Skip to main content

Advertisement

SpringerLink
Log in

Online and Offline Sexual Health-Seeking Patterns of HIV-Negative Men Who Have Sex with Men

  • ORIGINAL PAPER
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

To inform health information targeting, we used cross-sectional data from 2577 HIV-negative MSM to identify groups of men who access similar sources. Offline, more men reported talking to a physician about HIV than about having sex with men; fewer than half attended a safer sex workshop. Online, men sought information primarily through Internet search engines, GLBT websites, or health websites. A latent class analysis identified four groups of health seekers: minimal health seekers, those who accessed online sources only, those who sought information mostly from health professionals, and those who sought information from diverse sources. Minimal health seekers, 9% of the sample, were the group of greatest concern. They engaged in unprotected anal sex with multiple partners but infrequently testing for HIV or sought sexual health information. By encouraging health seeking from diverse sources, opportunities exist to increase men’s knowledge of HIV/STI prevention and, when necessary, access to medical care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Center for Disease Control and Prevention. Sexually transmitted disease surveillance 2007. Atlanta, GA: U.S. Department of Health and Human Services; 2008.

  2. Center for Disease Control and Prevention. HIV/AIDS surveillance report: cases of HIV infection and AIDS in the United States and Dependent Areas, 2007. Atlanta, GA: Department of Health and Human Services; 2009.

  3. Gee R. Primary care health issues among men who have sex with men. J Am Acad Nurse Pract. 2006;18(4):144–53.

    Article  PubMed  Google Scholar 

  4. Robertson AE. The mental health experiences of gay men: a research study exploring gay men’s health needs. J Psychiatr Ment Health Nurs. 1998;5(1):33.

    Article  CAS  PubMed  Google Scholar 

  5. Folkman S, Chesney MA, Pollack L, Phillips C. Stress, coping, and high-risk sexual behavior. Health Psychol. 1992;11(4):218–22.

    Article  CAS  PubMed  Google Scholar 

  6. Berg MB, Mimiaga MJ, Safren SA. Mental health concerns of HIV-infected gay and bisexual men seeking mental health services: an observational study. Aids Patient Care STDS. 2004;18(11):635–43.

    Article  PubMed  Google Scholar 

  7. Celentano DD, Valleroy LA, Sifakis F, et al. Associations between substance use and sexual risk among very young men who have sex with men. Sex Transm Dis. 2006;33(4):265–71.

    PubMed  Google Scholar 

  8. Slavin S. Crystal methamphetamine use among gay men in Sydney. Contemp Drug Probl. 2004;31(3):425–65.

    Google Scholar 

  9. Cochran BN, Cauce AM. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment. J Subst Abuse Treat. 2006;30(2):135–46.

    Article  PubMed  Google Scholar 

  10. McNall M, Remafedi G. Relationship of amphetamine and other substance use to unprotected intercourse among young men who have sex with men. Arch Pediatr Adolesc Med. 1999;153(11):1130–5.

    CAS  PubMed  Google Scholar 

  11. Hays RB, Catania JA, McKusick L, Coates TJ. Help-seeking for AIDS-related concerns: a comparison of gay men with various HIV diagnoses. Am J Community Psychol. 1990;18(5):743–55.

    Article  CAS  PubMed  Google Scholar 

  12. Catania JA, Turner HA, Choi KH, Coates TJ. Coping with death anxiety: help-seeking and social support among gay men with various HIV diagnoses. AIDS. 1992;6(9):999–1005.

    Article  CAS  PubMed  Google Scholar 

  13. Roffman RA, Gillmore MR, Gilchrist LD, Mathias SA, Krueger L. Continuing unsafe sex: assessing the need for AIDS prevention counseling. Public Health Rep. 1990;105(2):202–8.

    CAS  PubMed  Google Scholar 

  14. Silvestre AJ, Kingsley LA, Rinaldo C Jr, Witt RC, Lyter DW, Valdiserri R. Factors associated with participation in HIV antibody screening and results disclosure. Health Soc Work. 1993;18(4):248–58.

    Google Scholar 

  15. Lovejoy NC, Morgenroth BN, Paul S, Freeman E, Christianson B. Potential predictors of information-seeking behavior by homosexual/bisexual (gay) men with a human immunodeficiency virus seropositive health status. Cancer Nurs. 1992;15(2):116–24.

    Article  CAS  PubMed  Google Scholar 

  16. Peterson JL, Coates TJ, Catania JA, Hilliard B, Middleton L, Hearst N. Help-seeking for AIDS high-risk sexual behavior among gay and bisexual African-American men. AIDS Educ Prev. 1995;7(1):1–9.

    CAS  PubMed  Google Scholar 

  17. Klitzman RL, Greenberg JD. Patterns of communication between gay and lesbian patients and their health care providers. J Homosex. 2002;42(4):65.

