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Dating applications apps on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. The of a multiple logistic regression analysis found that users of dating apps adjust odds ratio: 0.
Users of dating apps adjust odds ratio: 1. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.
This is an open access article distributed under the terms of the Creative Commons Attribution , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The Internet has long been a popular platform for seeking romantic and even sexual relationships [ 1 ]. A review article concluded that online sex seeking was associated with adverse sexual health such as sexually transmitted infections STIs , unsafe sex and unplanned pregnancies in both heterosexual and homosexual populations, hence, it was suggested that people who seek sexual partners on the Internet tend to be more sexually active and more willing to take risks [ 4 ].
The advancement of mobile technology allows Internet access through smartphones. Along with the growing popularity of smartphones and Internet access worldwide, a variety of location-based dating applications apps using the global positional system GPS have been launched. Compared with traditional online dating paradigms such as websites and chat rooms, these dating apps provide a more convenient and accessible way for people to meet friends and potential sexual partners. First, users can easily find sexual partners who are geographically nearby because of the GPS. Second, nowadays people tend to carry their smartphones with them at all times.
Users can easily access a wide pool of potential sexual partners anytime and anywhere as long as they carry their mobile phones. Third, unlike traditional dating websites which might require subscription fees, most of the dating apps are free. Therefore, it is highly possible that using dating apps is an emerging risk factor for unsafe sexual behaviours. studies found that the prevalence of having unprotected anal intercourse ranged from Moreover, homosexual men who used dating apps for more than one year were more likely to have unprotected anal intercourse [ 7 ].
Compared with nonusers, app users were ificantly more likely to have at least one self-reported prior diagnosis of STIs [ 8 ]. Insight into the use of social dating apps and its associated risky sexual behaviours will both allow researchers and clinicians to understand the phenomenon and guide the de of tailored interventions. However, to date, the evidence regarding the negative effects of smartphone dating apps on sexual health has been conflicting, inconclusive or not generalizable.
A study in the United States found that homosexual app users were more likely to have more sexual partners [ 8 ] whereas another study in Hong Kong did not find this association [ 9 ]. Furthermore, studies mainly focused on homosexual men. The association between using dating apps and sexual health in heterosexual people and women is poorly understood.
Distinct differences in sexual practices and sexual risks between people of different genders [ 10 ] and sexual orientations [ 11 ] have been evident in studies. For example, men were more likely to intend to engage in sexual activities than women [ 10 ]. Oral and anal sexual intercourse was more common in homosexual men then heterosexual men. Bisexual and homosexual women were more likely to have more sexual partners than heterosexual women [ 11 ].
The lack of knowledge about the effects of using dating apps on sexual health in male and female subjects of various sexual orientations necessitated the present study. The specific objective of the present study was to explore the association between the use of smartphone dating apps and risky sexual behaviours, including the of sexual partners with whom students have had unprotected sexual intercourse, inconsistent condom use and not using a condom the last time students had had sexual intercourse. It was hypothesized that the use of dating apps was associated with these behaviours. This was a cross-sectional study.
Subjects were recruited from four university campuses in Hong Kong by convenience sampling. Subjects were excluded if they did not speak or understand English, Cantonese or Mandarin; had already been recruited to the study; or were not college students. A coded and anonymous questionnaire was self-completed by subjects. Questionnaires were available in English and Chinese. Bilingual field workers were present to explain the aims, procedures and nature of the study; obtain written consent; distribute and collect questionnaires; and answer questions raised by subjects.
Subjects were informed that they could skip any questions they did not want to answer. The questions about the use of dating apps, sexual behaviours and sexual orientation were adopted from studies [ 5 , 8 , 12 — 17 ].
Subjects were asked if they were using any smartphone dating apps[ 5 ]. Users of dating apps were asked how long they had been using them [ 5 , 16 ]. Subjects were asked if they had ever had sexual intercourse [ 15 ]. Those who had sexual intercourse experience were asked at what age they had had their first sexual intercourse[ 15 ]; the gender of their sexual partners [ 17 ]; the of sexual partners in the past 1 month, the past 3 months and their entire lives [ 8 , 13 , 15 ]; the of sexual partners they had had unprotected sexual intercourse with; the frequency of their condom use[ 9 ]; and whether they had used a condom the last time they had had sexual intercourse [ 15 ].
