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The American Men’s Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) living in the United States. This Rapid Surveillance Report describes the third cycle of data collection (September 2015 through April 2016; AMIS-2015). The key indicators are the same as previously reported for AMIS (December 2013-May 2014, AMIS-2013; November 2014-April 2015, AMIS-2014). The AMIS survey methodology has not substantively changed since AMIS-2014. MSM were recruited from a variety of websites using banner advertisements and email blasts. Additionally, participants from AMIS-2014 who agreed to be recontacted for future research were emailed a link to the AMIS-2015 survey. Men were eligible to participate if they were age 15 years and older, resided in the United States, provided a valid US ZIP code, and reported ever having sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (
The American Men’s Internet Survey (AMIS) is an annual online behavioral survey of men who have sex with men (MSM) who live in the United States. The methods have been previously published [
As in the prior year, AMIS participants were recruited through convenience sampling from a variety of websites using banner advertisements or email blasts to website members (hereafter referred to generically as “ads”). The survey was not incentivized. Data on the number of clicks on all banner ads were obtained directly from the websites. In AMIS-2014, data on the number of clicks on geospatial social networking banner ads were instead obtained by counting the number of clicks on the survey landing page. Men who clicked on the ads were taken directly to the survey website hosted on a secure server administered by SurveyGizmo (Boulder, CO, USA). Participants were also recruited by emailing participants from the previous cycle of AMIS (AMIS-2014) who consented to be recontacted for future studies. To be eligible for the survey, participants had to be 15 years of age or older, consider themselves to be male, and report that they had oral or anal sex with a man at least once in the past (hereafter referred to as MSM). Persons who reported being younger than 15 years of age or refused to provide their age were not asked any other screening questions. Those MSM who met the eligibility criteria and consented to participate in the study started the online survey immediately. The full questionnaire for AMIS-2015 is presented in
AMIS-2015 ran from September 2015 through April 2016, and resulted in 137,608 persons clicking on the ads and landing on the study’s recruitment page (
Recruitment outcomes for the American Men’s Internet Survey, United States, 2015.
Recruitment outcomes | Total | Recruitment type | |||||
Gay social |
General gay |
General social |
Geospatial social |
AMIS-2014 |
|||
Clicked ad, n | 137,608 | 4680 | 3968 | 66,500 | 62,261 | 199 | |
Screened,a n (%) | 46,207 (33.58) | 3671 (78.44) | 1165 (29.36) | 30,581 (45.99) | 10,630 (17.07) | 160 (80.40) | |
Ineligible,bn (%) | 20,288 (43.91) | 740 (20.16) | 463 (39.74) | 16,206 (52.99) | 2868 (26.98) | 11 (6.88) | |
Not age ≥15 yearsc | 14,246 (70.22) | 615 (83.11) | 369 (79.70) | 11,056 (68.22) | 2197 (76.60) | 9 (81.82) | |
Not malec | 15,255 (75.19) | 559 (75.54) | 381 (82.29) | 11,800 (72.81) | 2505 (87.34) | 10 (90.91) | |
Not ever MSMc | 19,804 (97.61) | 620 (83.78) | 454 (98.06) | 16,046 (99.01) | 2673 (93.20) | 11 (100.00) | |
Nonresidentc | 15,502 (76.41) | 624 (84.32) | 377 (81.43) | 11,469 (70.77) | 2573 (89.71) | 9 (81.82) | |
Eligible,b n (%) | 25,919 (56.09) | 2931 (79.84) | 702 (60.26) | 14,375 (47.01) | 7762 (73.02) | 149 (93.13) | |
Consented,d n (%) | 20,351 (78.52) | 2181 (74.41) | 586 (83.48) | 10,818 (75.26) | 6623 (85.33) | 143 (95.97) | |
Unduplicated,e n (%) | 18,060 (88.74) | 2032 (93.17) | 552 (94.20) | 9410 (86.98) | 5926 (89.48) | 140 (97.90) | |
Success,f n (%) | 11,597 (64.21) | 1568 (77.17) | 426 (77.17) | 6372 (67.72) | 3104 (52.38) | 127 (90.71) | |
MSM past 12 months,g n (%) | 10,330 (89.07) | 1456 (92.86) | 381 (89.44) | 5425 (85.14) | 2953 (95.14) | 115 (90.55) | |
Valid ZIP code,h n (%) | 10,217 (98.91) | 1451 (99.66) | 381 (100.00) | 5396 (99.47) | 2875 (97.36) | 114 (99.13) |
a Proportion is of total who clicked ad. Includes those who started the screening questionnaire.
