To be able to examine the possible mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the organization between online/offline dating location 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 characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted also for venture sexual risk behavior (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 place for HIV-positive, HIV negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating location was included in all three models by making a new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV-positive, and HIV-oblivious men. Backpage Escorts nearest Markland, Manitoba. We performed a sensitivity analysis restricted to partnerships in which only 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 tests were done and reported, this approach does lead to a higher danger of one or more false positive organizations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics of online and offline partners and partnerships are revealed 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 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 on-line 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 internet partners (50.9% vs. Backpage escorts closest to Markland. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often 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 strongly 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 groups, one for each HIV status. Backpage escorts in Manitoba. 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 men no association was evident between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 venture (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating place on UAI became somewhat stronger (though not significant) 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 critical) 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 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 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-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 risk of UAI than offline dating. Backpage Escorts near me Markland. For HIV-negative men 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). Backpage Escorts near me Markland. Only among guys who suggested they were not aware 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 on-line associates than with offline partners. 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 accountable for the increased UAI in online established ventures. This could be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV negative guys no effect of online dating on UAI was detected, either in univariate or in any of the multivariate models. Among HIV-unaware men, online dating was connected with UAI but just significant when adding associate and partnership variants to the model.
A key strength of this study was that it investigated the relationship 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 simply 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 guys 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, mainly among young men 21 , but in comparison 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 behavior patterns within one group of guys. However it may also reflect secular 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 place on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It's difficult 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 guys trying to shield 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 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 examined 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, accurate knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-unaware men, judgements on UAI WOn't 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 individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting cannot be regarded as a very successful 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. Backpage Escorts near me Markland, Manitoba.
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. However, serosorting may raise the weight of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and oblivious MSM and stimulate timely HIV testing (i.e., after risk occasions 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 fast changing dating approaches as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of battles will be different. Our data are 8years old and internet-based dating has developed since then. Backpage Escorts Near Me Marco Manitoba. Backpage Escorts Near Me Maskawata Manitoba. Nevertheless these results are useful, as they demonstrate how net-based partner acquisition may lead to more information on the sex partner, and this might 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 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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