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Try out PMC Labs and tell us what you think. Learn More. Online venues might facilitate sexual encounters, but the extent to which finding partners online is associated with sexual risk behaviour and sexual health outcomes is unclear.
We describe use of the internet to find sexual partners in a representative sample in Britain. Finding sexual partners online in the past year was reported by After age-adjustment, those reporting a non-heterosexual identity were more likely to report this. STI diagnoses and HIV testing were more common among men reporting finding partners online adjusted for age, partner s, same-sex partnershipsbut not women.
Finding partners online was associated with markers of sexual risk, which might be important for clinical risk assessment, but this was not matched by uptake of sexual health services. Online opportunities to find partners have increased, so these data might underestimate the importance of this social phenomenon for public health and STI control. Sexual partner s and sexual mixing patterns are important epidemiological drivers of transmission and persistence of STIs in populations. In San Francisco, a syphilis outbreak among men who have sex with men MSM was traced back to an online chatroom.
Use of the internet to find sexual partners has frequently been described in MSM populations, 8 w3—w5 while less is known about finding partners online among heterosexuals. Studies investigating this issue have predominately been conducted in unrepresentative samples, with research mainly carried out in clinic studies, 7 9 w6 online convenience surveys, 10 or among youth.
In this study, data from the third National Survey of Sexual Attitudes and Lifestyle Natsal-3a national probability sample survey conducted —, were used to: a estimate the prevalence of using the internet to find sexual partners among men and women in Britain and b examine associations between reporting use of the internet to find partners and sociodemographic factors, sexual behaviour and sexual health outcomes. The response rate was Interviews were carried out via computer-assisted personal interviews, with participants completing computer-assisted self-interviews CASI to answer more sensitive questions.
Full details of the methodology have been published elsewhere. The non-response rate for this question was 2. The Natsal-3 questionnaire also asked about a broad range of sociodemographic factors and sexual and health behaviours. Full methodological details have been described elsewhere.
Analysis was performed using Stata V. The prevalence of using the internet to find sexual partners in the past year, and associated sociodemographic characteristics, were estimated for men and women reporting one or more new sexual partners in the past year men weighted population prevalence: We also present estimates for the wider sexually experienced population, defined as participants reporting at least one sexual partner, ever men weighted population prevalence: Use of the internet to find sexual partners was initially treated as the dependent outcome variable.
Then, internet-use to find partners was treated as the independent exposure variable when examining how reporting of key sexual health outcomes varied according to whether or not participants used the internet to find partners. Multivariable logistic regression was used to present adjusted OR aOR for key factors associated with sexual health outcomes and reporting using the internet to find partners in the univariable analysis.
Participants aged 35—44 years were most likely to report doing so Variations in reporting finding sexual partners on the internet by key sociodemographic and health behaviours in men reporting one or more new sexual partners in the past year and those reporting at least one sexual partner, ever — Variations in reporting finding sexual partners on the internet by key sociodemographic and health behaviours in women reporting one or more new sexual partners in the past year and those reporting at least one sexual partner, ever — After adjusting for age, identifying as non-heterosexual was associated with reporting finding partners online in the main study population.
Female participants with no steady partner were more likely to report using the internet to find sexual partners, compared with participants with a steady partner. In regard to National Statistics Socio-economic Classifications NSSEC17 men and women in full-time education were less likely to have used the internet to find partners than their counterparts in managerial and professional occupations aOR 0.
For men only, access to the internet at home was associated with using the internet to find partners aOR 3. For women, there was an association with using the internet to find partners and having used drugs other than cannabis in the past year aOR 2. As in the main study population, in the wider sexually experienced population more men than women reported doing so 5.
Associations with sexual identity, relationship status and substance use were also identified in the sexually experienced population for both genders, but the association with NSSEC was observed for women only. There was no association with having access to the internet at home for either gender. Reporting using the internet to find sexual partners in the past year was associated with reporting sexual risk behaviours among those reporting new partners in the past year table 3.
Reporting finding partners online in the past year in relation to sexual behaviour and risk perception, by sex — Those reporting higher partner s, condomless sex with two or more sexual partners and overlapping partnerships, all in the past year, were more likely to report using the internet to find sexual partners, and these associations persisted after age-adjustment. For men, there was a particularly strong association between reporting a same-sex partnership in the past year and finding partners online aOR 9.