b Proportion is among total screened. Ineligible includes those who did not complete the screening questionnaire.
c Proportion is among total ineligible. Includes those who may not have responded to the question. MSM: men who have sex with men.
d Proportion is among eligible.
e Proportion is among consented. Unduplicated removes participants who were marked as duplicates using IP address and demographic data matching.
f Proportion is among unduplicated. Success removes participants who did not pass the test for survey completeness.
g Proportion is among successes.
h Proportion is among MSM in the past 12 months. Valid US ZIP codes were those that could be matched to the ZIP code-to-county crosswalk files created by the US Department of Housing and Urban Development. Any ZIP codes that could not be matched to this list were then hand-validated by checking against the ZIP code locator tool on the USPS website. ZIP codes that could not be found were classified as invalid.
Almost all these surveys (10,217/10,330, 98.91%) provided a valid US ZIP code. ZIP codes provided by participants were validated by merging them with the 2015 ZIP code-to-county crosswalk files created by the US Department of Housing and Urban Development [
For AMIS-2015 analyses, participants were categorized as either being AMIS-2014 participants who took the survey again or new participants from website/app types based on target audience and purpose: gay social networking (n=1), gay general interest (n=2), general social networking (n=4), and geospatial social networking (n=2). Recruitment outcomes and demographic characteristics for the AMIS-2014 participants are presented and for all behavioral outcomes, they are recategorized according to their original recruitment source. We do not provide the names of the websites/apps to preserve operator and client privacy, particularly where a category has only one operator. The participants who were eligible, consented, unduplicated, successful, reported male-male sex in the past 12 months, and provided a valid US ZIP code were included in analyses of participant characteristics and behavior.
For AMIS-2015, we created a more refined population density variable for each participant’s county of residence as determined by their ZIP code. The levels of the population density variable are from the National Center for Health Statistics (NCHS) Rural-Urban classification scheme [
The analysis methods for AMIS-2015 did not substantively differ from those previously published but are repeated in this report for clarity [
Approximately seven in 10 (7291/10,217, 71.36%) participants included in this report were white and non-Hispanic, less than half were 40 years of age or older (4326/10,217, 42.34%), and their most common region of residence was the South followed by the West (
Characteristics of MSM participants in the American Men’s Internet Survey by recruitment type, United States, 2015.
Participant characteristics | Total, n (%) | Recruitment type, n (%) | ||||||
Gay social |
General gay |
General social |
Geospatial social |
AMIS-2014 |
||||
<.001 | ||||||||
Black, non-Hispanic | 675 (6.61) | 33 (2.27) | 15 (3.94) | 444 (8.23) | 176 (6.12) | 7 (6.14) | ||
Hispanic | 1387 (13.58) | 73 (5.03) | 36 (9.45) | 755 (13.99) | 511 (17.77) | 12 (10.53) | ||