    Article  PubMed  Google Scholar 

  18. Godin G, Naccache H, Pelletier R. Seeking medical advice if HIV symptoms are suspected. Qualitative study of beliefs among HIV-negative gay men. Can Fam Physician. Apr. 2000;46:861–8.

    CAS  Google Scholar 

  19. Elford J, Bolding G, Maguire M, Sherr L. Do gay men discuss HIV risk reduction with their GP? AIDS Care. 2000;12(3):287–90.

    Article  CAS  PubMed  Google Scholar 

  20. Bradner CH, Ku L, Lindberg LD. Older, but not wiser: how men get information about AIDS and sexually transmitted diseases after high school. Fam Plann Perspect. 2000;32(1):33–8.

    Article  CAS  PubMed  Google Scholar 

  21. Cant B. Gay men’s narratives and the pursuit of well-being in healthcare settings: a London study. Crit Public Health. 2008;18(1):41–50.

    Article  Google Scholar 

  22. Cant B. Exploring the implications for health professionals of men coming out as gay in healthcare settings. Health Soc Care Community. 2006;14(1):9–16.

    Article  PubMed  Google Scholar 

  23. Coleman S, Boehmer U, Kanaya F, Grasso C, Tan J, Bradford J. Retention challenges for a community-based HIV primary care clinic and implications for intervention. Aids Patient Care STDS. 2007;21(9):691–701.

    Article  PubMed  Google Scholar 

  24. DiFranceisco W, Kelly JA, Sikkema KJ, Somlai AM, Murphy DA, Stevenson LY. Differences between completers and early dropouts from 2 HIV intervention trials: a health belief approach to understanding prevention program attrition. Am J Public Health. 1998;88(7):1068.

    Article  CAS  PubMed  Google Scholar 

  25. Orellana ER, Picciano JF, Roffman RA, Swanson F, Kalichman SC. Correlates of nonparticipation in an HIV prevention program for MSM. AIDS Educ Prev. 2006;18(4):348–61.

    Article  PubMed  Google Scholar 

  26. Basta T, Shacham E, Reece M. Psychological distress and engagement in HIV-related services among individuals seeking mental health care. AIDS Care. 2008;20(8):969–76.

    Article  PubMed  Google Scholar 

  27. Tobias CR, Cunningham W, Cabral HD, et al. Living with HIV but without medical care: barriers to engagement. Aids Patient Care STDS. 2007;21(6):426–34.

    Article  PubMed  Google Scholar 

  28. Rumptz MH, Tobias C, Rajabiun S, et al. Factors associated with engaging socially marginalized HIV-positive persons in primary care. Aids Patient Care STDS. 2007;21(Suppl 1):S30–9.

    PubMed  Google Scholar 

  29. Bradford JB. The promise of outreach for engaging and retaining out-of-care persons in HIV medical care. Aids Patient Care STDS. 2007;21(Suppl 1):S85–91.

    PubMed  Google Scholar 

  30. McOwan A, Gilleece Y, Chislett L, Mandalia S. Can targeted HIV testing campaigns alter health-seeking behaviour? AIDS Care. 2002;14(3):385–90.

    Article  CAS  PubMed  Google Scholar 

  31. Rajabiun S, Mallinson RK, McCoy K, et al. “Getting me back on track”: the role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care. Aids Patient Care STDS. 2007;21(Suppl 1):S20–9.

    PubMed  Google Scholar 

  32. Cabral HJ, Tobias C, Rajabiun S, et al. Outreach program contacts: do they increase the likelihood of engagement and retention in HIV primary care for hard-to-reach patients? Aids Patient Care STDS. 2007;21(Suppl 1):S59–67.

    PubMed  Google Scholar 

  33. Warwick I, Douglas N, Aggleton P, Boyce P. Young gay men and HIV/AIDS: towards a contextual understanding of sexual risk. Sex Educ. 2003;3(3):215.

    Article  Google Scholar 

  34. Bolding G, Davis M, Sherr L, Hart G, Elford J. Use of gay Internet sites and views about online health promotion among men who have sex with men. AIDS Care. 2004;16(8):993–1001.

    Article  CAS  PubMed  Google Scholar 

  35. Bolding G, Davis M, Hart G, Sherr L, Elford J. Where young MSM meet their first sexual partner: the role of the Internet. AIDS Behav. 2007;11(4):522–6.

    Article  PubMed  Google Scholar 

  36. Hooper S, Rosser BRS, Horvath KJ, Oakes JM, Danilenko G. 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 Behav. 2008;12(6):867–75.

