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The American Men’s Internet Survey (AMIS) is an annual web-based behavioral survey conducted in the United States of men who have sex with men (MSM). This rapid surveillance report describes the sixth cycle of data collection (September-December 2018; AMIS 2018). The key indicators were the same as those previously reported for past AMIS cycles. The AMIS methodology has not substantively changed since AMIS 2017. MSM were recruited from a variety of websites using banner advertisements and email blasts. In addition, participants from AMIS 2017 who agreed to be recontacted for future research were emailed a link to AMIS 2018. Men were eligible to participate if they were aged ≥15 years, resided in the United States, provided a valid US ZIP code, and reported ever having sex with a man or identified as gay or bisexual. The analysis was limited to those who reported having oral or anal sex with a male partner in the past 12 months. We examined demographic and recruitment characteristics using multivariable regression modeling (
The American Men’s Internet Survey (AMIS) is an annual web-based behavioral survey conducted in the United States of men who have sex with men (MSM). AMIS was developed to produce timely data from large-scale monitoring of behavior trends among MSM recruited on the web. It was designed to complement the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance (NHBS) system, which collects data on MSM in major US cities every 3 years through venue-based recruitment [
The methods and past AMIS cycle data (AMIS 2013, AMIS 2014, AMIS 2015, AMIS 2016, and AMIS 2017) have been previously published [
This supplemental report has updated the existing information with the data collected in AMIS 2018. The methods in AMIS 2018 have not changed from the previously published methods, unless otherwise noted. An in-depth analysis, discussion, and limitations of multiyear trends for indicators reported herein have been published and include data for the first 4 cycles of AMIS (AMIS 2013 to AMIS 2016) [
Similar to the previous year’s recruitment process, AMIS participants were recruited through convenience sampling from a variety of websites using banner advertisements or email blasts to members of the website (hereafter referred to generically as
Several data cleaning steps were performed on the raw data set of eligible responses to obtain the final analysis data set, in the same manner as in previous AMIS cycles [
First, to deduplicate survey responses, demographic data for near-complete (>70%) survey responses with nonunique internet protocol addresses were compared, and responses that showed a 100% match for age, race, ethnicity, ever having sex with a woman, and email address were considered to be duplicate responses. Only the observation with the highest survey completion was retained. The data set was, then, limited to those surveys that were deemed successful. Finally, the data set was restricted to include participants who reported having oral or anal sex in the past 12 months and who provided a valid US ZIP code. ZIP codes were validated in the same manner as done in AMIS 2017 [
The study was conducted in compliance with federal regulations governing the protection of human subjects and was reviewed and approved by our institution’s human subjects research review board. No incentive was provided to the participants. Data sets for analyses were stored on secure data servers with access only granted to study staff. The study data are protected under a federal certificate of confidentiality that prevents legal action to force data release.
For the AMIS 2018 analyses, participants were categorized as either AMIS 2017 participants who took the survey again or new participants from the website or app based on the target audience and purpose: gay social networking (n=2), gay general interest (n=1), general social networking (n=4), and geospatial social networking (n=2). Recruitment outcomes and demographic characteristics for the AMIS 2018 participants are presented in the first two tables, and thereafter, they are recategorized to how they were originally recruited in AMIS 2017. We did not provide the names of the websites or apps to preserve operator and client privacy, particularly when a category has only one operator. Participants whose data were eligible, unduplicated, and successful and who provided consent; reported having male-male sex in the past 12 months; and provided a valid US ZIP code were included in analyses of participant characteristics and behavior.
