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 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 often reported as known (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 frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts near Sugden. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with on-line 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 strongly associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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 distinct reference classes, one for each HIV status. Among HIV positive guys, UAI was more common in online in comparison to 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 men, UAI was more common in online compared 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 behaviour in the venture (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat more powerful (though not essential) 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 also 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 partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-connected 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. Sugden Alberta backpage escorts. Backpage Escorts near Sugden, Alberta. For HIV negative guys 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). Only among guys who indicated they were not conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.
Among HIV-positive men, in univariate analysis UAI was reported significantly more often with online 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 non significant; this suggests that differences in partnership factors between online and also offline partnerships are liable for the increased UAI in online established ventures. 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 guys no effect of online dating on UAI was found, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was associated with UAI but only significant when adding associate and venture variants to the model.
An integral strength of this study was that it explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided prejudice brought on by potential differences between men just dating online and those only 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 include a lot 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 connected with UAI among HIV-negative men, 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 behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Backpage Escorts Near Me Sullivan Lake Alberta. However it could also reflect 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 today additionally make use of the Net for dating.
For HIV-unaware men the impact of dating location on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It is hard to assess the real risk for HIV for these men: do they behave as HIV-negative men who are attempting to shield themselves from HIV infection, or as HIV positive guys attempting to protect 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 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 tested HIV-positive. The study population included the MSM reported in this study 15
Because determinations on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV-negative men and HIV status-unaware men, conclusions 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 also the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot 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 caution 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 surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the load of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and oblivious MSM and arouse timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up-to-date as it pertains to accelerated shifting dating methods 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 battles will vary. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they demonstrate how net-based partner acquisition can lead to more information on the sex partner, and this may 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 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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