Motivations, dating app relationships, unintended consequences and change in sexual behaviour in dating app users at an Australian music festival

Background: Despite the popularity of dating apps, there remain scarce data on the motivations, consequences and their influence on sexual behaviour change in the Australian population. Objective: To explore motivations, dating app relationships, unintended consequences and change in sexual behaviour in dating app users at an Australian music festival. Methods: A cross-sectional study design was used. Festival patrons aged 18–30 at a major Australian music festival completed a paper-based survey. Logistic regression was used to identify which factors were associated with an increase in sexual partners since using dating apps. Results: The primary reasons for dating app use (N=437) were boredom (59.7%), casual sex (45.1%) and casual dating (42.8%). A third of users used them at music festivals (33.8%, n=432). A third of participants had used dating apps for more than 2 years (33.3%) and a third (33.0%) of users claimed to have changed their sexual behaviour after app use, including increased frequency of sexual activity (70.0%), number of sexual partners (57.1%) and sexual experimentation (42.1%). Dating app users tended not to discuss sexually transmitted infections (STI) status with a sexual partner regardless of whether they had met them on an app or not: 38.5% would ‘never’ and 36.9% would ‘sometimes’ have safe sex discussions with partners met via apps. Condoms were ‘always’ used for 36.9% of dating app users when meeting partners via dating apps, compared to 29.9% met by other means. 8.6% of dating app users reported having contracted STIs, and 2.8% had unwanted pregnancies with those met on dating apps. After adjusting for socio-demo graphics, those who had an STI after engaging in sexual activity with a person met via a dating app had 2.4 times the odds of reporting an increase in sexual partners, and those who had used a dating app for over 2 years had twice the odds of reporting an increase in sexual partners. When condom use was entered into the model, those that ‘often’ or ‘sometimes’ used a condom with a new dating app partner were twice as likely to report an increase in sexual partners since using dating apps, compared to those who ‘always’ used a condom with a new dating app partner. Sexual orientation and STI discussions with a new sexual dating app partner were not associated with an increase in dating app partners. Conclusion: Dating app usage is common and users report increased sexual activity, sexual partners and experimentation. STI discussions with potential partners and condom use remained low regardless of how partners were met and despite an increase in sexual partners since using dating apps. Given the high-risk nature of individuals that utilise dating apps, safe sex discussion, including STIs, pregnancies and condom use should be promoted to improve sexual health outcomes

Geosocial networking dating app usage and risky sexual behavior in young adults attending a music festival : cross-sectional questionnaire study

Background: Despite the prevalent use of geosocial networking dating apps (GNDAs), there is limited research on their impact on sexual health outcomes among young music festivals attendees. Objective: This study aims to explore the use of GNDAs and risky sexual behaviors of young adults attending a music festival. Methods: The music festival attendees (N=862) completed a cross-sectional questionnaire study encompassing demographics, dating app use, and risky sexual behaviors in the past year. Associations between these variables were estimated using bivariate and multivariate logistic regression analyses. Results: Of the respondents, 51.9% (448/862) had used GNDAs in the previous year. Compared with people who had 1 partner, people who had 2-5 sexual partners in the previous year had almost 7 times the odds of using dating apps (odds ratio [OR] 6.581, 95% CI 4.643-9.328) and those who had more than 5 partners had 14 times the odds of using dating apps (OR 14.294, 95% CI 8.92-22.906). Condom users were more likely to be app users (P<.001), as were those who relied on emergency Plan B (P=.002), but people using hormonal contraception were less likely to use dating apps (P=.004). After adjusting for sexual orientation and relationship status, those having casual sex had 3.096 (95% CI 2.225-4.307; P<.001) times the odds of using dating apps and those having multiple sexual partners had 3.943 (95% CI 2.782-5.588; P<.001) times the odds of using dating apps. Similarly, after adjusting for sexual orientation, relationship status, and number of sexual partners, people who had no discussions before having sex about sexually transmitted infections (STIs) or boundaries were more likely to use dating apps (OR 1.755, 95% CI 1.232-2.500; P=.002). Those who perceived the risk of having sex without contraception to be very high had 2.486 (95% CI 2.213-5.096; P=.01) times the odds of using dating apps than those who perceived no risk. Compared with those who perceived no risk, people who thought that the risk of having multiple sexual partners was low to high had 1.871 (95% CI 1.024-3.418; P=.04) times the odds of using dating apps. A significant number of app users (389/440, 88.4%) indicated that GNDAs should promote safe sex. Conclusions: This study identified that festival goers engaging in certain high-risk sexual behaviors, including casual sex, having multiple sexual partners, and having sex without discussion about STI status and boundaries, are more likely to use dating apps. Festival goers who perceived sex without any form of contraception, having sex while drunk, and having multiple sexual partners as risky were more likely to be app users. Policy makers and GNDA developers should acknowledge the vulnerability of their users to adverse sexual health outcomes and use GNDAs as a platform to promote risk-reduction practices

