310, R00MH093201 and FIC 1D43TW009532) from National Institutes of Health, WT and F-yL is receiving grants (5R25TW009340) from UJMT Fogarty Fellowship and JB is receiving grants (R25TW0093) from UJMT Fogarty Fellowship.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Guangdong Provincial Center for Skin Diseases and STI Control, University of North Carolina at Chapel Hill and the University of California, San Francisco. IRB approval number 11413.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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