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 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 online partners more often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts nearest Cloverdale. 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 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 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 distinct reference categories, one for each HIV status. Among HIV positive men, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident 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 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-related multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (though not significant) for the HIV positive guys (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 essential) for HIV-oblivious 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 likewise associated 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 only 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. Cloverdale British Columbia backpage escorts. Backpage Escorts nearest Cloverdale, British Columbia. For HIV negative men this lack 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 men who indicated they weren't aware of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently with on-line 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 implies that differences in partnership factors between online and offline partnerships are accountable for the increased UAI in online established ventures. This might be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative guys no effect of online dating on UAI was observed, either in univariate or in any of the multivariate models. Among HIV-oblivious men, online dating was associated with UAI but only significant when adding partner and venture variables to the model.
A vital strength of this study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided prejudice caused by potential differences between men only dating online and those just dating offline, a weakness of several previous studies. British Columbia Backpage Escorts. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a lot of MSM, and prevent potential differences in men sampled through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not connected with UAI among HIV negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in comparison 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 guys. Backpage Escorts Near Me Coal River British Columbia. Nevertheless it can also reflect lay 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 make use of the Internet for dating.
For HIV-unaware guys the effect 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 real risk for HIV for these guys: do they act as HIV-negative men who want to shield themselves from HIV infection, or as HIV-positive guys trying 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 are HIV-positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and sensed HIV-negative MSM were examined HIV positive. The study population included the MSM reported in this study 15
Because conclusions on UAI seem to be partially based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-unaware guys, 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 as well as the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as a very successful method of avoiding 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 perceived 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 on-line HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may increase the load of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and excite timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up-to-date as it pertains to rapid altering dating approaches as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of engagements will vary. Our data are 8years old and internet-based dating has developed since then. Nevertheless these results are useful, as they reveal how web-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 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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