To facilitate comparisons, the key indicators and analytic approach used in AMIS were designed to mirror those used by the NHBS system [
The analysis methods for AMIS 2018 did not substantively differ from those previously published but are repeated in this report for clarity. Overall, chi-square tests were used to identify whether participant characteristics differed significantly among recruitment sources. Multivariable logistic regression modeling was used to determine significant differences in behaviors based on the self-reported HIV status while controlling for race or ethnicity, age group, NHBS city residency, and type of recruitment website. The metropolitan statistical areas included in the NHBS system in 2018 were as follows: Atlanta, Georgia; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Denver, Colorado; Detroit, Michigan; Houston, Texas; Los Angeles, California; Memphis, Tennessee; Miami, Florida; Nassau-Suffolk, New York; New Orleans, Louisiana, New York City, New York; Newark, New Jersey; Philadelphia, Philadelphia; Portland, Oregon; San Diego, California; San Francisco, California; San Juan, Puerto Rico; Seattle, Washington; Virginia Beach-Norfolk, Virginia; and Washington, District of Columbia. HIV testing behaviors were only examined among those who did not report that they were living with HIV, and these data were presented in participant characteristics. The multivariable logistic regression results were presented as adjusted odds ratios (aORs) with 95% CI and Wald chi-square
AMIS 2018 was conducted from September 2018 to December 2018 and resulted in 91,142 persons screened for eligibility (
Recruitment outcomes for the American Men’s Internet Survey, United States, 2018.
Recruitment outcomes | Total | Gay social networking (n=2)a | General gay interest (n=1)a | General social networking (n=4)a | Geospatial social networking (n=2)a | AMISb 2017 participants | |||||||
Screenedc, N | 91,142 | 1288 | 197 | 80,768 | 7406 | 1483 | |||||||
|
49,131 (53.91) | 279 (21.66) | 140 (71.07) | 46,689 (57.81) | 1857 (25.07) | 166 (11.19) | |||||||
|
Not >15 years of agee | 22,659 (46.12) | 115 (41.22) | 13 (9.29) | 21,507 (46.06) | 951 (51.21) | 73 (43.98) | ||||||
|
Not malee | 38,832 (79.04) | 226 (81) | 48 (34.29) | 36,830 (78.88) | 1590 (85.62) | 138 (83.13) | ||||||
|
Not MSMe,f | 48,398 (98.51) | 257 (92.11) | 53 (37.86) | 46,233 (99.02) | 1697 (91.38) | 158 (95.18) | ||||||
|
Nonresidente | 36,714 (74.73) | 220 (78.85) | 131 (93.57) | 34,637 (74.19) | 1597 (86) | 129 (77.71) | ||||||
Eligiblec, n (%) | 42,011 (46.09) | 1009 (78.34) | 57 (28.93) | 34,079 (42.19) | 5549 (74.93) | 1317 (88.81) | |||||||
Consentedg, n (%) | 40,847 (97.23) | 964 (95.54) | 55 (96.49) | 33,087 (97.09) | 5429 (97.84) | 1312 (99.62) | |||||||
Unduplicatedh, n (%) | 34,252 (83.85) | 859 (89.11) | 51 (92.73) | 27,527 (83.20) | 4639 (85.45) | 1176 (89.63) | |||||||
Successi, n (%) | 12,246 (35.75) | 489 (56.93) | 39 (76.47) | 8150 (29.61) | 2537 (54.69) | 1031 (87.67) | |||||||
MSM in the past 12 monthsj, n (%) | 10,232 (83.55) | 434 (88.75) | 32 (82.05) | 6424 (78.82) | 2395 (94.40) | 947 (91.85) | |||||||
Valid ZIP codek, n (%) | 10,129 (98.99) | 430 (99.08) | 32 (100) | 6351 (98.86) | 2375 (99.16) | 941 (99.37) |
aRefers to the number of websites or apps in this category.
bAMIS: American Men’s Internet Survey.
cProportion of participants who started the screening questionnaire.
dProportion of total participants screened. Participants who did not complete the screening questionnaire were considered ineligible.
eProportion of ineligible participants, including those who did not respond to the question.
fMSM: men who have sex with men or identify as gay or bisexual.
gProportion of eligible participants.
hProportion of participants who consented. Deduplication removes participants who were marked as duplicates using the internet protocol address and demographic data matching.
iProportion of unduplicated participants. Success removes participants who do not pass the test for completeness.
jProportion of successes.
kProportion of men who had sex with men in the past 12 months. Valid US ZIP codes were those that could be matched to the ZIP code for 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 US Postal Service website. ZIP codes that could not be found were classified as invalid.
