Use of Gay chatlines and online dating platforms as potential mediators or moderators in the relationship between loneliness, self-rated attractiveness and HIV acquisition risk among gbMSM in Vancouver, Canada

Gay, bisexual, and other men who have sex with men (gbMSM) remain disproportionately affected by HIV. Interaction between psychosocial factors likely plays a role in HIV acquisition risk. We aimed to analyse the association of loneliness and self-rated attractiveness with HIV acquisition risk, and determine whether these associations were mediated by gay telephone chatlines or online dating platforms.This cross-sectional study included HIV-negative gbMSM aged ≥16 enrolled into the Momentum Health Study from February 2012 to February 2015. Loneliness, self-rated attractiveness (exposures) and use of gay chatlines or online dating platforms (mediators) were assessed through self-interviews. HIV acquisition risk (outcome) was assessed by the HIV Incidence Risk Index. Weighted logistic regression modelled the association and moderation effect between exposures and outcome. Mediation models estimated three-way direct effect among exposures, mediators and outcome.Of 542 gbMSM, those who were lonely (adjusted odds ratio [aOR]: 1.54, 95% confidence intervals [CI]: 1.04-2.28) and attractive (aOR: 1.69; 95% CI: 1.04-2.76) had increased odds for HIV acquisition risk. Our moderation analysis demonstrated a heightened joint effect among lonely and attractive participants (aOR: 1.70; 95% CI:1.08- 2.65). Use of gay telephone chatlines or online dating platforms mediated 30.5% of the association between loneliness and HIV acquisition risk, but did not mediate attractiveness and HIV acquisition risk.Our findings suggest that the provision of interventions focusing on mental health support and safer sex practices through gay telephone chatlines or online dating platforms is promising to help alleviate the HIV burden among gbMSM.