Potential of Mobile Social Apps for HIV Prevention Interventions among Men Who Have Sex with Men (MSM)

In recent years, the global burden of sexually transmitted HIV infections has become increasingly severe. Men who have sex with men (MSM) have emerged as one of the high-risk populations for HIV/AIDS, owing to the high prevalence of HIV-related risky sexual behaviors within this group.

A systematic review published in The Lancet Infectious Diseases in 2013 showed that the HIV prevalence among men who have sex with men (MSM) increased from 1.77% in 2000 to 5.98% in 2010. The highest prevalence rates were observed in the Southwest and Northwest regions, at 10.21% and 6.49%, respectively (in 2010). Notably, in more than two-thirds of the provinces, the HIV prevalence among MSM exceeded that of people who inject drugs and female sex workers (Figures 1 and 2). Therefore, how to implement behavioral interventions for HIV prevention among the MSM population is one of the urgent issues that health professionals need to address.

Due to sociocultural factors, activities among men who have sex with men (MSM) often remain concealed. In the 1980s, they predominantly sought partners in gay bathhouses. By the late 1990s, the emergence and widespread adoption of computer networks provided them with greater opportunities to find anonymous partners. Currently, with the rapid advancement of smartphones, mobile gay dating apps have gradually become the primary platform for their social interactions. One study indicated that the majority of MSM in China (93.6%) own smartphones, while nearly half (40.6%) use at least one gay dating app.

Although the widespread adoption of smartphones and gay dating apps has facilitated anonymous partner acquisition among men who have sex with men (MSM), potentially increasing the risk of sexually transmitted disease (STD) epidemics—including HIV—within this population, it also presents health workers with opportunities to engage this group more effectively and implement health interventions. Currently, few apps are specifically designed for HIV prevention interventions targeting this population. A survey by the University of North Carolina showed that as of May 1, 2012, there were 69 English-language apps for HIV/STD prevention and care; of these, 29 were available exclusively on iTunes, and 12 were released solely on the Google Play Store. Only 10 apps were tailored to the gay community. Taking STD411 as an example, this app was launched in December 2010 with the aim of promoting sexual health among MSM. It covers four key areas: knowledge dissemination, reduction of high-risk sexual behaviors, promotion of condom use, and disease testing. Overall, user reviews for these apps have been unsatisfactory, with approximately half receiving ratings between 3.7 and 5 stars. Moreover, download and usage rates for such apps remain very low, with only 11 apps surpassing 1,000 downloads. Currently, Central South University is developing similar software with support from the National Natural Science Foundation of China. Expanding the potential user base and enhancing user satisfaction are critical considerations for developers and health professionals alike.

Another approach involves leveraging gay social networking apps with large user bases to implement health interventions. The most widely used gay dating apps in China currently include Blued, Jack’d, Grindr, Zank, and Feizan. A U.S. study utilizing gay dating apps (A4A Radar, Grindr, Jack’d, and Scruff) found that two-thirds of participants expressed willingness to obtain HIV-related health information through these platforms. However, further research is needed to assess the acceptability and feasibility of health interventions via gay dating apps in China.

In summary, health intervention apps for gay men remain an underdeveloped sector. It is hoped that more developers will join this effort to better improve the health of gay men and promote HIV prevention.

Author: Niu Lu, a Ph.D. candidate at the School of Public Health, Central South University; she received her bachelor’s degree from the Peking Union Medical College Hospital School of Nursing.