In total, 69.22% (7011/10,129) of the participants included in this report were non-Hispanic White and 41.76% (4230/10,129) were aged 15-24 years; the most common region of residence was the south, followed by the west (
Characteristics of men who have sex with men in the American Men’s Internet Survey by recruitment type, United States, 2018.
Participant characteristics | Total | Gay social networking (n=2)a | General gay interest (n=1)a | General social networking (n=3)a | Geospatial social networking (n=2)a | AMISb 2016 participants | ||||||||||
|
<.001 | |||||||||||||||
|
Black, non-Hispanic | 553 (5.46) | 36 (8.4) | <5 (—)d | 337 (5.3) | 127 (5.3) | 52 (5.5) |
|
||||||||
|
Hispanic | 1630 (16.09) | 32 (7.4) | <5 (—) | 1220 (19.21) | 269 (11.33) | 106 (11.26) |
|
||||||||
|
White, non-Hispanic | 7011 (69.22) | 333 (77.4) | 24 (75) | 4128 (65) | 1801 (75.83) | 725 (77.05) |
|
||||||||
|
Other or multiple races | 749 (7.39) | 16 (3.7) | <5 (—) | 546 (8.6) | 133 (5.6) | 51 (5.4) |
|
||||||||
|
<.001 | |||||||||||||||
|
15-24 | 4230 (41.76) | 18 (4.19) | 5 (15.63) | 3919 (61.71) | 153 (6.44) | 135 (14.35) |
|
||||||||
|
25-29 | 1308 (12.91) | 19 (4.42) | <5 (—) | 968 (15.24) | 197 (8.29) | 123 (13.07) |
|
||||||||
|
30-39 | 1503 (14.84) | 63 (14.65) | 5 (15.63) | 774 (12.19) | 484 (20.38) | 177 (18.81) |
|
||||||||
|
≥40 | 3088 (30.49) | 330 (76.74) | 21 (65.63) | 690 (10.86) | 1541 (64.88) | 506 (53.77) |
|
||||||||
|
.02 | |||||||||||||||
|
Northeast | 1632 (16.11) | 89 (20.70) | 7 (21.88) | 1007 (15.86) | 351 (14.78) | 178 (18.92) |
|
||||||||
|
Midwest | 2198 (21.70) | 93 (21.63) | <5 (—) | 1397 (22) | 509 (21.43) | 195 (20.72) |
|
||||||||
|
South | 3865 (38.16) | 163 (37.91) | 11 (34.38) | 2441 (38.43) | 906 (38.15) | 344 (36.56) |
|
||||||||
|
West | 2426 (23.95) | 85 (19.77) | 10 (31.25) | 1502 (23.65) | 606 (25.52) | 223 (23.70) |
|
||||||||
|
US-dependent areas | 8 (0.08) | <5 (—) | <5 (—) | <5 (—) | <5 (—) | <5 (—) |
|
||||||||
|
.12 | |||||||||||||||
|
Yes | 3338 (32.95) | 133 (30.93) | 15 (46.88) | 2022 (31.84) | 782 (32.93) | 386 (41.02) |
|
||||||||
|
No | 6791 (67.05) | 297 (69.07) | 17 (53.13) | 4329 (68.16) | 1593 (67.07) | 555 (58.98) |
|
||||||||
|
<.001 | |||||||||||||||
|
Urban | 3680 (36.33) | 129 (30) | 17 (53.13) | 2187 (34.44) | 906 (38.15) | 441 (46.87) |
|
||||||||
|
Suburban | 2110 (20.83) | 112 (26.05) | 5 (15.63) | 1351 (21.27) | 477 (20.08) | 165 (17.53) |
|
||||||||
|
Small or medium metropolitan | 3317 (32.75) | 138 (32.09) | 6 (18.75) | 2181 (34.34) | 715 (30.11) | 277 (29.44) |
|
||||||||
|
Rural | 1013 (10) | 51 (11.86) | <5 (—) | 627 (9.87) | 274 (11.54) | 57 (6.06) |
|
||||||||
|
<.001 | |||||||||||||||
|
Positive | 616 (6.08) | 42 (9.8) | <5 (—) | 205 (3.2) | 255 (10.74) | 110 (11.7) |
|
||||||||
|
Negative | 6725 (66.39) | 300 (69.77) | 25 (78.13) | 3758 (59.17) | 1868 (78.65) | 774 (82.25) |
|
||||||||
|
Unknown | 2788 (27.52) | 88 (20.47) | <5 (—) | 2388 (37.6) | 252 (10.61) | 57 (6.06) |
|
||||||||
Total, n (%) | 10,129 (100) | 430 (4.26) | 32 (0.32) | 6351 (62.70) | 2375 (23.45) | 941 (9.29) | N/Ag |
aRefers to the number of websites or apps in this category.
