Characteristics of online 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 on-line partners was more often reported as understood (61.4% vs. 49.4%; P 0.001), and in online 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 me Keoma. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less frequently reported with internet partners.
In univariate analysis, UAI was significantly more likely to happen in online 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 correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The result of dating location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the association of online dating using three distinct reference types, one for each HIV status. Among HIV-positive men, 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 apparent between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 ), additionally including variables concerning sexual behaviour in the partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat stronger (though not significant) 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 more powerful (and important) 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 also 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 venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the partnership, and sex-connected 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 related to a higher risk of UAI than offline dating. Keoma, Alberta backpage escorts. Backpage Escorts nearby Keoma, Alberta. For HIV negative men 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). Only among guys who suggested they were not conscious of their HIV status (a small group in this study), UAI was more common with online than offline associates.
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with on-line partners 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 nonsignificant; this implies that differences in partnership factors between online and offline partnerships are responsible for the increased UAI in online established partnerships. This may be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative men no effect of online dating on UAI was discovered, either in univariate or in any of the multivariate models. Among HIV-oblivious guys, online dating was connected with UAI but only significant when adding associate and venture variables to the model.
A vital strength of the study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided bias due to potential differences between men only dating online and those just dating offline, a weakness of numerous previous studies. Alberta Backpage Escorts. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a lot of MSM, and avoid potential differences in guys 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, mostly 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 Kerensky Alberta. However it might also represent secular changes; possibly in the beginning of online dating a more high-risk group of guys used the Internet, and over time online dating normalized and not as high risk MSM nowadays additionally utilize the Net for dating.
For HIV-unaware guys the impact of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's difficult to assess the actual risk for HIV for these guys: do they behave as HIV negative men that are trying to shield themselves from HIV infection, or as HIV-positive men trying to protect 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're HIV-positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and perceived HIV-negative MSM were examined HIV positive. The study population included the MSM reported in this study 15
Because conclusions on UAI appear to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-oblivious guys, determinations on UAI WOn't 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 the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting can't be regarded as a very effective method 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
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 easier. However, serosorting may increase the burden of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and oblivious MSM and stimulate timely HIV testing (i.e., after risk events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up-to-date in regards to rapid shifting dating processes as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will change. Our data are 8years old and internet-based dating has developed since then. Yet these results are useful, as they show how internet-based partner acquisition can lead to more information on the sex partner, and this may affect 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's, 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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