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Characteristics 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 on-line partners was more often reported as understood (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 understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts nearest Agate. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with internet partners.

In univariate analysis, UAI was significantly more prone 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 connected 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 different reference types, one for each HIV status. Among HIV positive men, 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 ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online in comparison to 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 variables concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat stronger (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 effect of online dating on UAI became stronger (and important) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).

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The number 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 venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Other factors 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 evidence that online dating was independently related to a higher risk of UAI than offline dating. Agate, British Columbia backpage escorts. Backpage Escorts nearest Agate, British Columbia. For HIV negative men 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). Simply among men who indicated they weren't conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline partners.

Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with on-line associates than with offline associates. When correcting for associate characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership variables between online and also offline partnerships are liable for the increased UAI in online established partnerships. This may be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative men no effect of online dating on UAI was found, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only important when adding partner and venture variants to the model.

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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 offline casual partners. This prevented prejudice due to potential differences between guys just dating online and those only dating offline, a weakness of several previous studies. British Columbia Backpage Escorts. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in men sampled through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11

Online dating wasn't correlated with UAI among HIV negative men, a finding in agreement with some previous studies, mostly among young men 21 , but in contrast with other studies 1 - 5 This may be because of the fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Backpage Escorts Near Me Ahousat British Columbia. Nonetheless it could also represent secular changes; possibly in the beginning of online dating a more high-risk group of men used the Internet, and over time online dating normalized and not as high risk MSM today additionally use the Net for dating.

For HIV-oblivious guys the impact of dating location on UAI didn't change by adding partner features, but it improved 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 guys that are trying to protect themselves from HIV infection, or as HIV positive guys attempting to guard 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're HIV-positive and engage in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the oblivious and sensed HIV negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15

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Because determinations on UAI seem to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious guys, conclusions on UAI WOn't 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't be regarded as a very powerful method of avoiding 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 surroundings. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after hazard events 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 fast altering dating procedures as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive opportunities, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Nevertheless these results are useful, as they reveal how web-based partner acquisition may lead to more information on the sex partner, and this may impact on the frequency of UAI.

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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 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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