White, non-Hispanic | 7291 (71.36) | 1271 (87.59) | 301 (79.00) | 3733 (69.18) | 1899 (66.05) | 87 (76.32) | ||
Other or multiple races | 864 (8.46) | 74 (5.10) | 29 (7.61) | 464 (8.60) | 289 (10.05) | 8 (7.02) | ||
<.001 | ||||||||
15-24 | 2821 (27.61) | 32 (2.21) | 37 (9.71) | 2155 (39.94) | 581 (20.21) | 16 (14.04) | ||
25-29 | 1583 (15.49) | 36 (2.48) | 61 (16.01) | 983 (18.22) | 491 (17.08) | 12 (10.53) | ||
30-39 | 1487 (14.55) | 112 (7.72) | 86 (22.57) | 516 (9.56) | 740 (25.74) | 33 (28.95) | ||
≥40 | 4326 (42.34) | 1271 (87.59) | 197 (51.71) | 1742 (32.28) | 1063 (36.97) | 53 (46.49) | ||
.002 | ||||||||
Northeast | 2038 (19.95) | 304 (20.95) | 72 (18.90) | 1074 (19.90) | 566 (19.69) | 22 (19.30) | ||
Midwest | 2127 (20.82) | 344 (23.71) | 73 (19.16) | 1152 (21.35) | 530 (18.43) | 28 (24.56) | ||
South | 3739 (36.60) | 467 (32.18) | 132 (34.65) | 2000 (37.06) | 1098 (38.19) | 42 (36.84) | ||
West | 2305 (22.56) | 335 (23.09) | 103 (27.03) | 1166 (21.61) | 679 (23.62) | 22 (19.30) | ||
US dependent areas | 8 (0.08) | 1 (0.07) | 1 (0.26) | 4 (0.07) | 2 (0.07) | 0 (0.0) | ||
<.001 | ||||||||
Yes | 3731 (36.52) | 565 (38.94) | 177 (46.46) | 1855 (34.38) | 1090 (37.91) | 44 (38.60) | ||
No | 6486 (63.48) | 886 (61.06) | 204 (53.54) | 3541 (65.62) | 1785 (62.09) | 70 (61.40) | ||
<.001 | ||||||||
Urban | 4101 (40.18) | 572 (39.45) | 189 (49.74) | 2073 (38.45) | 1214 (42.28) | 53 (46.49) | ||
Suburban | 2041 (20.00) | 363 (25.03) | 71 (18.68) | 1092 (20.26) | 494 (17.21) | 21 (18.42) | ||
Small/ medium metropolitan | 3076 (30.14) | 387 (26.69) | 97 (25.53) | 1679 (31.14) | 883 (30.76) | 30 (26.32) | ||
Rural | 988 (9.68) | 128 (8.83) | 23 (6.05) | 547 (10.15) | 280 (9.75) | 10 (8.77) | ||
<.001 | ||||||||
Positive | 955 (9.35) | 108 (7.44) | 26 (6.82) | 411 (7.62) | 395 (13.74) | 15 (13.16) | ||
Negative | 7143 (69.91) | 1102 (75.95) | 302 (79.27) | 3566 (66.05) | 2080 (72.35) | 93 (81.58) | ||
Unknown | 2119 (20.74) | 241 (16.61) | 53 (13.91) | 1419 (26.32) | 400 (13.91) | 6 (5.26) | ||
Total | 10,217 | 1451 | 381 | 5396 | 2875 | 114 |
a Chi-square test for difference in characteristics between recruitment types.
b NHBS: National HIV Behavioral Surveillance System.
C There were 11 participants living in US territories or provided military addresses, which could not have an NCHS urban/rural category assigned.
Most participants reported having anal sex without a condom with another man within the past 12 months (
Sexual Behaviors with Male Partners of MSM Participants in the American Men’s Internet Survey, United States, 2015.
Participant characteristics | n | Sexual behaviors with male partners in the past 12 months | |||||
Anal intercourse without a condom | Anal intercourse without a condom with a partner of discordant or unknown HIV status | ||||||
n (%) | n (%) | ||||||
955 | 721 (75.50) | <.001b | 329 (34.45) | <.001b | |||
Black, non-Hispanic | 161 | 105 (65.22) | .08 | 35 (21.74) | .002 | ||
Hispanic | 152 | 113 (74.34) | .70 | 48 (31.58) | .92 | ||
White, non-Hispanic | 573 | 454 (79.23) | REF | 221 (38.57) | REF | ||
Other or multiple races | 69 | 49 (71.01) | .50 | 25 (36.23) | .37 | ||
15-24 | 50 | 40 (80.00) | .83 | 18 (36.00) | .76 | ||
25-29 | 107 | 92 (85.98) | .04 | 42 (39.25) | .37 | ||
30-39 | 181 | 147 (81.22) | .91 | 68 (37.57) | .45 | ||
