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Online Sex-Seeking, Substance Use, and Risky Behaviors in Taiwan: Results from the 2010 Asia Internet MSM Sex Survey

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Abstract

We conducted an online behavioral survey to estimate the prevalence of online sex-seeking and substance use behaviors and to compare risky behaviors among men using different venues to seek sex with men. A cross-sectional online survey, the Asia Internet MSM Sex Survey, was conducted online from January 1 to February 28, 2010. Of the 1,645 participants enrolled from Taiwan, 72.4% reported the Internet as the main way of seeking sexual partners, 73.9% had had sex with partners found online, and 16% had used recreational drugs in the previous 6 months. There was no evidence to suggest that men who looked for sex through the Internet were more likely to engage in unprotected anal intercourse with their casual partners than those using other gay venues. Having had online sex partners in the previous 6 months was significantly associated with being young [adjusted odd ratio (AOR) = 0.97, 95% CI: 0.95–0.99], having had no steady partners in the previous year (AOR = 0.24, 95% CI: 0.15–0.39), having had more than five partners in the previous 6 months (AOR = 4.57, 95% CI: 2.95–7.11), having used recreational drugs in the previous 6 months (AOR = 2.24, 95% CI: 1.30–3.87), and having had an STI in the previous 6 months (AOR = 4.24, 95% CI: 1.59–11.30). In conclusion, because the Internet is a popular meeting place for MSM in Taiwan, effective and targeted prevention programs should be developed to minimize the HIV transmission risk in the Internet era.

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References

  • Aoki, B., Ngin, C., Mo, B., & Ja, D. (1989). AIDS prevention models in the Asian American communities. In V. Mays, G. Albee, & S. Schneider (Eds.), Primary prevention of AIDS: Psychological approaches (pp. 290–308). Newbury Park, CA: Sage.

    Google Scholar 

  • Bolding, G., Davis, M., Hart, G., Sherr, L., & Elford, J. (2005). Gay men who look for sex on the Internet: Is there more HIV/STI risk with online partners? AIDS, 19, 961–968.

    Article  PubMed  Google Scholar 

  • Bowen, A. M., Daniel, C. M., Williams, M. L., & Baird, G. L. (2008a). Identifying multiple submissions in Internet research: Preserving data integrity. AIDS and Behavior, 12, 964–973.

    Article  PubMed  Google Scholar 

  • Bowen, A. M., Williams, M. L., Daniel, C. M., & Clayton, S. (2008b). Internet based HIV prevention research targeting rural MSM: Feasibility, acceptability, and preliminary efficacy. Journal of Behavioral Medicine, 31, 463–477.

    Article  PubMed  Google Scholar 

  • 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 Syndromes, 44, 235–243.

    Article  PubMed  Google Scholar 

  • de Lind van Wijngaarden, J. W., Brown, T., Girault, P., Sarkar, S., & van Griensven, F. (2009). The epidemiology of human immunodeficiency virus infection, sexually transmitted infections, and associated risk behaviors among men who have sex with men in the Mekong Subregion and China: Implications for policy and programming. Sexually Transmitted Diseases, 36, 319–324.

    Article  PubMed  Google Scholar 

  • Drumright, L. N., Patterson, T. L., & Strathdee, S. A. (2006). Club drugs as causal risk factors for HIV acquisition among men who have sex with men: A review. Substance Use and Misuse, 41, 1551–1601.

    Article  PubMed  Google Scholar 

  • Elford, J., Bolding, G., Davis, M., Sherr, L., & Hart, G. (2004). Web-based behavioral surveillance among men who have sex with men: A comparison of online and offline samples in London, UK. Journal of Acquired Immune Deficiency Syndromes, 35, 421–426.

    Article  PubMed  Google Scholar 

  • Elford, J., Bolding, G., & Sherr, L. (2001). Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms. AIDS, 15, 1409–1415.

    Article  PubMed  Google Scholar 

  • Fernandez, M. I., Bowen, G. S., Varga, L. M., Collazo, J. B., Hernandez, N., Perrino, T., et al. (2005). High rates of club drug use and risky sexual practices among Hispanic men who have sex with men in Miami, Florida. Substance Use and Misuse, 40, 1347–1362.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N., Mukherjee, P. P., & Palamar, J. J. (2007a). Multi-level modeling to explain methamphetamine use among gay and bisexual men. Addiction, 102(Suppl. 1), 76–83.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N., Palamar, J. J., & Mukherjee, P. P. (2007b). Poly-club-drug use among gay and bisexual men: A longitudinal analysis. Drug and Alcohol Dependence, 89, 153–160.

    Article  PubMed  Google Scholar 

  • Hidaka, Y., Ichikawa, S., Koyano, J., Urao, M., Yasuo, T., Kimura, H., et al. (2006). Substance use and sexual behaviours of Japanese men who have sex with men: A nationwide internet survey conducted in Japan. BMC Public Health, 6, 239.

    Article  PubMed  Google Scholar 

  • Hirshfield, S., Remien, R. H., Humberstone, M., Walavalkar, I., & Chiasson, M. A. (2004a). Substance use and high-risk sex among men who have sex with men: A national online study in the USA. AIDS Care, 16, 1036–1047.

    Article  PubMed  Google Scholar 

  • Hirshfield, S., Remien, R. H., Walavalkar, I., & Chiasson, M. A. (2004b). Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: A nested case-control study. Journal of Medical Internet Research, 6, e41.

    Article  PubMed  Google Scholar 

  • Hospers, H. J., Kok, G., Harterink, P., & de Zwart, O. (2005). A new meeting place: Chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men. AIDS, 19, 1097–1101.

