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08-Jan-2018 14:03

Rural MSM who used the Internet to meet sex partners were more likely to report any UAI (a OR: 1.89 (1.12-3.19)) and insertive UAI (a OR: 2.16 (1.13- 4.10)) with the last sex partner than those who did not use the Internet. Recent surveys report that between 30% and 50% of MSM have had sex with partners they have met online and there is a growing concern that using the Internet to meet partners is associated with sex behaviors, such as unprotected anal intercourse (UAI), that put men at risk for HIV infection (Benotsch, 2002; Bolding, 2005; J.

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Respondents who had multiple partners were asked if they met any of their partners on line.

Second, the bivariate association between Internet use and UAI, stratified by rural versus urban residence was examined, and a Mantel-Haenszel homogeneity test was used to determine statistical significance of the interaction between residence and Internet use to meet sex partners.

Finally, the interaction between Internet use and residence was assessed in three separate multivariate logistic regression models (modeling any UAI, receptive UAI, and insertive UAI), where an interaction term (Internet use*residence) was forced into the model to test our hypothesis about this interaction.

Our use of the lower quartile also approximates the distribution of urban and rural residents of the United States: according to the 2000 US Census, 21% of Americans live in an area classified as rural For all categorical variables (race/ethnicity, education, type of partner at last sex, respondent and last sex partner’s serostatus, Internet use to meet sex partners, and UAI), frequencies were calculated and χ tests were done to assess differences in the distribution of the variables between rural and urban MSM, and between MSM who were and were not missing explanatory variables.

Age was the only continuous variable used in this analysis.

To address the interaction between residence and Internet use to meet sex partners and its association with risky sex behavior, this analysis was carried out in 3 stages.



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