Data published on the same sample indicated that UAI among app-met partners was associated with longer duration of app use, more sexually explicit profile photos, and more past month app-met partners [ 45 ]. Similar results were found in a national sample of internet-using MSM [ 37 ] and in a city study of MSM recruited in person [ 38 ]. Research on online social networking in relation to sexual behaviors has focused on a number of specific outcomes, such as individual representations of sexuality via online platforms [ 8 , 9 ], transmission of social norms that encourage sexual risk behavior [ 10 , 11 ], and the facilitation of sexual contact with partners met online [ 12 , 13 ]. Clinicians who want to incorporate SNS-based interventions in their practice may find these first-generation SNS-based studies highlighted above promising; however, a need for more robust research to understand the impact of SNS on sexual risk behaviors will greatly benefit the tailoring and implementation of future efforts [ 56 ]. For this review, studies were identified by searching for peer-reviewed publications in Google Scholar and PubMed, and through consultations with experts in the field. However, those who reported UAI with their last app-met partner had a greater number of lifetime and recent sex partners compared to those who did not report UAI with an app-met partner. Finally, geosocial networking apps that cater to heterosexual as well as MSM communities, such as Tinder, are unexplored in the literature to date; examination of these SNS platforms and their association with risk and protective behaviors is warranted. The literature on app use among MSM also highlights opportunities for HIV testing [ 49 ] and the feasibility and acceptability of app-based recruitment and intervention [ 42 , 43 , 50 ].
While findings are mixed, the widespread use of SNS for sexual communication and partner seeking presents opportunities for the delivery and evaluation of public health interventions. SNS also offer a prime opportunity for public health researchers and clinicians who are interested in promoting safer sex to reach a large number of individuals and tap into networks where health promotion messaging may diffuse rapidly. For purposes of this review, we will define SNS as platforms that allow users to do the following: Others have noted differences in sexual risk behaviors by MSM recruited via diverse SNS platforms [ 46 ] but few have extended their analyses to include popular apps. While SNS have the potential to be powerful tools to promote sexual health, sex positivity, disease prevention, and linkage to care and treatment, they also have the capacity to become risky environments that can compromise interpersonal skills, promote risky norms around sexual behaviors and foster disease spread. This is an important point to remember for any clinician who wishes to develop SNS-based sexual health interventions: We used the following search terms: Together, these studies reflect the importance of considering communication content when evaluating online interactions — the topics young people discuss with their friends and the photos posted by their friends may play an important role in shaping offline behaviors that promote or deter sexual risk behaviors. Hightow-Weidman and colleagues [ 51 ] are already using SNS to notify partners of patients who tested positive for HIV and syphilis infection in North Carolina and the GYT campaign described above was successful in reaching thousands of youth through Facebook, Twitter and other SNS [ 23 ], demonstrating that interventions for prevention and treatment are feasible and acceptable. For this review, studies were identified by searching for peer-reviewed publications in Google Scholar and PubMed, and through consultations with experts in the field. Results of SNS-based interventions to reduce sexual risk are synthesized in order to offer hands-on advice for clinicians and researchers interested in engaging patients and study participants via online social networking. Findings of these cross-sectional studies should be fortified by more robust study designs that can further elucidate temporal sequencing between individual risk behavior and online social networking. This review provides an overview of recent research on the relationship between online social networking and sexual risk and protective behaviors with a focus on use of social networking sites SNS among young people and populations at high risk for sexually transmitted infections STIs. Network ties within groups increased over time and were associated with more requests for home-based HIV test kits and decreased sexual risk behavior among those in the intervention [ 54 ]. However, the opportunities for social connection and sexual partnering may be different in rural communities where MSM may experience greater difficulties meeting other MSM than in large urban settings with traditional gay neighborhoods. The ability to connect with strangers for sexual encounters may lead to increases in number of sexual partners but may also promote conversations related to safer sex and expectations for reduced risk behavior that can be difficult to negotiate in person [ 47 ]. This may be due, in large part, to variation across studies in sampling and lack of specificity about sites in which online partner seeking occurs. Clinicians who want to incorporate SNS-based interventions in their practice may find these first-generation SNS-based studies highlighted above promising; however, a need for more robust research to understand the impact of SNS on sexual risk behaviors will greatly benefit the tailoring and implementation of future efforts [ 56 ]. Because research on the relationship between online social networking and sexual behaviors is an emerging area of interest for clinicians and researchers, we will include studies in this review with a variety of sexual behavior outcomes; however, our primary interest will be studies that examined a behavioral risk outcome that can be directly tied with STI acquisition or transmission e. These findings suggest that actual online behavior and perceived behavior of peers in SNS-based networks may play an important role in determining sexual risk behaviors of young people. For example, Buhi et al. Abstract Online social networking refers to the use of internet-based technologies that facilitate connection and communication between users. In addition to evaluation of the GYT campaign [ 23 ], additional studies have been published using Facebook to deliver sexual health promotion and HIV risk behavior prevention messaging to young people [ 52 ] and African American and Latino MSM [ 53 ]. As such, our review includes mainstream SNS e. Data published on the same sample indicated that UAI among app-met partners was associated with longer duration of app use, more sexually explicit profile photos, and more past month app-met partners [ 45 ]. This research underscores the need to further evaluate whether associations between SNS and sexual risk behaviors are dictated by selection e.
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