bAMIS: American Men’s Internet Survey.
cA chi-square test for the difference in characteristics between recruitment types.
dPercentage is not reported due to an insufficient n.
eNHBS: National HIV Behavioral Surveillance.
fThe National Center for Health Statistics urban or rural category could not be assigned to 10 participants living in US territories.
gN/A: not applicable.
The number of men who have sex with men who participated in the American Men’s Internet Survey (AMIS) by state, 2018.
Approximately two-thirds (6926/10,129, 68.37%) of participants reported having anal sex without a condom with another male in the past 12 months, and about one-fifth (2390/10,129, 23.59%) of participants reported doing so with a partner of a discordant or an unknown HIV status (
Sexual behaviors with male partners of men who have sex with men in the American Men’s Internet Survey, United States, 2018.
Participant characteristics by HIV status | Participants (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 a discordant or an unknown HIV status | ||||||||||
|
|
n (%) | n (%) | ||||||||||
|
616 | 499 (81) | <.001b | 338 (54.87) | <.001b | ||||||||
|
|
||||||||||||
|
|
Black, non-Hispanic | 97 | 69 (71.13) | .31 | 39 (40.20) | .09 | ||||||
|
|
Hispanic | 73 | 58 (79.45) | .92 | 41 (56.16) | . 35 | ||||||
|
|
White, non-Hispanic | 406 | 341 (83.99) | Refc | 240 (59.11) | Refc | ||||||
|
|
Other or multiple races | 29 | 21 (72.41) | .40 | 13 (44.83) | .42 | ||||||
|
|
||||||||||||
|
|
15-24 | 43 | 37 (86.05) | .76 | 24 (55.81) | .86 | ||||||
|
|
25-29 | 40 | 37 (92.50) | .12 | 24 (60) | .29 | ||||||
|
|
30-39 | 104 | 86 (82.69) | .36 | 60 (57.69) | >.99 | ||||||
|
|
≥40 | 429 | 339 (79.02) | Refc | 230 (53.61) | Refc | ||||||
|
|
||||||||||||
|
|
Yes | 255 | 203 (79.61) | .89 | 137 (53.73) | .89 | ||||||
|
|
No | 361 | 296 (81.99) | Refc | 201 (55.68) | Refc | ||||||
|
|
||||||||||||
|
|
Gay social networking | 59 | 45 (76.27) | >.99 | 33 (55.93) | .83 | ||||||
|
|
General gay interest | 7 | 5 (71.43) | .52 | 4 (57.14) | .95 | ||||||
|
|
General social networking | 260 | 205 (78.85) | Refc | 128 (49.23) | Refc | ||||||
|
|
Geospatial social networking | 290 | 244 (84.14) | .10 | 173 (59.66) | .43 | ||||||
|
9513 | 6427 (67.56) | Refb,c | 2052 (21.57) | Refb,c | ||||||||
|
|
||||||||||||
|
|
Black, non-Hispanic | 456 | 294 (64.47) | .32 | 130 (28.51) | .008 | ||||||
|
|
Hispanic | 1557 | 1049 (67.37) | .05 | 367 (23.57) | .79 | ||||||
|
|
White, non-Hispanic | 6605 | 4526 (68.52) | Refc | 1357 (20.55) | Refc | ||||||