≥40 | 617 | 442 (71.64) | REF | 201 (32.58) | REF | ||
Yes | 422 | 325 (77.01) | .14 | 142 (33.65) | .83 | ||
No | 533 | 396 (74.30) | REF | 187 (35.08) | REF | ||
Gay social networking | 108 | 79 (73.15) | .35 | 48 (44.44) | .18 | ||
General gay interest | 26 | 22 (84.62) | .30 | 12 (46.15) | .37 | ||
General social networking | 413 | 290 (70.22) | REF | 137 (33.17) | REF | ||
Geospatial social networking | 408 | 330 (80.88) | .59 | 132 (32.35) | .01 | ||
9262 | 5843 (63.09) | REF | 1581 (17.07) | REF | |||
Black, non-Hispanic | 514 | 316 (61.48) | .55 | 92 (17.90) | .44 | ||
Hispanic | 1235 | 804 (65.10) | .27 | 248 (20.08) | .05 | ||
White, non-Hispanic | 6718 | 4244 (63.17) | REF | 1116 (16.61) | REF | ||
Other or multiple races | 795 | 479 (60.25) | .05 | 125 (15.72) | .06 | ||
15-24 | 2771 | 1713 (61.82) | <.001 | 524 (18.91) | .001 | ||
25-29 | 1476 | 1072 (72.63) | <.001 | 257 (17.41) | .63 | ||
30-39 | 1306 | 930 (71.21) | <.001 | 224 (17.15) | .37 | ||
≥40 | 3709 | 2128 (57.37) | REF | 576 (15.53) | REF | ||
Yes | 3309 | 2055 (62.10) | .17 | 570 (17.23) | .82 | ||
No | 5953 | 3788 (63.63) | REF | 1011 (16.98) | REF | ||
Gay social networking | 1343 | 706 (52.57) | <.001 | 222 (16.53) | .49 | ||
General gay interest | 363 | 234 (64.46) | .59 | 60 (16.53) | .87 | ||
General social networking | 5028 | 3120 (62.05) | REF | 816 (16.23) | REF | ||
Geospatial social networking | 2528 | 1783 (70.53) | <.001 | 483 (19.11) | .06 |
a Wald chi-square from multivariate logistic regression comparing behavior (yes vs no) among group with some characteristic compared to a referent (REF) group.
b Wald chi-square from multivariate logistic regression comparing behavior (yes vs no) among HIV-positive participants compared to HIV-negative or unknown serostatus participants. Model controlled for race/ethnicity, age, NHBS residency, and recruitment type.
C NHBS: National HIV Behavioral Surveillance System.
Almost one-quarter (235/955, 24.6%) of HIV-positive participants reported using marijuana in the past 12 months (
Substance using behaviors of MSM participants in the American Men’s Internet Survey, United States, 2015.
Participant characteristics | n | Substance use behaviors in the past 12 months | |||||
Used marijuana | Used other substance(s) | ||||||
n (%) | n (%) | ||||||
955 | 235 (24.61) | <.001b | 273 (28.59) | <.001b | |||
Black, non-Hispanic | 161 | 40 (24.84) | .35 | 31 (19.25) | .06 | ||
Hispanic | 152 | 39 (25.66) | .89 | 49 (32.24) | .39 | ||
White, non-Hispanic | 573 | 144 (25.13) | REF | 175 (30.54) | REF | ||
Other or multiple races | 69 | 12 (17.39) | .07 | 18 (26.09) | .60 | ||
15-24 | 52 | 15 (30.00) | .88 | 14 (28.00) | .48 | ||
25-29 | 109 | 43 (40.19) | .003 | 43 (40.19) | .02 | ||
30-39 | 187 | 53 (29.28) | .67 | 69 (38.12) | .19 | ||
≥40 | 627 | 124 (20.10) | REF | 147 (23.82) | REF | ||
Yes | 422 | 110 (26.07) | .35 | 125 (29.62) | .45 | ||
No | 533 | 125 (23.45) | REF | 148 (27.77) | REF | ||
Gay social networking | 108 | 20 (18.52) | .89 | 28 (25.93) | .97 | ||
General gay interest | 26 | 4 (15.38) | .48 | 7 (26.92) | .93 | ||
General social networking | 413 | 90 (21.79) | REF | 95 (23.00) | REF | ||
Geospatial social networking | 408 | 121 (29.66) | .04 | 143 (35.05) | .14 | ||
9262 | 2127 (22.96) | REF | 1622 (17.51) | REF | |||
Black, non-Hispanic | 514 | 91 (17.70) | .06 | 67 (13.04) | .02 | ||
