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Some studies have shown that online-based MSM were more likely to report different socio-demographic profiles , compared with offline-based MSM.The online-based sample was significantly younger (Internet sample mean age 33.2 years old, offline 37.6 years old) and was comprised of more bisexual men (Internet sample 20%, offline 5%) than the offline MSM sample  MSMs reported risky sexual behavior (e.g., UAI, having multiple sex partners) and showed an increase in the prevalence of UAI.
In the past few decades, several studies  have reported that online-based MSM were more likely to have UAI with male sex partners than offline-based MSM, but the findings are inconsistent and show some conflicting outcomes due to different regions or low statistical power.Targeted interventions of HIV prevention programs or services are recommended when designing preventive interventions to be delivered via the Internet. Many studies showed that MSM seeking male sexual partners (sampled offline or from fixed venues, such as gay bars, bathrooms, or clubs) engage in several risky sexual behaviors, such as UAI, having multiple sex partners and anal sex .However, the studies are limited because offline sampling misses MSM who do not go to these venues due to fear of discrimination, and some HIV-positive MSM who are at high risk for transmission of HIV or STDs may not go to these places either.The recruitment of MSM for studies is a challenge for researchers because no sampling frame exists for MSM and public acknowledgement of membership may also be stigmatized in some cases [); they also perceive that this method is convenient and cost-effective because it is private, anonymous, safe and convenient in the process of communication.Although many studies have applied offline-based sampling to MSM  sampling MSM who seek male sexual partners via the Internet have shown that such online-based sampling is cost-effective and has lots of advantages.Men who have sex with men (MSM) are a high risk population for human immunodeficiency virus (HIV) infection.
Our study aims to find whether MSM who were recruited online had a higher prevalence of self-reported unprotected anal intercourse (UAI) than those who were recruited offline.
Based on fourteen studies, MSM who were recruited online (online-based group) reported that 33.9% (5,961/17,580) of them had UAI versus 24.9% (2,700/10,853) of MSM who were recruited offline (offline-based group).
The results showed that it is more likely for an online-based MSM group to have UAI with male partners than an offline-based MSM group [odds ratio ( A substantial percentage of MSM were recruited online, and they were more inclined to engage in UAI than MSM who were recruited offline.
In our research, we conducted a meta-analysis to assess whether online-based MSM had a higher self-reported UAI prevalence than offline-based MSM.
Studies published before December 2013 that examined the prevalence of UAI among MSM were carefully selected from the following databases: Pub Med (1966 to 2013), Springer (1996 to 2013), Cochrane Library (1993 to 2013), Google Scholar (1987 to 2013), China National Knowledge Infrastructure (CNKI, 1979 to 2013) and the Wanfang database (Chinese, 1990 to 2013). The databases were searched using the following key words: “men who have sex with men”, “Internet”, “web”, “online”, “offline”, “venue”, “MSM”, “gay”, “homosexuality”, “risky behavior”, “sexual behavior” or “anal intercourse”.
No language restrictions were carried out for this study.