Archives of Sexual Behavior

, Volume 46, Issue 4, pp 1079–1087 | Cite as

Online Partner Seeking and Sexual Risk Among HIV+ Gay and Bisexual Men: A Dialectical Perspective

  • Dean G. CruessEmail author
  • Kaylee E. Burnham
  • David J. Finitsis
  • Chauncey Cherry
  • Tamar Grebler
  • Brett M. Goshe
  • Lauren Strainge
  • Moira O. Kalichman
  • Seth C. Kalichman
Original Paper


For almost two decades, researchers have explored the relationship between online partner seeking (OPS) and HIV/STI transmission risk behavior among men who have sex with men (MSM), including gay- and bisexual-identified men. A dichotomy has emerged with some findings that OPS is associated with greater sexual risk behavior, and a sparser but emerging literature that men may use OPS for sexual risk reduction. This study examined the association between proportion of partners met online and sexual risk behavior in a sample of 170 HIV-positive gay- and bisexual-identified men. Participants completed assessments including psychosocial factors and a comprehensive assessment of sexual behavior, including total number of male partners, and condomless insertive and receptive anal sex with HIV-negative/unknown serostatus partners or HIV-positive male partners. Our findings support taking a dialectical stance and indicate that OPS may impact risk differently given different individual and contextual circumstances.


Sexual minority men HIV Internet Online partner seeking Sexual behavior Sexual orientation 



This study was funded by an NIMH research Grant (R34MH087120). This research was also partially supported by an NIMH training Grant (T32MH074387).

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflicts of Interest

Co-author Seth C. Kalichman has current research grants from both NIMH and NIDA. All other co-authors declare no conflict of interest.