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

A positive approach to adolescent sexual health promotion: A qualitative evaluation of key stakeholder perceptions of the Australian Positive Adolescent Sexual Health (PASH) Conference

Background: Positive youth development (PYD) models are effective in improving adolescent sexual health. Adolescent programs including peer educators, parents and the wider community also demonstrate effectiveness in improving sexual health outcomes. An innovative Positive Adolescent Sexual Health (PASH) Conference model has been introduced in Northern NSW, Australia. It is run by the North Coast PASH Consortium, which is based on a health promotion framework. It takes a positive and holistic approach to sexual health education, and incorporates peer educators, parents, community workers and teachers. This study provides an introductory evaluation of the PASH Conference and identifies areas for increased effectiveness. It is intended as an early piece of research to inform future evaluations and to provide introductory information for public health educators. Methods: Data collection included semi-structured interviews with 13 key stakeholders of the PASH Conference. Interviews were recorded, transcribed verbatim and analysed using deductive thematic analysis. Results: Subjects included 2 teachers, 2 parents, 2 youth conference workers, 2 organisers, 2 presenters and 3 Peer Educators engaging Peers (PEEPs). Stakeholders perceived that young people were engaged to strengthen their sexual health and wellbeing due to many factors. These followed 3 themes: a safe and open learning environment, empowerment of young people and involvement of the support system and broader community. Multiple recommendations were identified across 2 themes: changes to conference format and planning, and enhancing stakeholder engagement. Discussion: The PASH Conference is a promising new youth development design promoting positive adolescent sexual health, which may provide a feasible model for public health educators to trial. Elements of the conference identified as engaging to youth align well with those in PYD research literature. This study provides an early piece of research to inform the design of future research on the PASH Conference including evaluation of behavioural outcomes. It provides introductory information to inform PASH Conference development to further increase its effectiveness

Multimedia campaign on a shoestring : promoting \u27Stay Active - Stay Independent\u27 among seniors

Issue addressed: This paper describes a multimedia campaign implemented in rural New South Wales on a budget smaller than that typical of many published campaigns. The \u27To Be Young at Heart- Stay Active Stay Independent\u27 (SASI) campaign was one arm of a multi- strategic program to reduce falls among seniors by promoting physical activity. Methods: This 18-month campaign used social marketing techniques. Central to this campaign was strong formative research, significant use of corporate, community and media partnerships and a detailed, strategic distribution plan. Campaign reach was evaluated by a community intercept survey. Results: A variety of high quality information, education and communication (IEC) resources were developed. Overall, the campaign cost was calculated at $191,000. The actual cost of$42,000 (excluding staff time) was used to generate almost double this amount in sponsorship ($82,000). In the mid-campaign reach survey, 36% recognised the campaign and attributed this to television (58%), newspaper (33%), poster (13%) and bus-back advertising (8%). Of these respondents, 21% reported seeking information about physical activity, 33% reported increased intention to be more active, and 22% reported becoming more active as a result of the campaign. Conclusions: It is possible to develop and deliver a well designed, multimedia campaign on a limited budget by using sound formative research and engaging community and corporate partners to generate sponsorship. An effective distribution strategy is crucial and may require additional partnerships at State or national level.<br /