To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adapted the association between online/offline dating place and UAI for features 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 adjusted also for partnership sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership sort (i.e., casual or anonymous). As we assumed a differential effect of dating location for HIV-positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was included 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-oblivious men. Backpage Escorts nearest Simon Lakes, Alberta. We performed a sensitivity analysis confined 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 lose potentially significant associations. As a fairly large number of statistical evaluations were done and reported, this strategy does lead to an increased danger of one or more false-positive organizations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics of online 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 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 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 nearby Simon Lakes. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more likely to happen in online than in offline partnerships (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly associated 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 different reference types, one for each HIV status. Backpage escorts closest to Alberta. Among HIV-positive guys, 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-oblivious guys, UAI was more common in online compared to 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 behaviour in the partnership (sex-related multiple drug use, sex frequency and partner type), the independent 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 guys (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became stronger (and critical) 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 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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just 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 associated with a higher risk of UAI than offline dating. Backpage Escorts near Simon Lakes. For HIV negative guys this dearth 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). Backpage escorts in Simon Lakes. Simply 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 guys, in univariate analysis UAI was reported significantly more frequently with online associates than with offline associates. When adjusting 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 also offline partnerships are liable for the increased UAI in online established partnerships. This could be due to a mediating effect of more info on associates, (including perceived HIV status) on UAI, or to other variables. 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-unaware men, online dating was correlated with UAI but just essential when adding partner and partnership variables to the model.
An integral strength of this study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided bias due to potential differences between men only dating online and those just dating offline, a weakness of several previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in guys sampled through Internet or face-to-face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not correlated with UAI among HIV-negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in contrast 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. However it can also reflect secular changes; maybe 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 now also make use of the Internet for dating.
For HIV-oblivious guys the effect of dating location on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is hard to evaluate the real risk for HIV for these men: do they act as HIV-negative guys who want to shield themselves from HIV infection, or as HIV positive men trying to safeguard 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 are HIV positive and engage in UAI with HIV-negative partners 12 Formerly 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 important. In HIV negative men and HIV status-unaware men, conclusions on UAI will not 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 and the HIV window phase 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 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. Backpage escorts nearby Simon Lakes Alberta.
Relationship online may offer other chances for communication on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Yet, serosorting may raise the burden of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and oblivious MSM and spark 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 as it pertains to fast altering dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me Silverwood Alberta. Backpage Escorts Near Me Simons Valley Alberta. However these results are useful, as they show how web-based partner acquisition can result in more information on the sex partner, and this might 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 immuno deficiency 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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