To be able to examine the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adapted the association between online/offline dating place and UAI for characteristics of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted additionally for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and venture sort (i.e., casual or anonymous). As we assumed a differential effect of dating place for HIV-positive, HIV negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was contained in all three models by making a brand new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV negative, HIV positive, and HIV-unaware men. Backpage Escorts nearby Bartstow, Alberta. We performed a sensitivity analysis restricted to partnerships in which only one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to miss potentially important associations. As a fairly large number of statistical tests were done and reported, this approach does lead to a higher risk of one or more false-positive associations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of online and offline partners and partnerships are shown in Table 2 The median age of the partners was 34years (IQR 28-40). Compared to offline partners, more online partners were Dutch (61.3% vs. 54.0%; P 0.001) and were defined as a known partner (77.7% vs. 54.4%; P 0.001). The HIV status of online partners was more frequently reported as understood (61.4% vs. 49.4%; P 0.001), and in online partnerships, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their on-line partners more frequently knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with internet partners (50.9% vs. Backpage escorts closest to Bartstow. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more inclined to occur in on-line than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three distinct reference types, one for each HIV status. Backpage Escorts near me Alberta. Among HIV positive guys, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online in comparison to offline ventures, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
In multivariate model 3 (Tables 4 and 5 ), additionally including variables concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat more powerful (though not essential) for the HIV-positive men (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV-negative men (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became stronger (and essential) for HIV-oblivious guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The number of sex partners in the preceding 6months of the index was likewise correlated with UAI (OR = 6.79 95 % CI 2.86-16.13 for those with 50 or more recent sex partners compared to those with fewer than 5 recent sex partners). UAI was significantly more likely if more sex acts had happened in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to only one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within partnership.
In this large study among MSM attending the STI clinic in Amsterdam, we found no evidence that online dating was independently related to a higher danger of UAI than offline dating. Backpage Escorts nearby Bartstow. For HIV-negative men this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive guys there was a non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Backpage escorts near Bartstow. Only among guys who indicated they were not informed of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV-positive men, in univariate analysis UAI was reported significantly more frequently with on-line partners than with offline associates. When correcting for partner features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became non-significant; this implies that differences in partnership variables between online and also offline partnerships are in charge of the increased UAI in online established ventures. This may be because of a mediating effect of more info on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative guys no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was connected with UAI but only significant when adding associate and venture variables to the model.
A key strength of the study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted prejudice due to potential differences between guys just dating online and those only dating offline, a weakness of numerous previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and prevent potential differences in men tried through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Online dating was not connected with UAI among HIV negative guys, a finding in agreement with some previous studies, mainly among young men 21 , but in comparison with other studies 1 - 5 This may be because of the fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Nonetheless it might also represent lay changes; perhaps in the beginning of online dating a more high-risk group of men used the Internet, and over time online dating normalized and not as high-risk MSM now additionally utilize the Net for dating.
For HIV-unaware guys the impact of dating location on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's difficult to evaluate the actual risk for HIV for these men: do they behave as HIV negative guys who are attempting to protect themselves from HIV infection, or as HIV positive guys trying to shield their HIV-negative partner from HIV infection? A study by Horvath et al. reported that 72% of men who were never tested for HIV, profiled themselves online as being HIV-negative, which might be problematic if they're HIV positive and participate in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the oblivious and perceived HIV negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI appear to be partly based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV-negative guys and HIV status-unaware guys, conclusions on UAI WOn't only be based on perceived HIV status of the partner but in addition on one's own negative status. HIV serosorting is challenged by the frequency of HIV testing as well as the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as a very successful method of avoiding HIV transmission 22 Besides interventions to trigger the uptake of HIV and STI testing in sexually active men, interventions to caution against UAI based on sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts in Bartstow Alberta.
Relationship online may offer other opportunities for communication on HIV status than dating in physical environments. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may raise the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and oblivious MSM and excite timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date when it comes to fast altering dating approaches as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Barrhead Alberta. Backpage Escorts Near Me Bashaw Alberta. Nevertheless these results are useful, as they reveal how net-based partner acquisition can result in more information on the sex partner, and this might influence on the frequency of UAI.
AMC, Academic Medical Center; aOR, adjusted odds ratio; CI, confidence interval; CINIMA, Center for Infection and Immunology Amsterdam; DAG, directed acyclic graph; HIV, human immuno-deficiency virus; i.e., id est, it is, for example; IQR, interquartile range; MEC, Medical Ethics Committee; MSM, men who have sex with men; OR, odds ratio; RIVM, National Institute of Public Health and the Environment, Centre for Infectious Disease Control; STI, sexually transmitted infection; UAI, unprotected anal intercourse; UMCU, University Medical Center Utrecht
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