|
|
Other or multiple races | 720 | 449 (62.36) | .03 | 166 (23.05) | .78 | ||||||
|
|
||||||||||||
|
|
15-24 | 4187 | 2626 (62.72) | <.001 | 799 (19.08) | .08 | ||||||
|
|
25-29 | 1268 | 965 (76.10) | <.001 | 292 (23.03) | .08 | ||||||
|
|
30-39 | 1399 | 1072 (76.63) | <.001 | 308 (22.02) | .37 | ||||||
|
|
≥40 | 2659 | 1764 (66.34) | Refc | 653 (24.56) | Refc | ||||||
|
|
||||||||||||
|
|
Yes | 3083 | 2103 (68.21) | .41 | 732 (23.74) | .002 | ||||||
|
|
No | 6430 | 4324 (67.25) | Refc | 1320 (20.53) | Refc | ||||||
|
|
||||||||||||
|
|
Gay social networking | 503 | 280 (55.66) | <.001 | 108 (21.47) | .73 | ||||||
|
|
General gay interest | 42 | 25 (59.52) | .57 | 6 (14.29) | .23 | ||||||
|
|
General social networking | 6587 | 4385 (66.57) | Refc | 1266 (19.22) | Refc | ||||||
|
|
Geospatial social networking | 2366 | 1725 (72.91) | <.001 | 668 (28.23) | <.001 |
aWald chi-square
bWald chi-square
cRef: The reference group being compared to within the multivariate logistic regression models.
dNHBS: National HIV Behavioral Surveillance.
In total, 31.93% (3235/10,129) of participants reported using marijuana, 2.31% (234/10,129) reported using methamphetamines, and 20.43% (2069/10,129) reported using other illicit substances in the past 12 months (
Substance use behaviors of men who have sex with men in the American Men’s Internet Survey, United States, 2018.
Participant characteristics by HIV status | Participants (N) | Used marijuana | Used methamphetamines | Used other substances | ||||||||||||||
|
|
n (%) | n (%) | n (%) | ||||||||||||||
|
616 | 189 (30.68) | .001b | 50 (8.12) | <.001b | 169 (27.44) | <.001b | |||||||||||
|
|
|||||||||||||||||
|
|
Black, non-Hispanic | 97 | 18 (18.56) | .12 | <5 (—)c | .21 | 8 (8.24) | <.001 | |||||||||
|
|
Hispanic | 73 | 22 (30.14) | .91 | 5 (6.85) | .85 | 21 (28.77) | .15 | |||||||||
|
|
White, non-Hispanic | 406 | 137 (33.74) | Refd | 37 (9.11) | Refd | 130 (32.02) | Refd | |||||||||
|
|
Other or multiple races | 29 | 8 (27.58) | .81 | <5 (—) | .95 | 7 (24.14) | .77 | |||||||||
|
|
|||||||||||||||||
|
|
15-24 | 43 | 22 (51.16) | .002 | <5 (—) | .81 | 12 (27.91) | .82 | |||||||||
|
|
25-29 | 40 | 14 (35) | .88 | <5 (—) | .24 | 13 (32.50) | .62 | |||||||||
|
|
30-39 | 104 | 42 (40.38) | .96 | 11 (10.58) | .19 | 36 (34.62) | .20 | |||||||||
|
|
≥40 | 429 | 111 (25.87) | Refd | 34 (7.93) | Refd | 108 (25.17) | Refd | |||||||||
|
|
|||||||||||||||||
|
|
Yes | 255 | 81 (31.76) | .22 | 24 (9.41) | .19 | 70 (27.45) | .46 | |||||||||
