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 on-line 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 known (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 online partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts near Hagwilget. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more prone to occur in on-line 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 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 distinct reference types, 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 on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, UAI was more common in online when compared with offline partnerships, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
In multivariate model 3 (Tables 4 and 5 ), additionally including variants concerning sexual behavior in the venture (sex-associated multiple drug use, sex frequency and partner type), the separate 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 men (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became stronger (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 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 only 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 signs that online dating was independently associated with a higher risk of UAI than offline dating. Hagwilget British Columbia backpage escorts. Backpage escorts near me Hagwilget British Columbia. 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). Simply among men who suggested they weren't informed of their HIV status (a small group in this study), UAI was more common with online than offline associates.
Among HIV-positive guys, in univariate analysis UAI was reported significantly more frequently with on-line associates 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 indicates that differences in partnership variables between online and also offline partnerships are responsible for the increased UAI in online established ventures. This could be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other variables. Among HIV-negative guys no effect of online dating on UAI was discovered, either in univariate or in some of the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but only critical when adding partner and venture variants to the model.
An integral 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 averted prejudice due to potential differences between men just dating online and those simply 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 comprise a lot of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't associated with UAI among HIV negative men, a finding in agreement with some previous studies, mostly among young men 21 , but in comparison with other studies 1 - 5 This may be due to the reality that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of guys. Backpage Escorts Near Me Haina British Columbia. Yet it can also represent 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 nowadays also make use of the Net for dating.
For HIV-unaware men the effect of dating location on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It is hard to assess the real risk for HIV for these guys: do they act as HIV-negative guys who are attempting to shield 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 guys 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 unaware and perceived HIV negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI appear 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 guys and HIV status-unaware guys, conclusions on UAI will not 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. Hence serosorting cannot be regarded as an extremely effective way of avoiding HIV transmission 22 Besides interventions to trigger 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.
Dating online may offer other opportunities for communicating on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the burden of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and stimulate timely HIV testing (i.e., after hazard events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date when it comes to fast shifting dating procedures and 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 web-based dating has developed since then. Yet these results are useful, as they demonstrate how net-based partner acquisition can result in more information on the sex partner, and this may 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 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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