Characteristics of online and offline partners and ventures 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 known (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). Backpage escorts nearby North Knife Lake. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more likely to occur in online than in offline partnerships (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 impact of dating place on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three different reference categories, one for each HIV status. 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 men no association was apparent between UAI and internet partnerships (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 independent effect of online dating location on UAI became somewhat stronger (though not critical) for the HIV positive men (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 significant) for HIV-oblivious 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 occurred in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to only one sex act). Other variables 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 signs that online dating was independently associated with a higher risk of UAI than offline dating. North Knife Lake Manitoba Backpage Escorts. Backpage Escorts nearest North Knife Lake 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 non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among men who suggested they were not conscious of their HIV status (a small 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 often with on-line partners than with offline associates. When adjusting for partner 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 offline partnerships are responsible for the increased UAI in online established partnerships. This might be due to 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 discovered, either in univariate or in some of the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but only critical when adding associate and partnership variables to the model.
A vital strength of this study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted bias caused by potential differences between guys only dating online and those simply dating offline, a weakness of numerous previous studies. Manitoba Backpage Escorts. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in men sampled through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't connected 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 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 North River Manitoba. Nevertheless it may 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 less high-risk MSM today additionally utilize the Web for dating.
For HIV-oblivious guys the impact of dating place on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It is hard to assess the real risk for HIV for these men: do they behave as HIV-negative guys that are attempting to shield themselves from HIV infection, or as HIV positive guys 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're HIV positive and participate in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV negative MSM were tested HIV-positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI seem to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative guys 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 as well as 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 a very powerful method of avoiding HIV transmission 22 Besides interventions to trigger 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 opportunities for communication on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the weight of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and spark 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 in regards to rapid shifting dating approaches as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will change. Our data are 8years old and net-based dating has developed since then. However these results are useful, as they demonstrate how net-based partner acquisition may lead to more information on the sex partner, and this might 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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