    Article  PubMed  Google Scholar 

  37. Williams ML, Bowen AM, Horvath KJ. The social/sexual environment of gay men residing in a rural frontier state: implications for the development of HIV prevention programs. J Rural Health. 2005;21(1):48–55.

    Article  PubMed  Google Scholar 

  38. Rhodes SD. Hookups or health promotion? An exploratory study of a chat room-based HIV prevention intervention for men who have sex with men. AIDS Educ Prev. 2004;16(4):315–27.

    Article  PubMed  Google Scholar 

  39. Ayling R, Mewse AJ. Evaluating internet interviews with gay men. Qual Health Res. 2009;19(4):566–76.

    Article  PubMed  Google Scholar 

  40. Moskowitz DA, Melton D, Owczarzak J. PowerON: the use of instant message counseling and the Internet to facilitate HIV/STD education and prevention. Patient Educ Couns. 2009;77(1):20–6.

    Article  PubMed  Google Scholar 

  41. Gellaitry G, Cooper V, Davis C, Fisher M, Date HL, Horne R. Patients’ perception of information about HAART: impact on treatment decisions. AIDS Care. 2005;17(3):367–76.

    Article  CAS  PubMed  Google Scholar 

  42. Kalichman SC, Cherry C, Cain D, et al. Health information on the Internet and people living with HIV/AIDS: information evaluation and coping styles. Health Psychol. 2006;25(2):205–10.

    Article  PubMed  Google Scholar 

  43. Kalichman SC, Weinhardt L, Benotsch E, Cherry C. Closing the digital divide in HIV/AIDS care: development of a theory-based intervention to increase Internet access. AIDS Care. 2002;14(4):523–37.

    CAS  PubMed  Google Scholar 

  44. Bundorf MK, Wagner TH, Singer SJ, Baker LC. Who searches the internet for health information? Health Serv Res. 2006;41(3 Pt 1):819–36.

    Article  PubMed  Google Scholar 

  45. Kalichman SC, Cain D, Cherry C, Pope H, Eaton L, Kalichman MO. Internet use among people living with HIV/AIDS: coping and health-related correlates. Aids Patient Care STDS. 2005;19(7):439–48.

    Article  PubMed  Google Scholar 

  46. Rosser BRS, Gurak L, Horvath KJ, Oakes JM, Konstan J, Danilenko GP. The challenges of ensuring participant consent in internet-based sex studies: a case study of the Men’s INTernet Sex (MINTS-I and II) Studies. J Comput Mediat Commun. 2009;14:602–26.

    Article  Google Scholar 

  47. Rosser BRS, Oakes JM, Horvath KJ, Konstan JA, Danilenko GP, Peterson JL. 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 Behav. 2009;13:488–98.

    Article  PubMed  Google Scholar 

  48. SAS [computer program], Version 9.2. Cary: SAS Institute Inc; 2002–2008.

  49. Mplus [computer program], Version 5.21. Las Angeles: Muthén & Muthén; 1998–2009.

  50. Vermunt JK, Magidson J. Latent class cluster analysis. In: Hagenaars JA, McCutcheon AL, editors. Applied latent class analysis. New York: Cambridge University Press; 2002.

    Google Scholar 

  51. Akaike H. Factor analysis and AIC. Psychometrika. 1987;52(3):317–32.

    Article  Google Scholar 

  52. Rissanen J. Modeling by shortest data description. Automatica. 1978;14:465–71.

    Article  Google Scholar 

  53. Lo Y, Mendell N, Rubin DB. Testing the number of components in a normal mixture. Biometrika. 2001;88:767–78.

    Article  Google Scholar 

  54. Benotsch EG, Kalichman S, Weinhardt LS. HIV-AIDS patients’ evaluation of health information on the internet: the digital divide and vulnerability to fraudulent claims. J Consult Clin Psychol. 2004;72(6):1004–11.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The Men’s INTernet Sex (MINTS-II) study was funded by the National Institutes of Mental Health Center for Mental Health Research on AIDS, grant number 5 R01 MH063688-05. All research was carried out with the approval of the University of Minnesota Institutional Review Board, study number 0405S59661.

Author information

Authors and Affiliations

  1. Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55416, USA

    J. Michael Wilkerson, Derek J. Smolenski, Keith J. Horvath, Gene P. Danilenko & B. R. Simon Rosser

Authors
  1. J. Michael Wilkerson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Derek J. Smolenski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith J. Horvath
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gene P. Danilenko
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. R. Simon Rosser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Michael Wilkerson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wilkerson, J.M., Smolenski, D.J., Horvath, K.J. et al. Online and Offline Sexual Health-Seeking Patterns of HIV-Negative Men Who Have Sex with Men. AIDS Behav 14, 1362–1370 (2010). https://doi.org/10.1007/s10461-010-9794-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-010-9794-9

Keywords

Search

Navigation