  1. Benotsch, E. G., Kalichman, S. C., & Cage, M. (2002). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31(2), 177–183.CrossRefPubMedGoogle Scholar
  2. Berg, R. C. (2008). Barebacking among MSM Internet users. AIDS and Behavior, 12(5), 822–833.CrossRefPubMedGoogle Scholar
  3. Berry, M., Raymond, H. F., Kellogg, T., & McFarland, W. (2008). The Internet, HIV serosorting and transmission risk among men who have sex with men, San Francisco. AIDS, 22(6), 787–789. doi: 10.1097/QAD.0b013e3282f55559.CrossRefPubMedGoogle Scholar
  4. Cassels, S., Menza, T. W., Goodreau, S. M., & Golden, M. R. (2009). HIV serosorting as a harm reduction strategy. AIDS, 23(18), 2497–2506. doi: 10.1097/QAD.0b013e328330ed8a.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Centers for Disease Control and Prevention (CDC). (2013). HIV surveillance report, 2011 (Vol. 23). Atlanta, GA: Author. Accessed June 2016.
  6. Chiasson, M. A., Hirshfield, S., Remien, R. H., Humberstone, M., Wong, T., & Wolitski, R. J. (2007). A comparison of on-line and off-line sexual risk in men who have sex with men: An event-based on-line survey. Journal of Acquired Immune Deficiency Syndrome, 44, 235–243. doi: 10.1097/QAI.0b013e31802e298c.CrossRefGoogle Scholar
  7. Coxe, S., West, S. G., & Aiken, L. S. (2009). The analysis of count data: A gentle introduction to poisson regression and its alternatives. Journal of Personality Assessment, 91(2), 121–136. doi: 10.1080/00223890802634175.CrossRefPubMedGoogle Scholar
  8. Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychology, 20(4), 291–299. doi: 10.1037/0278-6133.20.4.291.CrossRefPubMedGoogle Scholar
  9. Finitsis, D. J., Stall, R. D., & Friedman, S. R. (2014). Theory, analysis, social justice, and criminalizing HIV transmission: A commentary on Lehman and colleagues. AIDS and Behavior, 18, 1007–1010. doi: 10.1007/s10461-014-0725-z.CrossRefPubMedGoogle Scholar
  10. Friedman, S. R., & Rossi, D. (2011). Dialectical theory and the study of HIV/AIDS and other epidemics. Dialectical Anthropology, 35(4), 403–427. doi: 10.1007/s10624-011-9222-1.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Grov, C., Golub, S. A., Mustanski, B., & Parsons, J. T. (2010a). Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men. Psychology of Addictive Behaviors, 24, 487–497.CrossRefPubMedGoogle Scholar
  12. Grov, C., Hirshfield, S., Remien, R. H., Humberstone, M., & Chiasson, M. A. (2013). Exploring the venue’s role in risky sexual behavior among gay and bisexual men: An event-level analysis from a national online survey in the U.S. Archives of Sexual Behavior, 42(2), 291–302. doi: 10.1007/s10508-011-9854-x.CrossRefPubMedGoogle Scholar
  13. Grov, C., Parsons, J. T., & Bimbi, D. S. (2010b). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39, 940–949. doi: 10.1007/s10508-009-9483-9.CrossRefPubMedGoogle Scholar
  14. Halkitis, P. N., & Parsons, J. T. (2003). Intentional unsafe sex (barebacking) among HIV-positive gay men who seek sexual partners on the internet. AIDS Care, 15(3), 367–378. doi: 10.1080/0954012031000105423.CrossRefPubMedGoogle Scholar
  15. Hatzenbuehler, M. L., O’Cleirigh, C., Mayer, K. H., Mimiaga, M. J., & Safren, S. A. (2011). Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Annals of Behavioral Medicine, 42(2), 227–234.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Hooper, S., Rosser, B. S., Horvath, K. J., Oakes, J. M., & Danilenko, G. (2008). An online needs assessment of a virtual community: What men who use the internet to seek sex with men want in Internet-based HIV prevention. AIDS and Behavior, 12(6), 867–875.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Horvath, K. J., Nygaard, K., & Rosser, B. R. S. (2010). Ascertaining partner HIV status and its association with sexual risk behavior among internet-using men who have sex with men. AIDS and Behavior, 14, 1376–1383. doi: 10.1007/s10461-009-9633-z.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Horvath, K. J., Oakes, M., & Rosser, B. R. S. (2008). Sexual negotiation and HIV serodisclosure among men who have sex with men with their online and offline partners. Journal of Urban Health, 85(5), 744–758. doi: 10.1007/s11524-008-9299-2.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Kalichman, S. C., Cherry, C., White, D., Jones, M., Grebler, T., Kalichman, M.O., … Schinazi, R.F. (2011). Sexual HIV transmission and antiretroviral therapy: A prospective cohort study of behavioral risk factors among men and women living with HIV/AIDS. Annals of Behavioral Medicine, 42(1), 111–119Google Scholar
  20. Kalichman, S. C., Eaton, L., White, D., Cherry, C., Pope, H., Cain, D., & Kalichman, M. O. (2007). Beliefs about treatments for HIV/AIDS and sexual risk behaviors among men who have sex with men, 1997–2006. Journal of Behavioral Medicine, 30, 497–503. doi: 10.1007/s10865-007-9123-6.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Kalichman, S. C., Johnson, J. R., Adair, V., Rompa, D., Multhauf, K., & Kelly, J. A. (1994). Sexual sensation seeking: Scale development and AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62(3), 385–397.CrossRefPubMedGoogle Scholar
  22. Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and Sexual Compulsivity Scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65(3), 586–601.CrossRefPubMedGoogle Scholar
  23. Kalichman, S. C., & Rompa, D. (2001). The Sexual Compulsivity Scale: Further development and use with HIV-positive persons. Journal of Personality Assessment, 76(3), 379–395.CrossRefPubMedGoogle Scholar
  24. Klausner, J. D., Wolf, W., Fischer-Ponce, L., Zolt, I., & Katz, M. H. (2000). Tracing a syphilis outbreak through cyberspace. Journal of the American Medical Association, 284(4), 447–449. doi: 10.10001/jama284.4.447.CrossRefPubMedGoogle Scholar
