To be able to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adjusted the organization between online/offline dating place and UAI for features of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted additionally for partnership sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating location for HIV-positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating location was contained in all three models by making a fresh six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV-positive, and HIV-unaware men. Backpage Escorts near me Pleasant Camp, British Columbia. We performed a sensitivity analysis confined 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 associations. As a fairly big number of statistical tests were done and reported, this approach does lead to a heightened risk of one or more false-positive organizations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics of on-line and offline partners and partnerships 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 online partners was more frequently 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 online partners more frequently understood 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 nearest Pleasant Camp. 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 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 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 association of online dating using three different reference groups, one for each HIV status. Backpage Escorts near me British Columbia. 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 partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, 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 ), also including variables concerning sexual behavior in the venture (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat stronger (though not critical) 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 result of online dating on UAI became stronger (and important) for HIV-unaware 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 also 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 partnership (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 associated with a higher danger of UAI than offline dating. Backpage escorts in Pleasant Camp. For HIV-negative guys this dearth 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 near Pleasant Camp. Only among guys who indicated 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 frequently with online partners 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 indicates that differences in partnership variables between online and also offline partnerships are in charge of the increased UAI in online established partnerships. This may be because of a mediating effect of more info 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-oblivious guys, online dating was connected with UAI but only significant when adding associate and venture variants to the model.
A key strength of this study was that it explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This prevented prejudice caused by potential differences between men just dating online and those only dating offline, a weakness of several previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could comprise a large number of MSM, and prevent potential differences in men sampled through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't correlated with UAI among HIV-negative guys, 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 behaviour patterns within one group of guys. Nevertheless it might also reflect lay 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 now additionally make use of the Internet for dating.
For HIV-oblivious 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 evaluate the actual risk for HIV for these guys: do they behave as HIV-negative men that are trying to shield themselves from HIV infection, or as HIV-positive guys attempting 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 problematic if they are HIV positive and engage in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV-negative MSM were tested HIV-positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-oblivious men, decisions 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 and the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as an extremely effective way 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 perceived HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts near Pleasant Camp British Columbia.
Dating online may offer other chances for communicating on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the weight of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and spark timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date as it pertains to fast changing dating strategies and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me Pitt Meadows British Columbia. Backpage Escorts Near Me Popkum British Columbia. Yet these results are useful, as they demonstrate how net-based partner acquisition may 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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