USE OF NEW TECHNOLOGIES FOR PROMOTION OF HIV

AND STI PREVENTION AMONG GAY, BISEXUAL AND

OTHER MEN WHO HAVE SEX WITH MEN

PhD Biomedical Research Methodology and Public Health

Miguel E. Alarcón Gutiérrez

Director: Cristina Rius i Gibert
Tutor: Irma Casas García
Antecedents
 HIV/STI in GBHSH

Gay, bisexual and other men who have sex with men (GBMSM)

European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2022 – 2021 data. Stockholm: ECDC; 2022.
Mobile technologies use

Extended use of dating mobile applications (apps)

among GBMSM
Easily accessible (50-88% use)

GPS for facilitate personal encounters

Gamification

Associated with:
High number of sexual partners

Drugs use for sex

Lower condom use

Lower testing rate

Higher STI’s prevalence

Wang, H., Zhang, L., Zhou, Y., Wang, K., Zhang, X., Wu, J., & Wang, G. (2018). The use of geosocial
networking smartphone applications and the risk of sexually transmitted infections among men who
have sex with men: a systematic review and meta-analysis. BMC Public Health, 18(1), 1178
 Mobile technologies use

Dating apps use as an opportunity to reach GBMSM at

risk

NGO’s exploratory use (Reaching out online)

Highly accepted among apps users

Mowlabocus, S., & Harbottle, J. (2014). Reaching Out Online: Digital Literacy, and the Uses of Social Media in Health
Promotion.
European Centre for Disease Prevention and Control. (2017). Effective use of digital platforms for HIV prevention
among men who have sex with men in the European Union/European Economic Area
 Objective
To evaluate the use of geosocial networks for the promotion of sexual health and prevention of
HIV and other STIs among GBHSH in the city of Barcelona between 2016-2019
 Specific objectives

To compare the sociodemographic and behavioral characteristics in

relation to sex among GBHSH according to the use of dating apps.

To estimate the response rate, acceptability and effectiveness of a

program that offers rapid testing for HIV and other STIs through apps
aimed at sexual-social contacts in MSM users in Barcelona during 2016-
2019.

To determine the epidemiological characteristics of MSM in users of apps

for sexual-social contacts and to estimate the prevalence of new
diagnoses of HIV, syphilis and Hepatitis C, as well as the factors
associated with the infection.
 Specific objective 1
Methodology

To compare the sociodemographic and behavioral characteristics in relation to sex among

GBHSH according to the use of dating apps

Study Cross-sectional

Ambit Barcelona

Study period 10 months

Population GBMSM Drassanes ITS clinic users

Dependent variable Use of dating apps

Univariate descriptive, bivariate
Statistics and multivariate logistic
regression
Specific objective 1
Results
 Specific objective 1
Results

Alarcón-Gutiérrez, M., Palma Díaz, D., Arando Lasagabaster, M., & García De Olalla Rizo, P. (2022). Prevalence of Dating App Usage in Gay, Bisexual, and Other Men Who Have Sex with
Men (GBMSM). Enf Emerg, 21(2), 73–80.
 Specific objective 1
Conclusions

CONCLUSIONS: The use of dating apps was significantly related to younger

GBMSM, with university studies, a high number of sexual partners, less use of
condoms, and chemsex practice. It is necessary to explore new ways of
accessing this population with higher risk factors
 Specific objective 2
Methodology
To estimate the response rate, acceptability and effectiveness of a program that offers rapid
testing for HIV and other STIs through apps aimed at sexual-social contacts in MSM users in
Barcelona during 2016-2019.
Study Cross-sectional

Ambit Barcelona

Study period 36 months

Population GBMSM dating app users

Dependent variable Response rate; Acceptability; Effectiveness

Univariate descriptive, bivariate and multivariate logistic
Statistics
regression
 Specific objective 2

Response rate, acceptability and effectiveness of an intervention

offering HIV/STI testing via apps among gay, bisexual and other
men who have sex with men in Barcelona, Spain, from 2016-2020
Alarcón Gutiérrez, M; Palma Díaz, D; Rius Gibert, C; García de Olalla, P

