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 online 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 often reported as known (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 frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts near Hummerston. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with online 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 strongly associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 groups, one for each HIV status. Among HIV-positive men, UAI was more common in online compared to offline ventures (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 guys, UAI was more common in online in comparison 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 variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner kind), the separate 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 stronger (and critical) for HIV-oblivious guys (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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-connected multiple drug use within venture.
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. Hummerston Manitoba Backpage Escorts. Backpage escorts near Hummerston, Manitoba. 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). Just among men 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 online partners than with offline partners. When adjusting for associate features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became non significant; this suggests that differences in partnership variables between online and also offline partnerships are liable for the increased UAI in online established ventures. This might be due to a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative guys no effect of online dating on UAI was observed, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but only important when adding associate and venture variables to the model.
A vital strength of this study was that it investigated 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 due to potential differences between guys only dating online and those just dating offline, a weakness of numerous previous studies. Manitoba Backpage Escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a lot of MSM, and avoid 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 men, 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 fact that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Backpage Escorts Near Me Husavik Manitoba. However it might also reflect 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 today also make use of the Internet for dating.
For HIV-unaware men the impact of dating location 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 guys: do they act as HIV negative men that want to protect themselves from HIV infection, or as HIV-positive guys trying 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're 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 included the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious guys, decisions 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 and also the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting cannot be regarded as an extremely successful method 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 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 environments. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may increase the load of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and oblivious MSM and stimulate 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 stay up-to-date as it pertains to accelerated shifting dating processes as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of battles will change. Our data are 8years old and internet-based dating has developed since then. However these results are useful, as they show how net-based partner acquisition may lead to more information on the sex partner, and this may impact 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 immunodeficiency virus; i.e., id est, it's, 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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