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ABSTRACT
The use of social networking applications (apps) on smartphones has the potential to impact sexual health and behaviour. This was the first systematic review to critically appraise and summarize the existing literature on the use of social networking apps on smartphones and their associated sexual health and sexual behaviour effects in lesbian, gay, bisexual and transgender populations. A systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. Studied outcomes included rates of unprotected sexual intercourse, the number of sexual partners, drug/alcohol use prior to/during sexual intercourse, sexually transmitted infections (STIs) testing and the prevalence of STIs. Among app users, the prevalence of unprotected sex ranged from 17.0% to 66.7%. The mean number of sexual partners ranged from 1.4 to 2.9 (last 1-month period), and from 46.2 to 79.6 (lifetime). Two studies found that the prevalence of HIV infection was 1.9% and 11.4%, respectively. The self-reported prevalence of prior diagnosis of STIs other than HIV ranged from 9.1% to 51.0%. It should be noted that the heterogeneity of the study design and outcome measures across different studies hindered the comparison of findings across different studies. Furthermore, the findings in some studies are not reliable due to methodological problems. Our results highlight the need for more research with rigorous methodology to understand the negative impacts of using these apps on sexual health and sexual behaviour. For future studies, the operational definition of outcomes, including social networking app use and unprotected anal intercourse (UAI), should be clearly outlined. The use of validated tools to measure sexual behaviour and biological measures of HIV and other STDs is preferable so that outcomes can be standardized to facilitate comparisons between studies and the pooling of data.