Hispanic | 1235 | 296 (23.97) | .78 | 220 (17.81) | .84 | ||
White, non-Hispanic | 6718 | 1570 (23.37) | REF | 1200 (17.86) | REF | ||
Other or multiple races | 795 | 170 (21.38) | .32 | 135 (16.98) | .94 | ||
15-24 | 2771 | 854 (30.82) | <.001 | 543 (19.60) | .02 | ||
25-29 | 1476 | 437 (29.61) | <.001 | 356 (24.12) | <.001 | ||
30-39 | 1306 | 297 (22.74) | .16 | 254 (19.45) | .96 | ||
≥40 | 3709 | 539 (14.53) | REF | 469 (12.64) | REF | ||
Yes | 3309 | 793 (23.96) | .002 | 633 (19.13) | <.001 | ||
No | 5953 | 1334 (22.41) | REF | 989 (16.61) | REF | ||
Gay social networking | 1343 | 187 (13.92) | .02 | 167 (12.43) | .13 | ||
General gay interest | 363 | 74 (20.39) | .92 | 57 (15.70) | .44 | ||
General social networking | 5028 | 1244 (24.74) | REF | 859 (17.08) | REF | ||
Geospatial social networking | 2528 | 622 (24.60) | .004 | 539 (21.32) | <.001 |
a Wald chi-square from multivariable logistic regression comparing behavior (yes vs no) among group with some characteristic compared to a referent (REF) group.
b Wald chi-square from multivariable logistic regression comparing behavior (yes vs no) among HIV-positive participants compared to HIV-negative or unknown serostatus participants. Model controlled for race/ethnicity, age, NHBS residency, and website type.
c NHBS: National HIV Behavioral Surveillance System.
HIV testing behaviors were examined among those who did not report being HIV-positive (
HIV testing behaviors of HIV-negative or unknown status MSM participants in the American Men’s Internet Survey, United States, 2015.
Participant characteristics | n | HIV testing behaviors | ||||
HIV tested ever | HIV tested past 12 months | |||||
n (%) | n (%) | |||||
Black, non-Hispanic | 514 | 445 (86.58) | .06 | 333 (64.79) | .02 | |
Hispanic | 1235 | 948 (76.76) | .35 | 715 (57.89) | .37 | |
White, non-Hispanic | 6718 | 5314 (79.10) | REF | 3645 (54.26) | REF | |
Other or multiple races | 795 | 620 (77.99) | .99 | 465 (58.49) | .81 | |
15-24 | 2771 | 1599 (57.70) | <.001 | 1286 (46.41) | <.001 | |
25-29 | 1476 | 1269 (85.98) | <.001 | 903 (61.18) | <.001 | |
30-39 | 1306 | 1160 (88.82) | <.001 | 858 (65.70) | <.001 | |
40 or older | 3709 | 3299 (88.95) | REF | 2111 (56.92) | REF | |
Yes | 3309 | 2774 (83.83) | <.001 | 2075 (62.71) | <.001 | |
No | 5953 | 4553 (76.48) | REF | 3083 (51.79) | REF | |
Gay social networking | 1343 | 1122 (83.54) | <.001 | 713 (53.09) | .005 | |
General gay interest | 363 | 311 (85.67) | .87 | 189 (52.07) | .002 | |
General social networking | 5028 | 3694 (73.47) | REF | 2512 (49.96) | REF | |
Geospatial social networking | 2528 | 2200 (87.03) | <.001 | 1744 (68.99) | <.001 | |
9262 | 7327 (79.11) | 5158 (55.69) |
a Wald chi-square from multivariable logistic regression comparing behavior (yes vs no) among group with some characteristic compared to a referent (REF) group.
b NHBS: National HIV Behavioral Surveillance System.
Compared to HIV-negative/unknown status participants, HIV-positive participants were significantly more likely to report sexually transmitted infection (STI) testing (AOR 4.00, 95% CI 3.43-4.68) and STI diagnosis (AOR 3.83, 95% CI 3.20-4.59) in the past 12 months (
Sexually transmitted infection testing and diagnosis of MSM participants in the American Men’s Internet Survey, United States, 2015.