|
|
No | 361 | 108 (29.92) | Refd | 26 (7.20) | Refd | 99 (27.42) | Refd | |||||||||
|
|
|||||||||||||||||
|
|
Gay social networking | 59 | 15 (25.42) | .63 | <5 (—) | .97 | 16 (27.12) | .84 | |||||||||
|
|
General gay interest | 7 | <5 (—) | .42 | <5 (—) | .96 | <5 (—) | .37 | |||||||||
|
|
General social networking | 260 | 73 (28.08) | Refd | 22 (8.97) | Refd | 61 (23.46) | Refd | |||||||||
|
|
Geospatial social networking | 290 | 100 (34.48) | .06 | 26 (8.9) | .96 | 89 (30.69) | .93 | |||||||||
|
9513 | 3046 (32.02) | Refb,d | 184 (1.93) | Refb,d | 1900 (19.97) | Refb,d | |||||||||||
|
|
|||||||||||||||||
|
|
Black, non-Hispanic | 456 | 122 (26.75) | .002 | 6 (1.32) | .18 | 60 (13.16) | <.001 | |||||||||
|
|
Hispanic | 1557 | 544 (34.94) | .86 | 42 (2.70) | .002 | 337 (21.64) | .10 | |||||||||
|
|
White, non-Hispanic | 6605 | 2071 (31.36) | Refd | 117 (1.77) | Refd | 1301 (19.70) | Refd | |||||||||
|
|
Other or multiple races | 720 | 269 (37.36) | .02 | 13 (1.81) | .81 | 173 (24.03) | <.001 | |||||||||
|
|
|||||||||||||||||
|
|
15-24 | 4187 | 1611 (38.48) | <.001 | 47 (1.12) | .009 | 861 (20.56) | .18 | |||||||||
|
|
25-29 | 1268 | 427 (33.68) | .01 | 22 (1.74) | .70 | 310 (24.45) | <.001 | |||||||||
|
|
30-39 | 1399 | 468 (33.45) | .03 | 41 (2.93) | .01 | 328 (23.45) | .005 | |||||||||
|
|
≥40 | 2659 | 540 (20.31) | Refd | 74 (2.78) | Refd | 401 (15.08) | Refd | |||||||||
|
|
|||||||||||||||||
|
|
Yes | 3083 | 1100 (35.68) | <.001 | 57 (1.85) | .35 | 731 (23.71) | <.001 | |||||||||
|
|
No | 6430 | 1946 (30.26) | Refd | 127 (1.98) | Refd | 1169 (18.18) | Refd | |||||||||
|
|
|||||||||||||||||
|
|
Gay social networking | 503 | 99 (19.68) | .002 | 21 (4.17) | .10 | 80 (15.90) | .33 | |||||||||
|
|
General gay interest | 42 | 19 (45.23) | .003 | <5 (—) | .93 | 11 (26.19) | .18 | |||||||||
|
|
General social networking | 6587 | 2294 (34.83) | Refd | 84 (1.28) | Refd | 1343 (20.39) | Refd | |||||||||
|
|
Geospatial social networking | 2366 | 632 (26.71) | .15 | 78 (3.30) | .65 | 464 (19.61) | .75 |
aWald chi-square
bWald chi-square
cPercentage is not reported due to an insufficient n.
dRef: The reference group being compared to within the multivariate logistic regression models.
eNHBS: National HIV Behavioral Surveillance.
HIV testing behaviors were examined among participants who were not HIV positive (
HIV testing behaviors of HIV-negative or unknown status men who have sex with men in the American Men’s Internet Survey, United States, 2018.