All subjects also completed a set of sociodemographic questions about age, gender, sexual orientation, relationship status, monthly income, student status, smoking habits and drinking habits. Multicollinearity diagnostics were performed for all regression models. In each regression model, only subjects with full data were included in the analysis. Imputation or other substitution methods were not used. The methods were carried out in accordance with the approved guidelines. Written informed consent was obtained from all individual participants included in the study. Subjects were recruited between September and December A total of subjects completed the cross-sectional survey.
Of these, subjects were included in the data analysis; the other 10 subjects were excluded because they indicated that they were not college students. The mean age was 20 years; Demographic information is shown in Table 1. Factors associated with having sexual intercourse experience, the corresponding chi-square statistics, adjusted odds ratios aOR derived from multiple logistic regression analyses and model evaluation statistics are shown in Table 2.
All factors that were ificant in the chi-square analysis remained statistically ificant in the multiple logistic regression analysis except for gender and monthly income. Factors associated with having sexual intercourse experience included using dating apps aOR: 1. Two hundred sixty subjects who had sexual intercourse experience were further analysed to explore factors associated with their sexual behaviours.
Their demographic information is shown in Table 3. The are shown in Table 4. To further explore the association between length of time using dating apps and of sexual partners in the last 3 months and in the last 1 month, the length of time using dating apps was put into the regression model. Subjects using dating apps for more than 12 months relative to nonusers were associated with a higher of sexual partners in the last 3 months and last 1 month.
The are shown in Table 5. The of multiple logistic regression found that users of dating apps aOR: 0. The are shown in Table 6. Users of dating apps aOR: 1. Moreover, female subjects were more likely to report that she or her partner did not use a condom the last time she had sexual intercourse aOR: 2. The are shown in Table 7. Logistic regression analysis found that the length of time using dating apps was not a ificant factor associated with risky sexual behaviours data not shown. To the best of our knowledge, this was the first study to examine the association between the use of dating apps and sexual health in a sample of heterosexual, bisexual and homosexual subjects.
The present study found that the use of dating apps was associated with having more sexual partners, having unprotected sexual intercourse with more sexual partners, an increased likelihood of having inconsistent condom use and an increased likelihood of not having used a condom the last time the subject had sexual intercourse.
It appeared that dating apps tended to skew their users toward risky sexual encounters. More than half of the study sample used dating apps suggesting that dating apps are popular among college students. There are at least two possible explanations. First, the nature of dating apps with their convenience, accessibility and mobility can facilitate sexual encounters [ 19 ].
Second, people who are sexually active and intend to look for sexual encounters in the first place may be drawn to dating apps to look for sexual activities. This merits further investigation to understand the causal relationship between using dating apps and the initiation of sexual intercourse. Compared with nonusers, dating app users were more likely to have more sexual partners in their entire lives 4.
This association remained after ing for sociodemographic factors. A study on homosexual men also found that, compared with nonusers, app users reported ificantly more sexual partners in their entire lives and in the last 3 months [ 8 ]. Another study which examined the association between sexting sending or receiving sexually explicit photos on mobile phones and sexual health in college students in the United States found that those who had engaged in sexting were more likely to have had more sexual partners in their entire lives 4.
Having multiple sexual partners is problematic because numerous studies suggest that it is associated with sexually transmitted disease infection, recreational drug use, alcohol consumption, dating violence and unplanned pregnancy [ 7 , 20 — 22 ]. We also found that, compared with nonusers, those who used dating apps for more than 12 months were more likely to have more sexual partners in the last 3 months and in the last 1 month. Conversely, there was no ificant difference in the of sexual partners in the last 3 months and the last 1 month between nonusers and those who used dating apps less than 12 months.
It appeared that using dating apps can lead to an increase in the of sexual partners. There were several possible explanations. First, a qualitative study about online dating suggested that online dating websites can extend the of people users meet and engage with sexually [ 1 ].
