Introduction

The growing popularity of the Internet as a meeting place for men who have sex with men (MSM) has been well documented. Between a quarter and a half of MSM said they used the Internet to look for sex in recent surveys conducted in the USA and UK (Benotsch, Kalichman, & Cage, 2002; Bolding, Davis, Hart, Sherr, & Elford, 2005; Elford, Bolding, Davis, Sherr, & Hart, 2004b; Elford, Bolding, & Sherr, 2001; Elford, Bolding, Sherr, & Hart, 2005; Kim, Kent, McFarland, & Klausner, 2001; Liau, Millet, & Marks, 2006; McFarlane, Bull, & Rietmeijer, 2000; Mettey, Crosby, DiClemente, & Holtgrave,2003; Rietmeijer, Bull, McFarlane, Patnaik, & Douglas, 2003; Taylor et al., 2004).

Since MSM are increasingly using the Internet to look for sex, this raises two key questions. Namely, are young men meeting their first male sexual partner through the Internet? If so, has this increased over time along with increasing access to the Internet? The answers to these questions are of importance for sexual health promotion and HIV prevention targeting young MSM. If the Internet were to play a role in first sexual experience among young MSM this would provide an opportunity for developing web-based interventions targeting men online, at an early point in their sexual career. Young MSM who seek sex on the Internet are at elevated risk compared with those who do not (McFarlane, Bull, & Rietmeijer, 2002).

The objective of this paper was to examine where young MSM met their first sexual partner and whether this has changed over time. In particular, how many young MSM said they met their first sexual partner through the Internet and did this increase between 1993–2002?

Methods

Participants

In May–June 2003, MSM using UK chat-rooms or personal profiles on gaydar and gay.com were invited to complete a confidential, anonymous self-administered questionnaire online. Gaydar and gay.com are two of the most popular Internet sites used by gay/bisexual men in the UK (personal communication, H. Badenhurst and M. Watson, site managers). For a one-month period a series of pop-ups and banners in UK chat-rooms and personal profiles advertised the survey. Clicking on a pop-up or banner took men to the homepage of the questionnaire which took between 15 and 30 minutes to complete. The research was part of the Internet and HIV study conducted among gay/bisexual men in the UK between 2002–2004. The methods have been described in detail elsewhere (Elford, Bolding, Davis, Sherr, & Hart, 2004a).

Measures

Men were asked to provide information on socio-demographic characteristics including age, ethnicity (white, black African, black Caribbean, Asian [Indian, Pakistani, Bangladeshi], South East Asian, mixed/other), educational attainment (three or more years full time education after the age of 16) and employment (currently employed, student, retired, unemployed). They were also asked about their sexual orientation (gay, bisexual, heterosexual) and HIV test history (date and result of last test). Men were asked where they had met their first male sexual partner. They were given the option of ticking ‘at a gay venue such as a bar or club’, ‘on the Internet’ or ‘other’––with a text box where they could type the “other” place. They were also asked how old they were when they first had sex with another man.

Data Analysis

To derive the calendar year when a respondent first had sex with another man, their age at first sex was subtracted from their age when they completed the survey. This number was then subtracted from 2003 (the year of the survey). For example, if a man was 24 years old when he completed the survey and 17 years old when he first had sex with another man, then he would have first had sex 7 years before the survey (24–17 = 7) i.e., in 1996.

Since we were interested in men who met their first sexual partner through the Internet, the analysis was restricted to respondents who said they had sex with another man for the first time between 1993 and 2002. Few men used the Internet to look for sex before 1993, so those who first had sex with another man before 1993 were not included. To focus on the sexual behaviour of young men in relation to the Internet, only men who were under 30 years of age at the time of the survey (in 2003) were included in the analysis. The analysis was also restricted to men who were 13 years or above when they first had sex with another man.

Data were analysed using SPSS for Windows version 12.0 (SPSS Inc., Chicago, Illinois, USA). Chi-squared tests for a trend were used to detect significant changes between 1993 and 2002 in the percentage of men who met their first sexual partner in a particular place (e.g., the Internet, a gay venue, etc.). Only men who provided complete information on when and where they met their first sexual partner were included.

Results

Sample

A total of 2,505 UK men completed the online questionnaire. While it is difficult to estimate a response rate for an Internet sample, electronic monitoring of respondents revealed that 75% of those who started the online questionnaire completed it (Bolding et al., 2005). The current analysis is based on 810 men who first had sex with another man between 1993–2002; were 13 years and above when they first had sex with another man; were under 30 years of age at the time of the survey; and who provided complete information on when and where they met their first male sexual partner.