Participant characteristics | Participants (N) | HIV testing behaviors | |||||||||
|
|
Ever tested for HIV | Tested for HIV in the past 12 months | ||||||||
|
|
n (%) | n (%) | ||||||||
|
|||||||||||
|
Black, non-Hispanic | 456 | 339 (74.34) | .46 | 256 (56.14) | .50 | |||||
|
Hispanic | 1557 | 1028 (66.02) | .87 | 799 (51.32) | .66 | |||||
|
White, non-Hispanic | 6605 | 4871 (73.75) | Refb | 3480 (52.69) | Refb | |||||
|
Other or multiple races | 720 | 489 (67.92) | .93 | 377 (52.36) | .73 | |||||
|
|||||||||||
|
15-24 | 4187 | 2115 (55.01) | <.001 | 1692 (40.41) | <.001 | |||||
|
25-29 | 1268 | 1057 (83.36) | .11 | 752 (59.31) | .001 | |||||
|
30-39 | 1399 | 1268 (90.64) | <.001 | 901 (64.40) | <.001 | |||||
|
≥40 | 2659 | 2398 (90.18) | Refb | 1650 (62.05) | Refb | |||||
|
|||||||||||
|
Yes | 3083 | 2339 (75.87) | <.001 | 1797 (58.29) | <.001 | |||||
|
No | 6430 | 4499 (69.97) | Refb | 3198 (49.74) | Refb | |||||
|
|||||||||||
|
Gay social networking | 503 | 414 (82.31) | <.001 | 261 (51.88) | .03 | |||||
|
General gay interest | 42 | 38 (90.47) | .22 | 19 (45.24) | .07 | |||||
|
General social networking | 6587 | 4243 (64.41) | Refb | 3063 (46.50) | Refb | |||||
|
Geospatial social networking | 2366 | 2128 (89.94) | .08 | 1640 (69.32) | <.001 | |||||
Total | 9513 | 6838 (71.88) | 4995 (52.51) |
aWald chi-square
bRef: The reference group being compared to within the multivariate logistic regression models.
cNHBS: National HIV Behavioral Surveillance.
In total, 42.59% (4314/10,129) of participants reported sexually transmitted infection (STI) testing in the past 12 months, and 10.08% (1022/10,129) of participants reported a diagnosis of STI in the past 12 months. Compared with HIV-negative or unknown status participants, HIV-positive participants were significantly more likely to report STI testing (aOR 3.50, 95% CI 2.89-4.24) and STI diagnosis (aOR 2.61, 95% CI 2.10-3.25) in the past 12 months (
Sexually transmitted infection testing and diagnosis of men who have sex with men in the American Men’s Internet Survey, United States, 2018.
Participant characteristics by HIV status | Participants (N) | STIa history in the past 12 months | ||||||||||
|
|
Tested for any STI | Diagnosed with any STI | |||||||||
|
|
n (%) | n (%) | |||||||||
|
616 | 448 (72.7) | <.001c | 135 (21.9) | <.001c | |||||||
|
|
|||||||||||
|
|
Black, non-Hispanic | 97 | 73 (75) | .46 | 24 (25) | .68 | |||||
|
|
Hispanic | 73 | 56 (77) | .89 | 23 (32) | .19 | |||||
|
|
White, non-Hispanic | 406 | 290 (71.4) | Refd | 80 (19.7) | Refd | |||||
|
|
Other or multiple races | 29 | 21 (72) | .53 | 6 (21) | .47 | |||||
|
|
|||||||||||
|
|
15-24 | 43 | 37 (86) | .09 | 13 (30) | .28 | |||||
|
|
25-29 | 40 | 30 (75) | .72 | 11 (28) | .92 | |||||
|
|
30-39 | 104 | 88 (84.6) | .28 | 33 (31.7) | .19 | |||||
|
|
≥40 | 429 | 293 (68.3) | Refd | 78 (18.2) | Refd | |||||
|
|
|||||||||||
|
|
Yes | 255 | 202 (79.2) | .004 | 62 (24.3) | .32 | |||||
|
|
No | 361 | 246 (68.1) | Refd | 73 (20.2) | Refd | |||||
|
|
|||||||||||
|
|
Gay social networking | 59 | 41 (70) | .93 | 10 (17) | .54 | |||||
|
|
General gay interest | 7 | 5 (71) | .99 | <5 (—) | .48 | |||||
|
|
General social networking | 260 | 184 (70.8) | Refd | 56 (21.5) | Refd | |||||