  25. Lewnard, J. A., & Berrang-Ford, L. (2014). Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: A meta-analysis of observational studies. Sexually Transmitted Infections, 90, 290–296. doi: 10.1136/sextrans-2013-051332.CrossRefPubMedGoogle Scholar
  26. Liau, A., Millett, G., & Marks, G. (2006). Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sexually Transmitted Diseases, 33(9), 576–584. doi: 10.1097/01.olq.0000204710.35332.c5.CrossRefPubMedGoogle Scholar
  27. LimeSurvey Project Team & Schmitz, C. (2011). LimeSurvey: An open source survey tool. Hamburg: LimeSurvey Project.Google Scholar
  28. Menza, T. W., Kerani, R. P., Handsfield, H. H., & Golden, M. R. (2011). Stable sexual risk behavior in a rapidly changing risk environment: Findings from population-based surveys of men who have sex with men in Seattle, Washington, 2003–2006. AIDS and Behavior, 15, 319–329. doi: 10.1007/s10461-009-9626-y.CrossRefPubMedGoogle Scholar
  29. Mustanski, B. (2007a). The influence of state and trait affect on HIV risk behaviors: A daily diary study of MSM. Health Psychology, 26, 618–626.CrossRefPubMedGoogle Scholar
  30. Mustanski, B. S. (2007b). Are sexual partners met online associated with HIV/STI risk behaviours? Retrospective and daily diary data in conflict. AIDS Care, 19(6), 822–827. doi: 10.1080/09540120701237244.CrossRefPubMedGoogle Scholar
  31. Parsons, J. T., Bimbi, D., & Halkitis, P. N. (2001). Sexual compulsivity among gay/bisexual escorts who advertise on the internet. Sexual Addiction and Compulsivity, 8, 101–112.CrossRefGoogle Scholar
  32. Parsons, J. T., Grov, C., & Golub, S. A. (2012). Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic. American Journal of Public Health, 102(1), 156–162. doi: 10.2105/AJPH.2011.300284.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Peng, K., & Nisbett, R. E. (1999). Culture, dialectics, and reasoning about contradiction. American Psychologist, 54(9), 741–754. doi: 10.1037/0003-066X.54.9.741.CrossRefGoogle Scholar
  34. Perry, N. S., Taylor, S. W., Elsesser, S., Safren, S. A., & O’Cleirigh, C. (2015). The predominant relationship between sexual environment characteristics and HIV-serodiscordant condomless anal sex among HIV-positive men who have sex with men (MSM). AIDS and Behavior. doi: 10.1007/s10461-015-1202-z.Google Scholar
  35. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  36. Rosser, B. S., Oakes, J. M., Horvath, K. J., Konstan, J. A., Danilenko, G. P., & Peterson, J. L. (2009). HIV sexual risk behavior by men who use the Internet to seek sex with men: Results of the Men’s INTernet Sex Study-II (MINTS-II). AIDS and Behavior, 13(3), 488–498. doi: 10.1007/s10461-009-9524-3.CrossRefPubMedGoogle Scholar
  37. Safren, S. A., O’Cleirigh, C., Skeer, M. R., Driskell, J., Goshe, B. M., Covahey, C., & Mayer, K. H. (2011). Demonstration and evaluation of a peer-delivered, individually-tailored, HIV prevention intervention for HIV-infected MSM in their primary care setting. AIDS and Behavior, 15(5), 949–958.CrossRefPubMedGoogle Scholar
  38. Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative on early detection of persons with harmful alcohol consumption—II. Addiction, 88(6), 791–804.CrossRefPubMedGoogle Scholar
  39. Schmidt, A., Barry, K., & Fleming, M. (1995). Detection of problem drinkers: The Alcohol Use Disorders Test (AUDIT). Southern Medical Journal, 68, 52–59.CrossRefGoogle Scholar
  40. Schroder, K. E. E., Carey, M. P., & Vanable, P. A. (2003). Methodological challenges in research on sexual risk behaviors: II Accuracy of self-reports. Annals of Behavioral Medicine, 26, 104–123.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Scott-Sheldon, L. A. J., Walstrom, P., Carey, K. B., Johnson, B. T., Carey, M. P., & the MASH Research Team. (2013). Alcohol use and sexual risk behaviors among individuals infected with HIV: A systematic review and meta-analysis 2012 to early 2013. Current HIV/AIDS Reports, 10(4), 314–323. doi: 10.1007/s11904-013-0177-5.CrossRefPubMedPubMedCentralGoogle Scholar
  42. Shiu, C. S., Chen, Y. C., Tseng, P. C., Chung, A. C., Wu, M. T., Hsu, S. T., & Ko, N. Y. (2014). Curvilinear relationship between depression and unprotected sexual behaviors among men who have sex with men. Journal of Sexual Medicine, 11(10), 2466–2473. doi: 10.1111/jsm.12638.CrossRefPubMedGoogle Scholar
  43. Sullivan, P. S., Hamouda, O., Delpech, V., Geduld, J. E., Prejean, J., Semaille, C., … The Annecy MSM Epidemiology Study Group. (2009). Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Annals of Epidemiology, 19(6), 423–431. doi: 10.1016/j.annepidem.2009.03.004.CrossRefPubMedGoogle Scholar
  44. Tashima, K. T., Alt, E. N., Harwell, J. I., Fiebich-Perez, D. K., & Flanigan, T. P. (2003). Internet sex-seeking leads to acute HIV infection: A report of two cases. International Journal of STD and AIDS, 14(4), 285–286. doi: 10.1258/095646203321264926.CrossRefPubMedGoogle Scholar
  45. Wells, H. K. (1972). Alienation and dialectical logic. Kansas Journal of Sociology, 8(1), 7–32.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Dean G. Cruess
    • 1
    • 2
    Email author
  • Kaylee E. Burnham
    • 1
    • 2
  • David J. Finitsis
    • 1
    • 2
  • Chauncey Cherry
    • 2
  • Tamar Grebler
    • 2
  • Brett M. Goshe
    • 1
    • 2
  • Lauren Strainge
    • 1
    • 2
  • Moira O. Kalichman
    • 2
  • Seth C. Kalichman
    • 1
    • 2
  1. 1.Department of Psychological SciencesUniversity of ConnecticutStorrsUSA
  2. 2.Institute for Collaboration on Health, Intervention, and PolicyStorrsUSA

Personalised recommendations