Features of on-line and offline partners and partnerships are revealed 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 known (61.4% vs. 49.4%; P 0.001), and in on-line ventures, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their on-line partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts near Decoigne. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more likely to happen in on-line than in offline partnerships (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was strongly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating place on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three different reference classes, one for each HIV status. Among HIV positive guys, UAI was more common in online when compared with offline ventures (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-unaware men, UAI was more common in online when compared with offline partnerships, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
In multivariate model 3 (Tables 4 and 5 ), also including variants concerning sexual behavior in the partnership (sex-related multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat stronger (though not critical) for the HIV-positive guys (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV negative guys (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became more powerful (and important) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The amount of sex partners in the preceding 6months of the index was likewise connected 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 occurred in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other variables significantly associated with UAI were group sex within the partnership, and sex-related multiple drug use within partnership.
In this large study among MSM attending the STI clinic in Amsterdam, we found no signs that online dating was independently associated with a higher risk of UAI than offline dating. Decoigne, Alberta Backpage Escorts. Backpage Escorts nearest Decoigne, Alberta. For HIV negative guys this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive men there was a non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among guys who suggested they were not conscious of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently with online associates than with offline associates. When adjusting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became non-significant; this suggests that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established partnerships. 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 detected, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but only important when adding partner and venture variables to the model.
An integral strength of this 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 bias due to potential differences between guys just dating online and those simply dating offline, a weakness of several previous studies. Alberta Backpage Escorts. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could comprise a large number of MSM, and prevent potential differences in men sampled through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't correlated with UAI among HIV negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in comparison with other studies 1 - 5 This may be due to 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. Backpage Escorts Near Me Decrene Alberta. Yet it can also represent lay changes; perhaps in the beginning of online dating a more high risk group of guys used the Internet, and over time online dating normalized and less high-risk MSM now additionally utilize the Web for dating.
For HIV-unaware men the impact of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It's difficult to evaluate the actual risk for HIV for these guys: do they behave as HIV-negative men who want to protect themselves from HIV infection, or as HIV-positive guys trying to guard their HIV negative partner from HIV infection? A study by Horvath et al. reported that 72% of guys who were never tested for HIV, profiled themselves online as being HIV-negative, which might be debatable if they are HIV positive and engage in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and perceived HIV negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-oblivious guys, conclusions on UAI will not only be based on perceived HIV status of the partner but also on one's own negative status. HIV serosorting is challenged by the frequency of HIV testing and also the HIV window phase 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 way of averting HIV transmission 22 Besides interventions to stimulate the uptake of HIV and STI testing in sexually active men, interventions to warn against UAI based on sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other opportunities for communicating on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may raise the weight of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after hazard 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 rapid altering dating strategies and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will be different. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they demonstrate how web-based partner acquisition can result in more information on the sex partner, and this might impact 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 immunodeficiency 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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