|
|
Geospatial social networking | 290 | 218 (75.2) | .28 | 67 (23.1) | .84 | |||||
|
9513 | 3866 (40.64) | Refc,d | 887 (9.32) | Refc,d | |||||||
|
|
|||||||||||
|
|
Black, non-Hispanic | 456 | 192 (42.1) | .90 | 49 (10.8) | .77 | |||||
|
|
Hispanic | 1557 | 642 (41.23) | .41 | 169 (10.85) | .25 | |||||
|
|
White, non-Hispanic | 6605 | 2669 (40.41) | Refd | 587 (8.89) | Refd | |||||
|
|
Other or multiple races | 720 | 293 (40.7) | >.99 | 68 (9.4) | .61 | |||||
|
|
|||||||||||
|
|
15-24 | 4187 | 1419 (33.89) | <.001 | 330 (7.88) | .09 | |||||
|
|
25-29 | 1268 | 631 (49.76) | <.001 | 161 (12.70) | <.001 | |||||
|
|
30-39 | 1399 | 676 (48.32) | <.001 | 153 (10.94) | .44 | |||||
|
|
≥40 | 2659 | 1140 (42.87) | Refd | 243 (9.14) | Refd | |||||
|
|
|||||||||||
|
|
Yes | 3083 | 1425 (46.22) | <.001 | 389 (12.62) | <.001 | |||||
|
|
No | 6430 | 2441 (37.96) | Refd | 498 (7.74) | Refd | |||||
|
|
|||||||||||
|
|
Gay social networking | 503 | 183 (36.4) | .72 | 41 (8.2) | .96 | |||||
|
|
General gay interest | 42 | 12 (29) | .06 | <5 (—)f | .62 | |||||
|
|
General social networking | 6587 | 2476 (37.59) | Refd | 545 (8.27) | Refd | |||||
|
|
Geospatial social networking | 2366 | 1188 (50.21) | <.001 | 296 (12.51) | .02 |
aSTI: sexually transmitted infection (includes chlamydia, gonorrhea, and syphilis).
bWald chi-square
cWald chi-square
dRef: The reference group being compared to within the multivariate logistic regression models.
eNHBS: National HIV Behavioral Surveillance.
fPercentage is not reported due to an insufficient n.
The sixth round of data collection for AMIS was successfully implemented and resulted in over 10,000 surveys from a diverse sample of internet-using MSM residing in all US states. A majority of eligible and enrolled participants were recruited from general social networking, were White, non-Hispanic, aged between 15 and 24 years, and reported being HIV negative. There were notable differences in key behavioral indicators by self-reported HIV status. Compared with HIV-negative or unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past year and more likely to have had anal sex without a condom with a serodiscordant or an unknown status partner. The reported use of marijuana, methamphetamines, and other illicit substances in the past year was higher among HIV-positive participants than among HIV-negative or unknown status participants. HIV-positive participants were also more likely to report testing and diagnosis of STIs than HIV-negative or unknown status participants. When stratified by HIV status, some significant differences in these behavioral indicators by demographics and recruitment websites were also observed.
American Men’s Internet Survey 2018 questionnaire.
American Men’s Internet Survey
adjusted odds ratio
men who have sex with men
National HIV Behavioral Surveillance System
sexually transmitted infection
The study was funded by a grant from the National Institutes of Health (P30AI050409)—the Emory Center for AIDS Research.
TS and PS are members of the Editorial Board of JMIR Public Health and Surveillance. However, they had no involvement in the editorial decision for this manuscript. The manuscript was reviewed and handled by an independent editor.