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 online partners was more frequently reported as understood (61.4% vs. 49.4%; P 0.001), and in on-line partnerships, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their online partners more frequently knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts in Clematis. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more prone 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 location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three distinct reference classes, 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 internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 ), additionally including variants concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place 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 men (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became stronger (and important) for HIV-oblivious 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 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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture 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 evidence that online dating was independently associated with a higher risk of UAI than offline dating. Clematis Manitoba Backpage Escorts. Backpage escorts nearest Clematis Manitoba. For HIV-negative guys this dearth 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). Simply among guys who indicated they were not informed of their HIV status (a little 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 partners than with offline associates. 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 implies that differences in partnership factors between online and offline partnerships are liable for the increased UAI in online established partnerships. This might 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 discovered, either in univariate or in any of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only important when adding partner and partnership variants 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 also offline casual partners. This prevented bias brought on by potential differences between men only dating online and those only dating offline, a weakness of several previous studies. Manitoba Backpage Escorts. By recruiting participants at the greatest 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 some previous studies 3 , 11
Online dating was not connected 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 due to the reality 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 Cloverdale Manitoba. However it might also represent secular 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 less high-risk MSM now additionally use the Web for dating.
For HIV-oblivious men the effect of dating place on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's hard to evaluate the real risk for HIV for these men: do they act as HIV negative guys 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 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 oblivious and perceived HIV-negative MSM were examined HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV negative guys 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 also the HIV window period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as an extremely successful 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 perceived HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communicating on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may raise the weight of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up to date in regards to rapid altering dating approaches as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive opportunities, the rules of battles will vary. Our data are 8years old and web-based dating has developed since then. Nevertheless these results are useful, as they demonstrate how web-based partner acquisition may lead to 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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