Features of online 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 on-line partners was more often 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 knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts nearby Rosebery. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with internet partners.
In univariate analysis, UAI was significantly more inclined 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 firmly associated 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 different reference types, 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-unaware men, UAI was more common in online when compared with 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 partnership (sex-related multiple drug use, sex frequency and partner kind), the separate 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 stronger (and essential) 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 also 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 only 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 associated with a higher danger of UAI than offline dating. Rosebery British Columbia Backpage Escorts. Backpage Escorts closest to Rosebery British Columbia. For HIV negative men this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive men there was a nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Only among guys who suggested they were not informed of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with on-line associates than with offline partners. 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 variables between online and offline partnerships are accountable for the increased UAI in online established ventures. This may be because of 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 discovered, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was connected with UAI but just essential when adding partner and partnership variables to the model.
A key strength of the 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 averted prejudice brought on by 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 biggest STI outpatient clinic in the Netherlands we could include a great number 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 was not associated with UAI among HIV-negative men, a finding in agreement with some previous studies, mostly 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 behaviour patterns within one group of guys. Backpage Escorts Near Me Rossland British Columbia. Nevertheless it might also represent 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 now additionally use the Web for dating.
For HIV-oblivious guys the effect of dating location on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these men: do they behave as HIV-negative guys that are trying to protect themselves from HIV infection, or as HIV positive men attempting to safeguard 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 are HIV positive and engage 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 conclusions on UAI appear to be partly based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. In HIV-negative guys and HIV status-oblivious guys, determinations 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 also the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as a very effective method of averting 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 communicating on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may increase the load 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 excite timely HIV testing (i.e., after danger events 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 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. Yet these results are useful, as they show how web-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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