{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:49:21Z","timestamp":1787024961483,"version":"build-2736575974"},"reference-count":32,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n With the growing popularity and convenience of the internet, an increasing number of men who have sex with men (MSM) are seeking casual sexual partners online. However, the effect of online casual sexual behavior on other HIV-related risk behaviors remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to explore the characteristics of internet-based casual sexual behavior and its relationship with HIV-related risk behaviors among MSM.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This cross-sectional study was conducted between June and December 2018 in 4 cities in Zhejiang Province, China. Peer-driven sampling was used for recruitment. Announcements were disseminated by 4 community-based organizations and 10 voluntary counseling and testing clinics online and offline. After informed consent, participants completed an electronic questionnaire covering demographic characteristics, casual sexual behaviors, HIV-related risk behaviors, and HIV prevention. SPSS (version 19.0; IBM Corp) was used to conduct chi-square tests, univariate and multivariate logistic regression analyses using a backward stepwise method based on the likelihood ratio test, and Poisson regression with robust variance to identify associations between finding casual sexual partners online and other risk behaviors.\n P<\/jats:italic>\n values of <.05 were considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the past 6 months, 40.2% (302\/751) of participants reported finding casual sexual partners online; 18.9% (142\/751) reported finding casual sexual partners offline; 7.6% (57\/751) reported having sexual intercourse with MSM without condoms after drinking alcohol; and 6.9% (52\/751) reported condomless sex after using stimulants. Among those who found partners online, 62.5% (188\/301) did so more than once per month and 39.5% (113\/286) had more than one online sexual partner. In total, 39.3% (114\/290) had sex with online partners at home and 10.1% (30\/297) sought partners in other cities. Compared with participants who engaged in receptive anal intercourse (or both roles), those who engaged only in insertive intercourse reported a higher proportion of finding partners online more than once per month (72.7% vs 57.4%,\n P<\/jats:italic>\n =.01), having more than 2 online sexual partners (52.1% vs 33.3%,\n P<\/jats:italic>\n =.002), and conducting inconsistent condom use with online sexual partners (40.0% vs 25.8%,\n P<\/jats:italic>\n =.01). Regression analysis showed that, compared with MSM who did not find partners online, those who did were more likely to report finding casual sexual partners offline (adjusted odds ratio [aOR] 9.398; 95% CI 5.956\u201014.829), having sex without condoms after drinking alcohol (adjusted prevalence ratio [aPR] 1.788; 95% CI 1.062\u20103.011), and having sexual intercourse without condoms after using stimulants (aPR 2.064; 95% CI 1.178\u20103.617).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Internet-based casual sexual behavior is increasingly common among MSM. Finding partners online was associated with offline partner-seeking and condomless use after alcohol or stimulant use. Future HIV prevention efforts should emphasize behavioral interventions tailored to MSM who use dating apps.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/71690","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T20:21:03Z","timestamp":1760732463000},"page":"e71690-e71690","source":"Crossref","is-referenced-by-count":8,"title":["Associations Between Online Casual Sexual Behavior and HIV-Related Risk Behaviors Among Men Who Have Sex With Men in Southeast China: Cross-Sectional Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2197-2733","authenticated-orcid":false,"given":"Lin","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-9976","authenticated-orcid":false,"given":"Zhongrong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-8527","authenticated-orcid":false,"given":"Wanjun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3242-249X","authenticated-orcid":false,"given":"Tingting","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3373-3393","authenticated-orcid":false,"given":"Xiaohong","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"issue":"11","key":"R1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26022","article-title":"HIV prevalence among men who have sex with men, transgender women and cisgender male sex workers in sub-Saharan Africa: a systematic review and meta-analysis","volume":"25","author":"Kloek","journal-title":"J Int AIDS Soc"},{"issue":"14","key":"R2","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1097\/QAD.0000000000003343","article-title":"Correlations between community-level HIV preexposure prophylaxis coverage and individual-level sexual behaviors among United States MSM","volume":"36","author":"Mann","journal-title":"AIDS"},{"issue":"9","key":"R3","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1097\/QAD.0000000000003231","article-title":"The cost-effectiveness of a resilience-based psychosocial intervention for HIV prevention among MSM in India","volume":"36","author":"Kazemian","journal-title":"AIDS"},{"issue":"6","key":"R4","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1007\/s11904-019-00471-4","article-title":"History of the HIV epidemic in China","volume":"16","author":"Wu","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"11","key":"R5","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1111\/jcpt.13772","article-title":"Men who have sex with men is the high-risk drug resistance population: a meta-analysis of HIV-1 drug resistance profiles and trends in China","volume":"47","author":"Yuan","journal-title":"J Clin Pharm Ther"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1097\/QAD.0b013e32835ad489","article-title":"High HIV incidence and prevalence and associated factors among young MSM, 2008","volume":"27","author":"Balaji","journal-title":"AIDS"},{"issue":"2","key":"R7","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1097\/OLQ.0000000000000919","article-title":"Associations between cannabis use, sexual behavior, and sexually transmitted infections\/human immunodeficiency virus in a cohort of young men who have sex with men","volume":"46","author":"Gorbach","journal-title":"Sex Transm Dis"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1177\/003335491613100210","article-title":"Online hookup sites for meeting sexual partners among men who have sex with men in Rhode Island, 2013: a call for public health action","volume":"131","author":"Chan","journal-title":"Public Health Rep"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/14800","article-title":"Spatiotemporal analysis of men who have sex with men in Mainland China: social app capture-recapture method","volume":"8","author":"Hu","journal-title":"JMIR Mhealth