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We aimed to better understand potential changes that may be contributing to these epidemic trends, particularly new behavioural and demographic patterns in the online dating era since ~2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used joinpoint models to examine trends in reported incidence for three notifiable bacterial STIs (ie, chlamydia, gonorrhoea and syphilis) in the USA during 2010\u20132024, and analysed concurrent changes in sexual behaviour, online dating and sexual orientation demographics using three national datasets (ie, the National Survey of Family Growth, General Social Survey and How Couples Meet and Stay Together).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reported incidence rates of the three STIs increased during 2010\u20132019\u2009and declined after circa 2020. Common STI behaviour indicators (eg, partner change rate) did not show changes consistent with the STI trends. In contrast, online dating partnership data suggested higher shares of partnerships formed within the same age group among online daters than offline daters. Analyses of sexual orientation demographics revealed marked increases in the population share self-reported as bisexual, particularly among young adults and females, and identified two candidate groups for further investigation (same-sex males and bisexual females) with group-level partner change metrics correlated with STI incidence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>New partnership patterns among online daters and changing demographics of sexual orientation may have influenced STI trends in the USA during 2010\u20132024. Research is needed to quantify their impacts on STI epidemics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2026-004967","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:20:39Z","timestamp":1790702439000},"page":"e004967","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["How STI trends track changes in sexual behaviour, online dating and sexual orientation demographics: an analysis of reported bacterial STI incidence and three social behavioural surveys in the USA (2010\u20132024)"],"prefix":"10.1136","volume":"4","author":[{"given":"Haokun","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6987-6412","authenticated-orcid":false,"given":"Jason","family":"Zucker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7072-2995","authenticated-orcid":false,"given":"Sen","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7555-9728","authenticated-orcid":false,"given":"Wan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"2026092910203357000_4.3.e004967.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.08.008"},{"key":"2026092910203357000_4.3.e004967.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-026297","article-title":"Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011","volume":"9","author":"Feldkamp","year":"2019","journal-title":"BMJ Open"},{"key":"2026092910203357000_4.3.e004967.3","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1002\/bdr2.1409","article-title":"Maternal genitourinary infections and risk of birth defects in the National Birth Defects Prevention Study","volume":"110","author":"Howley","year":"2018","journal-title":"Birth Defects Res"},{"key":"2026092910203357000_4.3.e004967.4","doi-asserted-by":"publisher","DOI":"10.1086\/515536"},{"key":"2026092910203357000_4.3.e004967.5","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2024-259762","article-title":"Irreversible neurological manifestations in undiagnosed disseminated gonococcal infection","volume":"17","author":"Lin","year":"2024","journal-title":"BMJ Case Rep"},{"key":"2026092910203357000_4.3.e004967.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-5949.2010.00183.x"},{"key":"2026092910203357000_4.3.e004967.7","unstructured":"Centers for Disease Control and Prevention . 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