For women, this association was also ificant aOR 3. For men, there was also a positive association with reporting paying for sex in the past year and finding partners online aOR 2. Use of the internet to find sexual partners was associated with a range of poor sexual health outcomes, including STI diagnoses in the past year, and sexual health seeking behaviours for men in the age-adjusted analysis table 4.
Reporting higher partner s and younger age are both strong predictors of STI risk, 16 as is reporting a same-sex partner for men, 20 and the analyses for sexual health outcomes were therefore adjusted for the confounding effect of partner for both genders, and reporting a same-sex partner for men, in addition to age.
After adjusting for the potential confounders of age, partner and reporting a same-sex partner in the past year, associations persisted for men who reported having had an HIV test in the past year aOR 2. In contrast, associations with having had a test for HIV in the past year and emergency contraception use in the last year were observed for women in the age-adjusted analysis, and no associations persisted after adjustment. Reporting of sexual health outcomes and health seeking behaviours in relation to finding partners online in the past year, by sex — In the wider sexually experienced population, stronger associations between sexual health outcomes and reporting finding partners online were observed for men, and associations with several health seeking behaviours and poor sexual health outcomes were also observed for women see online supplement 2.
STI testing data were available for men and women aged 16—44 years who reported a new partner in the past year. Among these participants, 12 out of men 9. After adjusting for age, there was evidence of a weak association for men reporting use of the internet to find partners and detection of a non-viral STI aOR 2. Around 1 in 6 men and 1 in 10 women with at least one new sexual partner in the past year reported using the internet to find sexual partners, and this was most commonly reported among adults aged 35—44 years.
Reporting a non-heterosexual identity was strongly associated with finding partners online, as were reporting sexual risk behaviours for STIs and having a higher perceived risk of HIV and STIs. However, after adjusting for key behavioural confounders, we found weaker associations in men and no associations in women between using the internet to find sexual partners and sexual health clinic attendance or STI testing.
These data suggest a mismatch between need for table 3 and uptake table 4 of sexual health services in those using the internet to find sexual partners, who might be at higher risk of STIs. After adjusting for age, we observed a positive association between using the internet to find sexual partners and detection of a non-viral STI for men, but not for women, however the data should be interpreted with caution given the small s. To our knowledge, we present the first population-based study in a broad age-range to examine associations between finding partners online and sociodemographic factors, markers of sexual risk and sexual health outcomes.
These data are from a national probability survey, which avoids the selection bias of convenience and clinic samples. This study has several limitations. The data for Natsal-3 were collected between andand in the intervening time, new platforms for finding partners online have emerged and been adopted, and our observations might not reflect the current situation in this fast changing field. While the Natsal-3 fieldwork was being undertaken, dating-apps focusing on MSM, such as Grindr and Scruff were available, while dating-apps targeted at wider populations emerged later.
The location-based dating-app Tinder was launched in Septemberafter Natsal-3 fieldwork was complete, and by had amassed an estimated 50 million mostly heterosexual users worldwide. While our study will not have captured the social and behavioural changes that have occurred as new technologies have emerged, by examining the use of the internet to find partners at a point where the behaviour was relatively rare in the population, we have highlighted the need for further research in this field, and provided data for describing trends in future research conducted on a population-level.
Although Natsal-3 collected data on a wide range of sexual behaviours and health outcomes, questions concerning use of the internet to find sexual partners were limited. We do not know whether participants who reported using the internet to find sexual partners actually had sex with a partner met online. We also do not have event-level information on whether participants exhibited different behaviours with online versus offline partners, or whether different sexual health outcomes resulted from encounters with online partners. Comparisons of individuals' encounters with their offline and online partners might help to determine whether observed risk behaviours are associated with the individual, or with the internet itself.
In ASHR2, participants were asked specifically about both website and app use to find potential partners ever, and in the past year. Additionally, data collection took place a year later than for Natsal-3, and so this higher estimate of prevalence might be due to the increased availability of dating-apps. Unlike our study, ASHR2 asked whether participants had sex with a partner met online, and these estimates were lower than those of participants looking for partners online 2. However, our study reported associations between finding partners online and sociodemographic factors, markers of sexual risk and sexual health outcomes, whereas ASHR2 did not.
Use of the internet to find sexual partners has been well described for MSM, and our findings were consistent with other reports; 7 9 we observed that MSM were more likely to use the internet to find partners than heterosexual men and women. Studies including participants with diverse sexual orientations have stratified the analysis to for baseline differences in risk behaviour between different groups.
