Clickable Consent: How Men Who Have Sex with Men Understand and Practice Sexual Consent on Dating Apps and in Person.

Smartphone-based dating applications like Grindr are popular among men who have sex with men (MSM), and it is common for MSM to engage in sexual activity with other users. Despite this, there is limited research on MSM's negotiations of consent for online sexual interactions and in-person sexual encounters. This study examined MSM's understandings and practices of consent on dating apps and in person. Interpretative phenomenological analysis of 25 interviews with MSM dating app users revealed that many participants could identify key aspects of consent but did not always apply those understandings to their own practices. For online sexual interactions, some participants viewed consent as connecting to a dating app - a practice I term "clickable consent" - while other participants viewed consent as continuous and communicated consent in explicit and implicit ways. Although all participants negotiated consent online in preparation for an in-person sexual encounter, some renegotiated consent in person with explicit or non-explicit communication, while others did not renegotiate consent in person. Results shed light on how MSM's online conversations impact their in-app and in-person sexual activities, and reveal challenges that MSM face in digital and physical spaces. Conclusions, implications, and suggestions for future research are discussed further.

The Three Dimensions of Unsolicited Dick Pics: Men Who have Sex with Men's Experiences of Sending and Receiving Unsolicited Dick Pics on Dating Apps.

The unsolicited "dick pic" (DP), which refers to a photo of a penis that is sent without the consent of the recipient, has been identified as a form of technology-facilitated sexual violence (Powell & Henry, 2017). While men who have sex with men (MSM) experience elevated rates of technology-facilitated sexual violence, much of the research has focused on interactions between heterosexual men and women. This study investigated the experiences that MSM have with sending and receiving unsolicited DPs on dating apps. Analysis of interviews with 25 MSM dating app users in Canada revealed three "dimensions" of unsolicited DPs-consensual, wanted, and typical-that capture users' experiences of receiving such images relative to consent and sexual violence frameworks. Seven factors, including the attractiveness of the sender and the DP, had an impact on MSM's experiences. Unsolicited DPs were found to be sent for a variety of reasons, including to compliment the recipient and to coerce them into replying with sexual images. It is argued that MSM have trivialized unsolicited DPs and that these images are, according to current definitions, a form of technology-facilitated sexual violence that MSM experience on dating apps. However, there were variations in participants' experiences and some participants did not characterize unsolicited DPs as problematic or non-consensual, which challenges the notion that MSM always experience these images as sexually violent. These findings shed light on the complexities of unsolicited DPs and indicate the need to (re)examine definitions of technology-facilitated violence and explore MSM's consent practices within the context of dating apps.

Impact of a Mortality Prediction Rule for Organizing and Guiding Antimicrobial Stewardship Program Activities.

BACKGROUND: Antimicrobial stewardship program (ASP) surveillance at our hospital is supplemented by an internally developed surveillance database. In 2013, the database incorporated a validated, internally developed, prediction rule for patient mortality within 30 days of hospital admission. This study describes the impact of an expanded ASP review in patients at the highest risk for mortality. METHODS: This retrospective, quasi-experimental study analyzed adults who received antimicrobials with the highest mortality risk score. Study periods were defined as 2011-Q3 2013 (historical group) and Q4 2013-2018 (intervention group). Primary and secondary outcomes were assessed for confounders and analyzed using both unadjusted and propensity score weighted analyses. Interrupted time-series analyses also analyzed key outcomes. RESULTS: A total of 3282 and 5456 patients were included in the historical and intervention groups, respectively. There were significant reductions in median antimicrobial duration (5 vs 4 days; P < .001), antimicrobial days of therapy (8 vs 7; P < .001), antimicrobial cost ($96 vs $85; P = .003), length of stay (LOS) (6 vs 5 days; P < .001), intensive care unit (ICU) LOS (3 vs 2 days; P < .001), total hospital cost ($10 946 vs $9119; P < .001), healthcare facility-onset vancomycin-resistant Enterococcus (HO-VRE) incidence (1.3% vs 0.3%; P ≤ .001), and HO-VRE infections (0.6% vs 0.2%; P = .018) in the intervention cohort. CONCLUSIONS: Reductions in antimicrobial use, hospital and ICU LOS, HO-VRE, HO-VRE infections, and costs were associated with incorporation of a novel mortality prediction rule to guide ASP surveillance and intervention.

Not your unicorn: trans dating app users' negotiations of personal safety and sexual health.

This article reflects on 14 Australian trans dating app users' accounts of feeling safer (and less safe) when using apps, as well as their experiences of sexual healthcare. We explore both app use and healthcare in the context of the interdisciplinary field of 'digital intimacies', considering the ways that digital technologies and cultures of technological use both shape and are shaped by broader professional and cultural norms relating to sexuality and gender. Drawing on Preciado's [(2013). Testo junkie: Sex, drugs and biopolitics in the pharmacopornographic era. The Feminist Press] framework of 'pharmacopornographisation', the analysis aims to contextualise participants' experiences of being 'seen' and 'known' by health professionals and other app users. Our findings indicate that both dating apps and sexual health services rely on reductive systems of sorting and categorisation that reinforce binary understandings of genders and sexualities in order to facilitate data management and information sharing practices. Yet these same sorting and filtering technologies can also help trans app users avoid harassment, form intimate connections and seek appropriate healthcare.