The median age of the men at the time of the survey was 22 years (range 18–29 years). Their median age when they first had sex with another man was 17 years (range 13–28 years). The majority of the men were white and most were either in full-time employment or education. Under half said they had completed three or more years of education after the age of 16 years. Nearly all the men self-identified as gay (84%) or bisexual (15%) and just over a third (36%) said they were in a relationship with another man at the time of the survey. Less than half the men had had an HIV test; 38% were HIV-negative, 1% HIV-positive (Table 1).

Table 1 Socio-demographic characteristics of the sample (N = 810)
Full size table

Where Men Met Their First Sexual Partner

In addition to gay venues and the Internet (the two options men could tick), respondents provided information on other places where they had met their first sexual partner including school, work, college, university, public toilets, small ads, cruising grounds, telephone chatlines, a straight pub/club, a sports or social club, a party, through friends or on holiday.

Between 1993–2002, there was a significant increase in the percentage of respondents who met their first male sexual partner through the Internet (2.6–61.0%, test for trend, P < 0.001) (Table 2). There was a corresponding decrease in the percentage of men who met their first sexual partner at a gay venue (34.2%, 16.9%), school (23.7%, 1.3%), public sex environment (PSE), through small ads or telephone chat-lines (10.5%, 1.3%) (all P < 0.01). Since numbers were small and changes similar for these last three categories (PSE, small ads, telephone chatlines), they have been combined in Table 2. All other meeting places (e.g., through friends, at a party, work, college, etc.) were also combined because of small numbers. Overall the percentage of men who said they met their first sexual partner at an “other meeting place” also declined (28.9%, 19.5%, P < 0.001). However, the pattern was less clear-cut for individual meeting places within this group, in part because of small numbers in any one category (data available from authors on request).

Table 2 Where young men met their first male sexual partner 1993–2002
Full size table

Discussion

Our study shows that since 1993 there has been a substantial increase in the number of young MSM in the UK who met their first male sexual partner through the Internet. There was a corresponding decrease in the number who met their first sexual partner at a gay venue, at school, in a public sex environment, through small ads in the press or on telephone chat-lines.

This study suggests that many young MSM at the start of their sexual career are using the Internet to meet other men. The Internet therefore provides opportunities for sexual health promotion and HIV prevention among young MSM who may not otherwise have access to sex education material. In the UK, health promotion agencies have developed Internet-based resources to address sexual health, “coming out” and other issues among young gay and bisexual men. Examples include the Terrence Higgins Trust website www.ygm.org.uk and The Youth UK Group website www.gayyouthuk.org.uk. Our data support the importance of online sexual health interventions targeting young MSM. Online interventions of this kind maximise the potential of the Internet by tailoring interventions for specific groups of MSM and by using creative, interactive components.

Meeting a first sexual partner through the Internet may have some advantages for young MSM (Boies, 2002). Some men find the Internet to be a less stigmatising environment in which to meet other men compared with bar, clubs and ‘offline’ venues. In addition, as well as providing anonymity, the Internet allows MSM to manage and reveal their sexual identity in a way that suits them (Davis, Hart, Bolding, Sherr, & Elford, 2006a, b). These advantages may be particularly pertinent for MSM who are meeting their first sexual partner.

Our study has some limitations. It is based on an online sample so is likely to include more men who use the Internet to look for sex than a survey conducted in a community venue such as bars and clubs. As a consequence, this analysis may overestimate the extent to which MSM meet their first sexual partner through the Internet, and may include a disproportionate number of men who are comfortable with the Internet as a medium, regardless of their sexual activity. On the other hand, a number of community surveys have shown that around 40–50% of MSM now use the Internet to look for sex and that this has increased markedly since 2000 (Benotsch et al., 2002; Bolding et al., 2004; Elford et al., 2005; Kim et al., 2001; Liau et al., 2006). It seems likely, therefore, that the percentage of MSM who meet their first sexual partner through the Internet has indeed increased since 1993 although the absolute level may not be as high as reported here because of sampling bias. Studies among MSM recruited in other settings will clarify the true magnitude of the impact of the Internet on sexual debut.

Research by McFarlane et al. (2002) suggests that young MSM who meet sexual partners through the Internet may be at elevated risk for STI compared with those who do not. Although McFarlane et al. did not look specifically at young men who met their first sexual partner through the Internet, it seems likely that some of their respondents would have done so. It is possible, therefore, that meeting your first sexual partner through the Internet may be associated with an elevated risk for STI. Further research is required to clarify the relationship between where young MSM meet their first sexual partner and subsequent sexual risk behaviour, to inform prevention initiatives.

In conclusion, since 1993 there has been a substantial increase in the percentage of MSM in the UK who meet their first sexual partner through the Internet. At the same time there has been a corresponding decrease in the percentage of MSM who meet their first sexual partner at school or gay venues. Since an increasing number of young MSM appear to meet their first sexual partner through the Internet, this offers a valuable opportunity for developing online interventions targeting men early in their sexual careers.