Engagement with HIV and COVID-19 prevention within a geosocial networking app: a tale of two pandemics (Preprint)

BACKGROUND Geosocial networking (GSN) apps play a pivotal role in catalyzing sexual partnering, especially among men who have sex with men (MSM). OBJECTIVE To quantify the United States (US) prevalence and disparities in disclosure of pre-exposure prophylaxis (PrEP) use and COVID-19 vaccination among GSN app users, mostly MSM. METHODS We randomly sampled online Grindr profiles from the top 50 metropolitan areas as well as the 50 most rural counties in the US by population. Grindr provides an option to disclose current PrEP use (HIV positive, HIV negative, or HIV negative with PrEP use). We analyzed the free text in all profiles and recorded any mention of COVID-19 vaccination, which is passively reported. We performed multivariable logistic regression to assess independent associations with PrEP disclosure and COVID-19 vaccination. We used imputation analyses to test the robustness of the results. RESULTS We evaluated 1,889 urban and 384 rural profiles. Mean age among urban profiles was 32.9 years (SD 9.6); mean age among rural profiles was 33.5 years (SD 12.1), p=0.41. Among the urban profiles, 16% reported being vaccinated against COVID-19 and 23% reported PrEP use compared to 10% and 8% in rural profiles, respectively (p<0.01). Reporting COVID-19 vaccination (adjusted OR 1.7, 95%CI 1.2-2.4), living in an urban center (aOR 3.2, 95%CI 1.8-5.7), and showing a face picture as part of the Grindr profile (aOR 4.0, 95%CI 2.3-7.0) were positively associated with PrEP disclosure. Self-identified Black and Latino users were less likely to report PrEP use (aOR 0.6, 95%CI 0.4-0.9 and aOR 0.5, 95%CI 0.4-0.9, respectively). Reporting PrEP use (aOR 1.7, 95%CI 1.2-2.4), living in an urban center (aOR 2.5, 95%CI 1.4-4.5), ‘discreet’ status (aOR 1.6, 95%CI 1.0-2.5), and showing a face picture (aOR 2.7, 95%CI 1.5-4.8) were positively associated with reporting COVID-19 vaccination on the profile. Users in the southern US were less likely than users in the northeast to report COVID-19 vaccination (aOR 0.6, 95%CI 0.3-0.9). CONCLUSIONS Variations in PrEP disclosure are associated with race, whereas COVID-19 vaccination disclosure is associated with geographic area. However, rural GSN users were less likely to report both PrEP use and COVID-19 vaccination. We demonstrate a need to expand health preventative services in the rural US for sexual minorities. GSN platforms may be ideal for deployment of preventative interventions to improve access for this difficult to reach population. CLINICALTRIAL n/a