Abstract
Internet platforms have transformed male sex work by increasing visibility, client access, and opportunities for self-representation. This study presents a thematic analysis of usernames from MSM advertising services in California on one of the largest internet advertising platforms for male sex work between July and October 2024. We aimed to explore how MSM sex workers (MSMSW) construct identity online and how these practices might inform public health strategies, including health promotion, health communication, and/or digital outreach. Using Reflexive Thematic Analysis, we examined 2,554 usernames and identified three themes: "Familiarity vs Fantasy," "Dominance vs. Nurturance," and "Mainstream vs. Marginal," highlighting the negotiation of masculinity and sexuality online. Interpreted through hegemonic masculinity, the findings show how MSMSW construct personas that may reinforce dominant masculine ideals while navigating diverse sexual and emotional identities. This study advances understanding of how identity is marketed and consumed in digital sex work and offers insights for public health outreach targeting MSMSW and their clients. By considering the performative and strategic aspects of online self-presentation, interventions can better align with community realities, improving engagement, and reducing barriers to care.