Sexual risk behaviors among apps-using young men who have sex with men in Hong Kong

This study is among the first to examine the sexual risk behaviors and attendant factors of young men who have sex with men (YMSM) in Hong Kong using location-aware gay social networking mobile applications ("gay apps"). Among the 213 YMSM (Mage = 21.52, SD = 2.29 years, range 17-25) who reported their recent (past six months) sexual history with male partners and gay apps use, inconsistent condom use (ICU) during anal sex was fairly common (60.2% regular partners, 45.8% non-regular partners). One-fifth of the sample reported condomless internal ejaculation (CIE) during anal sex (19.3% insertive, 19.8% receptive). Frequent "Grindr" and "Jack'd" users were less likely to report anal sex, and hence ICU, with regular [adjusted odds ratio (AOR) = 0.72] and non-regular (AOR = 0.62) partners, respectively. Sexual partnering via apps doubled the odds of ICU with both regular (AOR = 1.99) and non-regular (AOR = 2.17) partners. The odds of ICU with regular partners also increased with relationship status (AOR = 2.86 exclusive, AOR = 3.23 non-exclusive) but reduced for those who never had STI/HIV testing (AOR = 0.27). With non-regular partners, YMSM's likelihood of ICU increased with more recent partners (AOR = 3.25) and drug use (AOR = 3.79), but reduced with group sex (AOR = 0.15). The odds of receptive CIE increased with alcohol consumption (AOR = 4.04), non-exclusive relationship (AOR = 4.10), and more recent partners (AOR = 2.47), but reduced with group sex (AOR = 0.15) and older age (AOR = 0.84). For insertive CIE, the odds increased with bisexual YMSM (AOR = 2.89), exclusive relationship (AOR = 3.97), and longtime apps-use (AOR = 1.81). The findings identify meaningful differences among YMSM app-users that inform sexual health intervention and suggest attention on alcohol or drug use during sex and condomless sex with non-exclusive regular partners.