However, in our population-based data non-heterosexual groups were too small to do this. Nevertheless, we were able to adjust for reporting a same-sex partner for men when investigating associations for risk perception and sexual health outcomes.
We observed associations between sexual risk behaviour and using the internet to find partners, which has ly been reported in convenience samples of MSM, 8 24 25 young heterosexuals 11 w6 and adult populations. For example, Bolding et al 9 found that individuals exhibited high-risk sexual behaviour both with partners met online and offline. Similarly, in a study of MSM, associations between high-risk sexual behaviour and internet partners was attributed to multiple partnerships and more commonly identified in individuals with both online and offline partners when compared with individuals with exclusively online or offline partners, although the observed differences were small.
In turn, each of these studies have suggested that associations between high-risk sexual behaviour and internet partners are more likely to be due to the individual's risk behaviour in general, rather than the internet being a risk environment, per se. This study has identified an important group within the population who exhibit higher sexual behavioural risk and risk perception, although it is unclear whether internet-use is the cause or a marker for increased sexual risk. There is evidence that the internet facilitates disassortative mixing among MSM, 3 8 and it might be that the same is true among heterosexuals and women who have sex with women such that the population using the internet to find partners might be a bridging population for the transmission of STIs between higher and lower risk groups.
This population might also be targeted for health promotion campaigns and interventions through the same medium that is being used to access partners. Sexual health information and advice is increasingly available online, 26 27 and although our study preceded the widespread use of dating-apps, other studies have explored their potential to be used for STI prevention.
For example, among MSM, dating-apps have been shown to enhance partner notification, 28 and it has been suggested that integrating HIV prevention interventions into dating-apps might allow for targeting of individuals who exhibit markers of risk in their individual profiles.
Awareness campaigns might be of particular importance to older adults who have recently acquired a new sexual partner, because this study has highlighted the internet as an important source of new partners for adults aged 35—44 years.
In our study population, approximately one in three men and one in six women aged 35—44 years reported using the internet to find a sexual partner. Older adults aged 35—44 years are less likely to attend sexual health clinics 16 and might have received inadequate sexual health education as young adults.
Further studies in the general population are needed to determine whether finding partners online is a risk in itself, or if it is a strategy more commonly adopted by individuals who exhibit riskier sexual behaviour. In survey research, this might be achieved by including more detailed questions, enabling event-level analyses about sexual behaviours with, and characteristics of, online and offline partners.
Questions concerning the specific internet meeting site or app used to find a sexual partner will be important to assess whether risks are associated with the internet generally or with specific online platforms for meeting partners, which might help target intervention strategies. Using the internet to find sexual partners was more common among men than women in —, and was strongly associated with reporting sexual risk, which might be important for clinical risk assessment. Since then, the range and availability of opportunities for finding sexual partners online have increased considerably and so these data might underestimate the public health ificance of this phenomenon.
Further in-depth research is needed to understand the extent of the risks associated with finding partners online, whether these risks are at the individual or partnership level, and the potential for tailored interventions to inform STI control. This study investigated the prevalence of, and factors associated with, use of the internet to find sexual partners using data from a national probability sample survey.
Finding sexual partners online was reported by around 1 in 6 men and 1 in 10 women aged 16—74 years with one or more new sexual partner s in the past year. It was associated with reporting sexual risk behaviour in men and women, while associations with sexual health service use outcomes were observed for men only. These data suggest a mismatch between need for and uptake of sexual health services in those using the internet to find sexual partners, who might be at higher risk of STIs.
There has been a considerable increase in online venues to meet sexual partners, and these data are therefore important for describing trends in future research. Handling editor: Jackie A Cassell. Twitter: Follow Nigel Field fienige. All authors contributed to data interpretation, reviewed successive drafts and approved the final version of the manuscript. Competing interests: None declared. Provenance and peer review: Not commissioned; externally peer reviewed. National Center for Biotechnology InformationU.
Sexually Transmitted Infections. Sex Transm Infect. Published online Apr Author information Article notes Copyright and information Disclaimer. This article has been cited by other articles in PMC.Adult searching online dating Ponce
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Finding sexual partners online: prevalence and associations with sexual behaviour, STI diagnoses and other sexual health outcomes in the British population