On press
Specific objective 2
Results
 Specific objective 2
Results
Response Acceptability Effectiveness
Variables Yes No cOR aOR Yes No cOR aOR Yes No cOR aOR
Age (median[IQR]) 32[27-39] 32[26-39] 1.00 [0.99-1.01] 1.00 [0.99-1.01] 32[27-39] 31[26-40] 1.01 [0.99-1.02] 1.01 [0.99-1.03] 30[25-35] 32[26-39] 0.98 [0.97-0.99] 0.98 [0.97-0.99]
Time of intervention
<14:00 31.40% 68.60% 0.91 [0.79-1.04] 87.70% 12.20% 1.15 [0.81-1.63] 1.13 [0.74-1.73] 12.30% 87.70% 2.17 [1.71-2.74] 2.47 [1.77-3.46]
14:00 to 17:00 33.60% 66.40% 1 86.20% 13.80% 1 1 6.10% 93.90% 1 1
17:00 or later 33.90% 66.10% 1.01 [0.88-1.16] 84.80% 15.20% 0.90 [0.65-1.22] 0.92 [0.64-1.32] 9.50% 90.50% 1.62 [1.27-2.07] 1.12 [0.80-1.55]
Time of connection
Connected in the last hour 33.50% 66.50% 1.58 [1.22-2.05] 1.87 [1.41-2.48] 86.20% 13.80% 1.81 [1.05-3.12] 1.98 [1.09-3.58] 6.90% 93.10% 2.88 [1.42-5.87] 4.89 [1.98-12.08]
More than 1 hour ago 24.10% 75.90% 1 1 77.50% 22.50% 1 2.50% 97.50%
Profile photograph
With photo 34.40% 65.60% 1.48 [1.24-1.75] 1.34 [1.11-1.64] 86.30% 13.70% 1.16 [0.77-1.74] 7.10% 92.90% 0.85 [0.64-1.12]
Without photo 26.20% 73.80% 1 1 84.50% 15.50% 1 8.30% 91.70% 1
District of the intervention
Ciudat vella 34.90% 65.10% 1.78 [1.43-2.22] 2.12 [1.64-2.74] 85.60% 14.40% 0.48 [0.24-0.95] 0.45 [0.19-1.08] 3.40% 96.60% 0.60 [0.38-0.94] 0.76 [0.46-1.37]
Eixample 24.90% 75.10% 1.10 [0.84-1.46] 1.23 [0.89-1.70] 89.80% 10.20% 0.71 [0.30-1.68] 0.65 [0.22-1.91] 4.20% 95.80% 0.73 [0.41-1.28] 0.93 [0.47-2.01]
Sants-Montjuic 23.10% 76.90% 1 1 92.50% 7.50% 1 1 5.60% 94.40% 1 1
Sant Gervasi 29.70% 70.40% 1.40 [0.96-2.05] 1.68 [1.10-2.59] 92.20% 7.80% 0.95 [0.28-3.17] 0.73 [0.22-1.91] 8.40% 91.60% 1.54 [0.80-2.96] 1.56 [0.64-4.33]
Gràcia 38.50% 61.50% 2.08 [1.67-2.60] 2.50 [1.93-3.24] 83.00% 17.00% 0.39 [0.20-0.78] 0.38 [0.16-0.91] 18.00% 82.00% 3.68 [2.52-5.39] 3.18 [2.07-5.42]
Horta-Guinardó 33.10% 66.90% 1.65 [1.27-2.14] 1.88 [1.39-2.54] 84.90% 15.10% 0.45 [0.21-0.97] 0.43 [0.16-1.13] 4.90% 95.10% 0.87 [0.51-1.50] 1.36 [0.73-2.83]
Nou Barris 37.60% 62.40% 2.01 [1.42-2.83] 1.74 [1.10-2.73] 88.20% 11.80% 0.60 [0.23-1.55] 0.39 [0.12-1.35] 6.60% 93.40% 1.19 [0.61-2.31] 1.83 [0.79-4.81]
Sant Andreu 37.10% 62.90% 1.97 [1.33-2.91] 2.22 [1.40-3.51] 92.30% 7.70% 0.97 [0.29-3.23] 0.91 [0.21-3.95] 14.60% 85.40% 2.87 [1.60-5.15] 5.08 [2.59-11.17]
Sant Martí 27.60% 72.40% 1.27 [0.83-1.94] 1.58 [0.97-2.56] 89.20% 10.80% 0.67 [0.20-2.26] 0.69 [0.16-3.05] 19.20% 80.80% 3.99 [2.33-6.85] 5.83 [3.09-12.42]
 Specific objective 2
Conclusions

CONCLUSIONS: Apps are an effective platform for sexual health promotion

targeting GBMSM, with a high response rate and acceptability. The response
rate and effectiveness in the present study were associated with recent user
connection to the apps, and performing the intervention in more disadvantaged
districts with fewer sexual health prevention services.
 Specific objective 3
Methodology

To determine the epidemiological characteristics of MSM in users of apps for sexual-

social contacts and to estimate the prevalence of new diagnoses of HIV, syphilis and
Hepatitis C, as well as the factors associated with the infection.

Study Cross-sectional

Ambit Barcelona

Study period 36 months

Population GBMSM app users who attended the intervention
Dependent variable Reactive HIV, syphilis or hepatitis C test
Univariate descriptive, bivariate and multivariate logistic
Statistics
regression
Specific objective 3
Results

Associated factors to HIV, syphilis or hepatitis C reactive testing in GBHSH

users of dating apps. Barcelona, 2016-2021
IRR* 95% CI valor P
Age 0.98 (0.95 - 1.02) 0.288
Foreign national 4.43 (2.05 - 9.57) <0.001
Condomless anal penetrationa 2.00 (1.00 - 3.99) 0.049
N of sexual partners a 1.05 (0.99 - 1.12) 0.104
Methamphetamine use for sexa 3.29 (1.45 - 7.43) 0.004
* Poisson regression
a
During last 12 months
 Specific objective 3
Conclusions

CONCLUSIONS: Reactive testing among dating apps users was

significantly associated to being foreign national, condomless penetration
and methamphetamine consumption. More specific interventions
oriented to promotion of sexual health in migrants and chemsex users
should be developed.
 Conclusions
So far…

Dating apps in GBMSM are used for younger individuals, with high educational level

Dating apps use is associated with sexual practices related to STI

Dating apps are an effective platform for sexual health promotion targeting GBMSM,
with a high response rate and acceptability

Dating apps reached users who tested positive for VIH/STI were more foreign
nationals, with less use of condom and more methamphetamine consumption
Thank you
Gràcies