Role of offline vs. online hookups in HIV serodiscussion among black and white MSM

Background: Among MSM, discussion of HIV status before first sex (serodiscussion) may reduce risk for HIV transmission. Black MSM are at disproportionately high risk for HIV infection and serodiscuss less frequently than do white MSM. Little is known about the partnership-level determinants in serodiscussion. Two candidate partnership-level risk factors include where the partners met (offline/online), and had sex once (“hookup”) or more than once (“ongoing”). Methods: Data are from an Atlanta cohort study examining HIV/STI incidence of black and white MSM. At baseline, 516 black and white participants aged ≥18 years, had ≥1 male sex partner, and had previously been tested for HIV, reported 1,861 partnerships in the past 12 months. Serodiscussion was compared by participant race, offline/online meeting, and hookup status using chi-square tests. Results: Overall, MSM serodiscussed in 60% of partnerships. MSM were less likely to serodiscuss with offline (56%) than online (65%) partners (OR=0.8, 95% CI[0.65,0.97]). Among offline partnerships, MSM serodiscussed less during hookups than in ongoing partnerships (43% vs. 70%, p<0.0001). These associations were not different by race; however, black MSM serodiscussed less than white MSM (50% vs. 68%, p<0.0001). In particular, black MSM serodiscussed least during offline hookups versus ongoing offline partnerships (38% vs. 62%, p<0.00001). Conclusions: Factors including where the partners met and hookup status may play a role in the likelihood of serodiscussion. Of all race-location-duration-specific groups, black MSM who met a hookup offline were the least likely to discuss HIV. This information can be used to target MSM groups for intervention.