Uhealth"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/35056","article-title":"Online partner seeking and sexual behaviors among men who have sex with men from small and midsized towns: cross-sectional study","volume":"6","author":"Pravosud","journal-title":"JMIR Form Res"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2024.102923","article-title":"Comparison of human immunodeficiency virus-related risky sexual behaviors between men who have sex with men only and men who have sex with men and women: a cross-sectional study in Eastern China","volume":"48","author":"Ge","journal-title":"Prev Med Rep"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1056720","article-title":"Providing HIV testing in men who have sex with men through a gay social networking app in China: a qualitative interview study with multisectoral service providers","volume":"10","author":"Zhao","journal-title":"Front Public Health"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284602","article-title":"Online partner seeking and high-risk behaviour in men who have sex with men and male-to-female transgendered people in Mumbai, India: implications for prevention strategies","volume":"18","author":"Acharya","journal-title":"PLoS One"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/10171","article-title":"Leading by example: web-based sexual health influencers among men who have sex with men have higher HIV and syphilis testing rates in China","volume":"21","author":"Wu","journal-title":"J Med Internet Res"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1007\/s10461-007-9224-9","article-title":"Where young MSM meet their first sexual partner: the role of the Internet","volume":"11","author":"Bolding","journal-title":"AIDS Behav"},{"issue":"2","key":"R16","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s10508-018-1235-2","article-title":"Is online partner-seeking associated with increased risk of condomless sex and sexually transmitted infections among individuals who engage in heterosexual sex? A systematic narrative review","volume":"48","author":"Tsai","journal-title":"Arch Sex Behav"},{"issue":"9","key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/25360","article-title":"The characteristics and risk factors of web-based sexual behaviors among men who have sex with men in Eastern China: cross-sectional study","volume":"7","author":"Chen","journal-title":"JMIR Public Health Surveill"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2013022\u201307880\u20138","article-title":"Sexual uses of drug and alcohol among men who have sex with men in China: implications for HIV prevention","volume":"22","author":"Zhao P,","journal-title":"BMC Infect Dis"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.24\u201300172","article-title":"How cannabis and alcohol use influence sexual behavior among men who havesex with men (MSM): a secondary data analysis using ecological momentary assessment","author":"Simons","journal-title":"J Stud Alcohol Drugs"},{"issue":"11","key":"R20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312006","article-title":"Urban\u2013rural disparity in risky sexual behavior, HIV knowledge, and healthy practices among men who have sex with men: a cross-sectional study in Southeast China","volume":"19","author":"Chen","journal-title":"PLoS ONE"},{"issue":"8","key":"R21","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1097\/OLQ.0000000000001376","article-title":"Factors associated with online sex partners among gay, bisexual and other men who have sex with men: results from a national survey","volume":"48","author":"Kachur","journal-title":"Sex Transm Dis"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","DOI":"10.2196\/14803","article-title":"Stigma and web-based sex seeking among men who have sex with men and transgender women in Tijuana, Mexico: cross-sectional study","volume":"6","author":"Espinosa da Silva","journal-title":"JMIR Public Health Surveill"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1007\/s10461-021-03485-5","article-title":"A latent profile analysis of online dating patterns among single young men who have sex with men","volume":"26","author":"Choi","journal-title":"AIDS Behav"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4517-y","article-title":"Contextualizing condoms: a cross-sectional study mapping intersections of locations of sexual contact, partner type, and substance use as contexts for sexual risk behavior among MSM in Peru","volume":"19","author":"Passaro","journal-title":"BMC Infect Dis"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.3390\/v12010067","article-title":"The impact of human mobility on regional and global efforts to control HIV transmission","volume":"12","author":"Eshraghian","journal-title":"Viruses"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","first-page":"538","DOI":"10.3760\/cma.j.cn112338\u201320200328\u201300462","article-title":"Status of HIV infection among men who have sex with men in Harbin, 2009\u20132018","volume":"42","author":"Zhang","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1521\/aeap.2020.32.2.117","article-title":"HIV risk behaviors in relation to psychosocial factors and internet usage among Asian and Pacific Islander (API) men who had sex with men (MSM) in California","volume":"32","author":"Nemoto","journal-title":"AIDS Educ Prev"},{"issue":"6","key":"R28","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1007\/s10461\u2013019\u201302760\u2013w","article-title":"Characteristics of sex wvents, partners, and motivations and their associations with HIV\u2013risk behavior in a daily diary study of high\u2013risk men who have sex with men (MSM)","volume":"24","author":"Wray","journal-title":"AIDS Behav"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1007\/s10461-023-04210-0","article-title":"Latent class analysis of online platforms for partner-seeking and sexual behaviors among men who have sex with men from Central Kentucky","volume":"28","author":"Pravosud","journal-title":"AIDS Behav"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-021955","article-title":"Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey","volume":"9","author":"Zhu","journal-title":"BMJ Open"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/66139","article-title":"Awareness of sexual partner\u2019s HIV status among men who have sex with men in China: cross-sectional survey study","volume":"11","author":"Ma","journal-title":"JMIR Public Health Surveill"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-023-00502-6","article-title":"HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey","volume":"20","author":"Mwaniki","journal-title":"AIDS Res Ther"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e71690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:01:25Z","timestamp":1782842485000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e71690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":32,"URL":"https:\/\/doi.org\/10.2196\/71690","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"article-number":"v9i11e71690"}}