Journal Article

Influence of Social Media on Sexualized Drug Use and Chemsex Among Chinese Men Who Have Sex With Men: Observational Prospective Cohort Study

Fang, Yuan, Yang, Xue, Mo, Phoenix K H, Lau, Joseph T F, Ip, Tsun Kwan Mary, Wang, Zixin

2020

Overview

Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population. This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period. Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted. At Month 6, 6.9% (28/407) and 4.4% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU (β=.04; B=.002, 95% CI 0.001-0.01). Social media and gay social networking apps may be a major source of influence on MSM's perceptions and actual behaviors related to SDU.

• Publisher: Gunther Eysenbach MD MPH, Associate Professor,JMIR Publications
• Subject: Addictive behaviors / Adolescent / Adult / Anal intercourse / Antiretroviral drugs / Asian cultural groups / Attitudes / Bootstrap method / Bootstrapping / China - ethnology / Cohort analysis / Cohort Studies / Consent / Cross-Sectional Studies / Disease prevention / Drug abuse / Drug use / Drugs / Epidemics / Gays & lesbians / HIV / Homosexuality / Homosexuality, Male - psychology / Homosexuality, Male - statistics & numerical data / Hong Kong - epidemiology / Human immunodeficiency virus / Humans / Intervention / Locus of control / Male / Males / Mass media / Men / Men who have sex with men / Mens health / Networking / Observational studies / Original Paper / Partnerships / Path analysis / Peers / Perceived control / Perceptions / Polls & surveys / Prospective Studies / Sexual and Gender Minorities - psychology / Sexual and Gender Minorities - statistics & numerical data / Sexual Behavior / Sexual intercourse / Sexualization / Sexually transmitted diseases / Significant others / Social media / Social Media - statistics & numerical data / Social networks / Social research / Sociodemographics / Software / STD / Substance-Related Disorders - epidemiology / Substance-Related Disorders - psychology / Telephone surveys / Telephones / Theory of planned behavior / User behavior / Young Adult