Features of on-line and offline partners and ventures are revealed 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 in Metchosin. Participants more often 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 likely to occur 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 effect 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 groups, one for each HIV status. Among HIV positive men, UAI was more common in online in comparison to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was apparent between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online in comparison to 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 variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat stronger (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 significant) for HIV-unaware men (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 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 partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the partnership, 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 related to a higher danger of UAI than offline dating. Metchosin, British Columbia Backpage Escorts. Backpage Escorts nearby Metchosin British Columbia. 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). Just among guys who suggested they were not aware of their HIV status (a little group in this study), UAI was more common with online than offline associates.
Among HIV-positive men, in univariate analysis UAI was reported significantly more frequently with online partners than with offline partners. When correcting for partner characteristics, 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 factors between online and also offline partnerships are liable for the increased UAI in online established partnerships. This could be because of a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was observed, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but just essential when adding partner and venture variants to the model.
A vital strength of this 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 prevented bias due to potential differences between guys only 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 include a large number 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 contrast with other studies 1 - 5 This may be due to 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 Metlakatla British Columbia. Yet it could also reflect lay changes; maybe 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 nowadays also use the Internet for dating.
For HIV-unaware men the impact of dating place on UAI did not change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these men: do they act as HIV-negative guys that are attempting to protect themselves from HIV infection, or as HIV-positive guys trying to shield 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 are 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 analyzed HIV-positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI appear to be partially based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-unaware men, 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 the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting can't be regarded as a very effective way of preventing 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.
Dating online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may raise the weight of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and unaware MSM and spark timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up to date when it comes to fast altering 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 be different. 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 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 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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