To be able to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adapted the organization between online/offline dating location 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 additionally for partnership sexual risk behaviour (i.e., sex-related drug use and sex frequency) and venture kind (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-class variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV-negative, HIV-positive, and HIV-unaware guys. Backpage Escorts nearby Sullivan Bay 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 lose potentially significant organizations. As a fairly big number of statistical evaluations were done and reported, this approach does lead to a higher risk of one or more false positive associations. Analyses 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 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 online partnerships, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their online partners more often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with internet partners (50.9% vs. Backpage escorts in Sullivan Bay. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more likely 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 firmly associated 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 different reference categories, one for each HIV status. Backpage escorts closest to British Columbia. Among HIV positive guys, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat more powerful (though not essential) 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 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 amount 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 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 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 related to a higher risk of UAI than offline dating. Backpage escorts nearby Sullivan Bay. 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 non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Backpage Escorts nearby Sullivan Bay. Just among men who indicated they were not informed of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with on-line associates 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 non significant; this implies that differences in partnership variables between online and also offline partnerships are accountable for the increased UAI in online established ventures. 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 guys no effect of online dating on UAI was found, either in univariate or in any of the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but just important when adding associate and partnership variables to the model.
A vital strength of this study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This prevented bias caused by potential differences between guys only dating online and those only dating offline, a weakness of several previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a lot of MSM, and prevent potential differences in guys sampled through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't 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 because of the fact that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. However 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 less high risk MSM now also utilize 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 hard to evaluate the real risk for HIV for these men: do they act as HIV negative men who want to shield themselves from HIV infection, or as HIV positive men attempting to guard 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 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 tested HIV positive. The study population included the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious guys, judgements 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 phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting cannot be regarded as a very successful method of preventing 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 nearby Sullivan Bay, British Columbia.
Relationship 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 simpler. However, serosorting may raise the weight of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and oblivious MSM and excite 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 remain up to date as it pertains to rapid altering dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Stuie British Columbia. Backpage Escorts Near Me Summerland British Columbia. Yet these results are useful, as they show how web-based partner acquisition can result in more information on the sex partner, and this might affect 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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