Online arenas may facilitate sexual encounters. However, to what extent finding sexual partners online is associated with sexual risk behavior and sexual health outcomes is still not fully explored.

A stratified randomized population based study on sexual and reproductive health and rights of 50,000 Swedes was conducted in 2017. The final sample consisted of 14,537 women and men aged 16-84 years. We identified sexual health factors associated with finding sexual partners online and estimated prevalences thereof.

Having used the internet to meet sexual partners was reported by 11% (95% confidence interval: 10.1-12.3) of men and 7% (95% confidence interval: 6.0-7.4) of women and was most common among men aged 30-44 years (13.7%). After adjustment, those reporting a non-heterosexual identity were most likely to meet sexual partners online. Meeting sexual partners online was also associated with reporting several sexual risk behaviors: condomless sex with temporary partner during the past 12 months, adjusted odds ratio (AOR): 5.1 (3.8-6.8) for women and AOR: 6.0 (4.5-7.9) for men, and having had a test for sexually transmitted infections (STIs) generated a 4-fold AOR for both sexes, STI diagnosis showed a 2-fold AOR, ever having paid or given other compensation for sex AOR: 4.8 (2.7-8.8) for women and AOR: 4.2 (2.9-6.1) for men as well as ever having received money or other compensation for sex AOR: 4.0 (1.3-11.9) for women and AOR: 6.0 (2.4-15.1) for men.

Meeting sexual partners online was associated with sexual risk behaviors, which is of importance in tailoring sexual health interventions and STI/HIV-control activities.

Few studies of online sexual behaviors are based on population-based surveys of the general population with results stratified by sexual identity. However, the use of lifetime prevalence of ever having used the internet, smartphone, or app to meet sexual partners has limitations.

Meeting sexual partners online was associated with sexual risk behaviors in a randomized sample of the Swedish population, which is of importance to tailoring sexual health interventions. Deogan C, Jacobsson E, Mannheimer L, et al. Meeting Sexual Partners Online and Associations With Sexual Risk Behaviors in the Swedish Population. J Sex Med 2020;17:2141-2147.

This study investigates how men who have sex with men (MSM) use chat and dating sites based on theories of stigma-related offline behavior and online self-disclosure. We hypothesize that hidden MSM (those who self-label as heterosexual or who hide their same-sex sexual attraction from family, friends, acquaintances, or a female romantic partner) differ from open MSM in how they behave on gay chat and dating sites and in offline gay venues. Drawing on a survey of 12,002 MSM, we show that hidden MSM tend to mask their identity on gay chat and dating sites while avoiding offline gay venues. They also focus more strongly on online sexual activities (e.g., masturbating during online chats) when using gay chat and dating sites. However, they spend the same amount of time on these sites, and they use them to initiate offline sexual encounters as often and as fast as open MSM.

The men who have sex with men (MSM) population in China has experienced a recent increase in HIV incidence. Due to the dual stigma and discrimination towards homosexuality and HIV infection, most MSM living with HIV/AIDS are hard to reach by offline intervention initiatives. We recruited HIV-positive MSM participants in Chengdu, China and assessed whether they disclosed their HIV status to partners, motivated a partner to receive testing, used condoms consistently, or initiated antiretroviral therapy. Participants were quasi-randomized to either the intervention or control arm. The intervention group was given instructions for an online program with four modules: an information exchange website, a bulletin board system, individualized online counseling with trained peer educators, and an animation game. All participants were re-assessed at 6 months. The study enrolled 202 HIV-positive MSM. The intervention group had significant increases in disclosing their HIV status to their partners (76.0% vs 61.2%, P=0.0388) and motivating partners to accept HIV testing (42.3% vs 25.5%, P=0.0156) compared with the control group, but there were no between-group differences in receiving early treatment or using condoms consistently. We found that a web-based intervention targeting HIV-positive MSM was an effective tool in increasing the uptake of HIV testing within this high-risk population.

Evidence is mixed as to whether meeting sexual partners online ('internet-partners') is associated with risky sexual behaviour and/or sexually transmitted infection transmission. Accordingly, we sought to estimate the prevalence of reporting various online romantic and sexual activities among Norwegian adolescents, including internet-partners, and the reason for meeting them and to examine differences in sexual behaviour, partnership characteristics and chlamydia infection prevalence among those reporting internet-partners versus those reporting only offline partners.

Population-based cross-sectional survey among sexually experienced girls and boys, 15-20 years, using electronic questionnaires and collecting urine samples for Chlamydia trachomatis PCR testing (79% provided both, n=1023). We used logistic regression to examine associations, adjusting for potentially confounding variables.

Overall, 30% of both genders reported internet-partners (ever). Boys (but not girls) with internet-partners had higher chlamydia prevalence than those reporting meeting sexual partners only offline (8.1%, 95% CI 4.3% to 13.7% vs 1.6%, 0.5% to 3.7%). Two-thirds of girls and 37% of boys reported meeting their most recent internet-partner to start a romantic relationship, while the remainder did so with the specific intention of having sex. Among both genders, reporting sexual (vs romantic) reasons for meeting their most recent internet-partners was associated with reporting several risky sexual behaviours, including multiple recent sex partners (adjusted OR girls: 3.27, boys: 2.48) and three-fold higher chlamydia prevalence.

This population-based study suggests that internet-partners are common among adolescents in Norway, and the reason for meeting them was more strongly associated with additionally reporting sexual risk behaviours and prevalent chlamydia infection than the internet itself as a meeting venue.