Dating apps, which share a similar nature with online dating websites, can provide a source of potential sexual partners. Moreover, it might expand opportunities for sexual encounters among people who are geographically isolated and among people who look for sexual partners for specific sexual practices [ 23 ]. Second, nowadays people carry their smartphones with them at all times. Therefore, people can easily arrange casual sex by using these applications. Third, it was suggested that people were more comfortable and ready to talk about sex in an online environment [ 1 , 24 ].
The association between early sexual initiation and the of sexual partners is consistent with that found in the United States [ 25 ] and mainland China [ 26 ] and is not unique to the population in the present study. Contrary to studies which found that sexual minority youths were more likely to have multiple sexual partners in their entire lives and in the last 3 months, this association cannot be found in the present study [ 7 ].
Contrary to the findings of studies about the use of dating apps among homosexual men [ 6 , 8 ], we found that, compared with nonusers, apps users were more likely to have had unprotected sexual intercourse with more sexual partners, inconsistent condom use and no condom use when they last had sexual intercourse. However, it is hard to compare our with those of the studies due to differences in study populations, control groups, the recall period of condom use and the definition of sexual intercourse. Subjects of the studies were all homosexual.
Studies by Grosskopf et al and Lee et al compared the pattern of condom use between app users and subjects who used the Internet not dating apps for dating [ 6 , 9 ]. It was possible that both groups had similar sexual practices, leading to no difference in the pattern of condom use. The recall period of condom use in the studies was the last 3 months [ 6 , 8 , 16 ]. The studies only assessed unprotected anal intercourse whereas the present study examined condom use in anal, oral and virginal intercourse.
Even though the risk of HIV transmission through oral sex is much lower than anal or vaginal sex, other viral and nonviral sexually transmitted diseases such as gonorrhoea, herpes and syphilis can be transmitted through oral sex [ 27 , 28 ]. Conversely, it was found that college students in the US who engaged in sexting were more like to have had more total unprotected vaginal and anal sex acts in the last 3 months than those who did not 7.
Several studies on homosexual men also suggested that seeking sexual partners online was associated with inconsistent condom use and unprotected anal intercourse [ 30 , 31 ]. First, given the popularity of dating apps and smartphones nowadays, it is impractical and unrealistic to stop people using dating apps. If using dating app causes more risky sexual behaviours, clinicians should develop interventions to promote the safe use of dating apps in order to reduce the likelihood of engaging in risky sexual behaviours among app users, especially for those with no history of risky sexual behaviours.
Second, we found that using dating apps was associated with more risk sexual behaviours. Therefore, users of dating apps should be targeted in risk assessment, screening as well as risk stratification. Third, the developers of these dating apps should take social responsibility. Educational elements such as popup preventive messages and notification to promote safe sex practices should be incorporated into the apps [ 32 ].
Besides, school-based interventions to promote safe sex and availability of condoms in school campuses and dormitories should be advocated. There were a of limitations to this study. First, subjects of this study were recruited in universities by convenience sampling and thus the study findings might not be generalizable to other populations. Compared with the general populations, the age range of our study subjects were narrow and the differences in socio-demographic factors between subjects were low. However, we used multicenter survey to expand the diversities of participants from different geographic locations, study disciplines, academic performance and socioeconomic status.
To establish a robust association between the use of dating apps and sexual health, people in general population should be recruited by probability sampling in future studies. Second, all outcomes were self-reported, which might have bias. However, using self-report measures to obtain data is a common and practical methodology in studies of behavioural health. To strengthen the validity and reliability of our data, all the questions were adapted from research studies. In addition, to avoid social desirability bias, the questionnaire was anonymous and self-completed by interviewees themselves.
Third, this cross-sectional study only provided clues regarding associations, and longitudinal studies are needed to establish any causal relationship between independent variables and sexual health. However, we did not have such variables in this present study. Fourth, we combined homosexual group with bisexual group in data analysis in order to improve the model fit of the regression models. Further study should recruit more people in each group and conduct subgroup analysis to explore whether there are differences in sexual risk behaviours between heterosexual, homosexual and bisexual people.
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