Features of on-line and offline partners and ventures are shown in Table 2 The median age of the partners was 34years (IQR 28-40). Compared to offline partners, more on-line 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 frequently knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts nearby Minburn. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more prone to happen 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 strongly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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. Among HIV-positive men, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was apparent between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, UAI was more common in online when compared with offline ventures, 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 behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating location on UAI became somewhat stronger (though not essential) for the HIV positive men (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 stronger (and important) for HIV-unaware men (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 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 occurred in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture 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 venture.
In this large study among MSM attending the STI clinic in Amsterdam, we found no evidence that online dating was independently associated with a higher danger of UAI than offline dating. Minburn Alberta Backpage Escorts. Backpage escorts near me Minburn, Alberta. For HIV-negative men this lack of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive guys there was a nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among guys who indicated 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 often with online associates 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 suggests that differences in partnership variables between online and offline partnerships are accountable for the increased UAI in online established partnerships. This could be because of a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was observed, either in univariate or in any of the multivariate models. Among HIV-unaware men, online dating was connected with UAI but only significant when adding partner and partnership variables to the model.
A key strength of this study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This prevented bias caused by 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 largest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and prevent potential differences in men tried through Internet or face-to-face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not correlated with UAI among HIV-negative men, 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 reality that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Backpage Escorts Near Me Mintlaw Alberta. Nevertheless it could also reflect 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 less high-risk MSM nowadays additionally make use of the Net for dating.
For HIV-unaware men the effect of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is hard to evaluate the real risk for HIV for these guys: do they act as HIV negative men who are trying to protect themselves from HIV infection, or as HIV-positive men attempting 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 problematic if they are HIV positive and engage in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and sensed HIV-negative MSM were analyzed HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV negative guys and HIV status-unaware men, decisions 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very powerful method of preventing HIV transmission 22 Besides interventions to trigger 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 chances for communicating on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may increase the load of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and arouse 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 as it pertains to rapid altering dating approaches and 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. Nevertheless these results are useful, as they demonstrate how internet-based partner acquisition may lead to more info on the sex partner, and this may 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 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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