In order to analyze the possible mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the organization between online/offline dating place and UAI for characteristics of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted 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 place 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 fresh six-class 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 in Finmoore British Columbia. We performed a sensitivity analysis limited to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to miss potentially significant organizations. As a rather large number of statistical evaluations were done and reported, this strategy does lead to a heightened risk of one or more false-positive associations. Investigations were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics 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 on-line partners was more frequently reported as understood (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 often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. Backpage Escorts closest to Finmoore. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more inclined 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 correlated 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 association of online dating using three distinct reference categories, one for each HIV status. Backpage escorts near British Columbia. 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 guys no association was apparent between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 variants concerning sexual behavior in the venture (sex-associated multiple drug use, sex frequency and partner kind), the separate effect of online dating location on UAI became somewhat stronger (though not critical) 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 more powerful (and essential) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The number 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 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-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 related to a higher risk of UAI than offline dating. Backpage escorts closest to Finmoore. For HIV-negative guys 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). Backpage Escorts in Finmoore. Only among men who suggested they were not conscious 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 often with online partners than with offline partners. When adjusting for partner features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established ventures. This may be due to a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other variables. 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 men, online dating was connected with UAI but only critical when adding partner and partnership variables to the model.
An integral strength of the study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted bias due to potential differences between guys just dating online and those just dating offline, a weakness of several previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a high number of MSM, and prevent potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some 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 contrast 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 guys. Yet it might also reflect secular 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 nowadays also make use of the Net for dating.
For HIV-unaware guys 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 difficult to assess the real risk for HIV for these men: do they behave as HIV-negative guys who want to shield themselves from HIV infection, or as HIV positive men trying 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 examined HIV-positive. The study population included the MSM reported in this study 15
Because decisions on UAI seem to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-unaware men, decisions 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 as well as 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 caution against UAI based on sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts nearest Finmoore, British Columbia.
Relationship online may offer other chances for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Yet, serosorting may increase the weight of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up to date when it comes to rapid shifting dating processes as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Fifth Cabin British Columbia. Backpage Escorts Near Me Fintry British Columbia. Yet these results are useful, as they demonstrate how internet-based partner acquisition can result in more info on the sex partner, and this might 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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