An emerging risk factor in sexual health : the use of dating applications on smartphones

Abstract

Smartphone dating applications (apps) have become popular in recent years. The use of dating apps has the potential to negatively impact sexual health. However, the association between the use of dating apps and sexual health is poorly understood. The study aimed to examine the association between the use of dating apps and sexual behaviours among college students in Hong Kong. First, a systematic review was undertaken to summarise the existing literature on the use of smartphone dating apps and associated risky sexual behaviours and sexual health outcomes. The systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Second, a cross-sectional multi-site study was conducted on college students in Hong Kong. Subjects were recruited in university campuses and asked to fill out a structured questionnaire (in a paper-and-pencil format), including question items on the use of dating apps, sexual behaviours (the number of sexual partners, type of sexual partner and condom use consistency), the sexual coercion subscale of the revised Conflict Tactics Scales, the Hospital Anxiety and Depression Scale, the 10-item version of the Perceived Stress Scale and the World Health Organization Quality of Life-BREF. Thirteen articles from 11 studies were identified in the systematic review. All studies were exclusively conducted in homosexual male populations. The heterogeneity of the study design, study samples and outcome measures across different studies limited the comparison and generalisation of study findings. The cross-sectional study found that compared with non-users, dating app users were more likely to engage in risky sexual behaviours – including having more sexual partners, having had unprotected sexual intercourse with more sexual partners in a lifetime, inconsistent condom use in a lifetime, having had a casual sexual partner without using a condom in the last sexual intercourse experience and drug use in conjunction with sex in a lifetime. In addition, app users were at greater risk of being sexually abused than non-users. It was found that victims of sexual dating violence had more severe depressive, anxiety and stress symptoms and poorer generic health-related quality of life (HRQOL), in particular, social, psychological and environmental aspects, than non-victims. Limitations of the study included its cross-sectional design, convenience sampling in universities and using self-reported outcomes. It was the first study to examine the association between the use of dating apps and sexual health in a sample of heterosexual, bisexual and homosexual subjects. Using dating apps was a risk factor of sexual health. With the growing popularity of smartphone dating apps, it is timely to consider the development and testing of novel interventions that can target app users so that they can remain safe when seeking sexual partners through dating apps. Moreover, users of dating apps should be targeted for sexual risk assessment, screening as well as for sexual risk stratification. Besides, given the detrimental effects of dating sexual violence on mental health and HRQOL, interventions designed to improve the mental health and HRQOL of victims of dating sexual violence should be developed in universities.