    Article  PubMed  Google Scholar 

  • Jenness, S. M., Neaigus, A., Hagan, H., Wendel, T., Gelpi-Acosta, C., & Murrill, C. S. (2010). Reconsidering the Internet as an HIV/STD risk for men who have sex with men. AIDS and Behavior, 14, 1353–1361.

    Article  PubMed  Google Scholar 

  • 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, 447–449.

    Article  PubMed  Google Scholar 

  • Ko, N. Y., Lee, H. C., Chang, J. L., Lee, N. Y., Chang, C. M., Lee, M. P., et al. (2006). Prevalence of human immunodeficiency virus and sexually transmitted infections and risky sexual behaviors among men visiting gay bathhouses in Taiwan. Sexually Transmitted Diseases, 33, 467–473.

    Article  PubMed  Google Scholar 

  • Lau, J. T., Kim, J. H., Lau, M., & Tsui, H. Y. (2003). Prevalence and risk behaviors of Chinese men who seek same-sex partners via the internet in Hong Kong. AIDS Education and Prevention, 15, 516–528.

    Article  PubMed  Google Scholar 

  • 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, 576–584.

    Article  PubMed  Google Scholar 

  • McFarlane, M., Bull, S. S., & Rietmeijer, C. A. (2000). The Internet as a newly emerging risk environment for sexually transmitted diseases. Journal of the American Medical Association, 284, 443–446.

    Article  PubMed  Google Scholar 

  • Meerkerk, G. J., Van Den Eijnden, R. J., & Garretsen, H. F. (2006). Predicting compulsive Internet use: It’s all about sex! Cyberpsychology, Behavior, and Social Networking, 9, 95–103.

    Google Scholar 

  • Mustanski, B. S. (2007). Are sexual partners met online associated with HIV/STI risk behaviours? Retrospective and daily diary data in conflict. AIDS Care, 19, 822–827.

    Article  PubMed  Google Scholar 

  • Plankey, M. W., Ostrow, D. G., Stall, R., Cox, C., Li, X., Peck, J. A., et al. (2007). The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study. Journal of Acquired Immune Deficiency Syndromes, 45, 85–92.

    Article  PubMed  Google Scholar 

  • Rhodes, S. D., Bowie, D. A., & Hergenrather, K. C. (2003). Collecting behavioural data using the world wide web: Considerations for researchers. Journal of Epidemiology and Community Health, 57, 68–73.

    Article  PubMed  Google Scholar 

  • Ross, M. W., Mattison, A. M., & Franklin, D. R. (2003). Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men. Substance Use and Misuse, 38, 1173–1183.

    Article  PubMed  Google Scholar 

  • Ruan, Y., Li, D., Li, X., Qian, H. Z., Shi, W., Zhang, X., et al. (2007). Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China. Sexully Transmitted Diseases, 34, 592–597.

    Google Scholar 

  • 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, 285–286.

    Article  PubMed  Google Scholar 

  • TCDC. (2010). Updated HIV/AIDS statistics in Taiwan. Retrieved September 20, 2010, from http://www.cdc.gov.tw/ch/ShowTopicText.ASP?TopicID=416.

  • TWNIC. (2010). 2009 Internet broadband usage in Taiwan. Taipei: Taiwan Network Information Center.

    Google Scholar 

  • Zhang, D., Bi, P., Lv, F., Tang, H., Zhang, J., & Hiller, J. E. (2007). Internet use and risk behaviours: An online survey of visitors to three gay websites in China. Sexually Transmitted Infections, 83, 571–576.

    Article  PubMed  Google Scholar 

  • Zhang, D., Bi, P., Lv, F., Zhang, J., & Hiller, J. E. (2008). Differences between Internet and community samples of MSM: Implications for behavioral surveillance among MSM in China. AIDS Care, 20, 1128–1137.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by grants (NSC 98-2314-B-006-053-MY2) from the National Science Council, Executive Yuan, Taiwan. We would like to acknowledge the role of Fridae in organizing this study and thank all participants in the study. We are grateful to Miss Yiin Lai and Mr. Chien-An Chen for their help in data collection.

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Authors and Affiliations

  1. Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan

    Nai-Ying Ko

  2. Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan

    Nai-Ying Ko, Hsin-Chun Lee & Wen-Chien Ko

  3. Asia Pacific Coalition on Male Sexual Health (APCOM), Bangkok, Thailand

    Stuart Koe

  4. Department of Medicine, Faculty of College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan

    Hsin-Chun Lee & Wen-Chien Ko

  5. Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Cheng-Fang Yen

  6. Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Cheng-Fang Yen

  7. Department of Psychiatry, Chang-Gang Hospital-Kaohsiung Medical Center, Kaohsiung, & School of Medicine, Chang-Gung University, Tao-Yuan, 123 Ta-Pei Rd., Niao-Sung District, Kaohsiung City, 83301, Taiwan

    Su-Ting Hsu

  8. Graduate Institute of Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung, Taiwan

    Su-Ting Hsu

Authors
  1. Nai-Ying Ko
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  2. Stuart Koe
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  3. Hsin-Chun Lee
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  4. Cheng-Fang Yen
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  5. Wen-Chien Ko
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Correspondence to Su-Ting Hsu.

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Ko, NY., Koe, S., Lee, HC. et al. Online Sex-Seeking, Substance Use, and Risky Behaviors in Taiwan: Results from the 2010 Asia Internet MSM Sex Survey. Arch Sex Behav 41, 1273–1282 (2012). https://doi.org/10.1007/s10508-012-9908-8

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  • DOI: https://doi.org/10.1007/s10508-012-9908-8

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