Participant characteristics | n | STI History in the Past 12 Months | |||||
Tested for any STIa | Diagnosed with any STIa | ||||||
n (%) | n (%) | ||||||
955 | 685 (71.73) | <.001c | 245 (25.65) | <.001c | |||
Black, non-Hispanic | 161 | 116 (72.05) | .39 | 48 (29.81) | .10 | ||
Hispanic | 152 | 109 (71.71) | .29 | 50 (32.89) | .75 | ||
White, non-Hispanic | 573 | 413 (72.08) | REF | 130 (22.69) | REF | ||
Other or multiple races | 69 | 47 (68.12) | .32 | 17 (24.64) | .25 | ||
15-24 | 50 | 44 (88.00) | .09 | 23 (46.00) | .02 | ||
25-29 | 107 | 89 (83.18) | .45 | 43 (40.19) | .09 | ||
30-39 | 181 | 152 (83.98) | .56 | 66 (36.46) | .77 | ||
≥40 | 617 | 400 (64.83) | REF | 113 (18.31) | REF | ||
Yes | 422 | 313 (74.17) | .10 | 128 (30.33) | .007 | ||
No | 533 | 372 (69.79) | REF | 117 (21.95) | REF | ||
Gay social networking | 108 | 71 (65.74) | .81 | 21 (19.44) | .40 | ||
General gay interest | 26 | 15 (57.69) | .25 | 3 (11.54) | .26 | ||
General social networking | 413 | 276 (66.83) | REF | 79 (19.13) | REF | ||
Geospatial social networking | 408 | 323 (79.17) | .006 | 142 (34.80) | .003 | ||
9262 | 3568 (38.52) | REF | 752 (8.12) | REF | |||
Black, non-Hispanic | 514 | 241 (46.89) | .01 | 57 (11.09) | .07 | ||
Hispanic | 1235 | 543 (43.97) | .92 | 150 (12.15) | .04 | ||
White, non-Hispanic | 6718 | 2458 (36.59) | REF | 481 (7.16) | REF | ||
Other or multiple races | 795 | 326 (41.01) | .30 | 64 (8.05) | .03 | ||
15-24 | 2771 | 997 (35.98) | <.001 | 229 (8.26) | .46 | ||
25-29 | 1476 | 753 (51.02) | <.001 | 169 (11.45) | <.001 | ||
30-39 | 1306 | 639 (48.93) | .004 | 154 (11.79) | .15 | ||
≥40 | 3709 | 1179 (31.79) | REF | 200 (5.39) | REF | ||
Yes | 3309 | 1493 (45.12) | <.001 | 350 (10.58) | <.001 | ||
No | 5953 | 2075 (34.86) | REF | 402 (6.75) | REF | ||
Gay social networking | 1343 | 365 (27.18) | <.001 | 59 (4.39) | .04 | ||
General gay interest | 363 | 143 (39.39) | .88 | 23 (6.34) | .27 | ||
General social networking | 5028 | 1746 (34.73) | REF | 313 (6.23) | REF | ||
Geospatial social networking | 2528 | 1314 (51.98) | <.001 | 357 (14.12) | <.001 |
a Sexually transmitted infection (STI) includes chlamydia, gonorrhea, and syphilis.
b Wald chi-square from multivariable logistic regression comparing behavior (yes vs no) among group with some characteristic compared to a referent (REF) group.
c Wald chi-square from multivariable logistic regression comparing behavior (yes vs no) among HIV-positive participants compared to HIV-negative or unknown serostatus participants. Model controlled for race/ethnicity, age, NHBS residency, and website type.
d NHBS: National HIV Behavioral Surveillance System.
Number of MSM participants in the American Men’s Internet Survey by state, 2015.
AMIS 2015 Questionnaire.
Recruitment and enrollment outcomes flow chart.
American Men’s Internet Survey
human immunodeficiency virus
Metropolitan Statistical Area
men who have sex with men
National Center for Health Statistics
National HIV Behavioral Surveillance System
sexually transmitted infection
The study was funded by a grant from the MAC AIDS Fund and by the National Institutes of Health (P30AI050409)—the Emory Center for AIDS Research.
Authors Sanchez and Sullivan are members of the Editorial Board of JMIR Public Health and Surveillance. However, they had no involvement in the editorial decision for this manuscript. It was reviewed and handled by an independent editor.