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 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 on-line partners was more frequently reported as understood (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 closest to St. Andrews. Participants more frequently reported multiple sexual contacts with online 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 on-line 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 connected 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 groups, 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 evident between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, 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 variants concerning sexual behavior in the partnership (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating place on UAI became somewhat stronger (though not essential) 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 result of online dating on UAI became stronger (and significant) for HIV-oblivious guys (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 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 venture, 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 danger of UAI than offline dating. St. Andrews, Manitoba backpage escorts. Backpage escorts near me St. Andrews, 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). Simply among men who indicated they weren't conscious 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 online partners than with offline associates. When correcting for associate features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became non-significant; this indicates that differences in partnership variables between online and offline partnerships are accountable for the increased UAI in online established partnerships. This might be because of a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV-negative guys no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but just critical when adding partner and venture variables to the model.
A vital strength of the 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 averted bias caused by potential differences between guys just dating online and those just dating offline, a weakness of several 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 some previous studies 3 , 11
Online dating was not correlated with UAI among HIV negative men, a finding in agreement with some previous studies, largely among young men 21 , but in comparison with other studies 1 - 5 This may be because of the fact 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 St. Boniface Manitoba. However it may also represent secular changes; perhaps 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 nowadays also use the Internet for dating.
For HIV-unaware men 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 evaluate the actual risk for HIV for these men: do they behave as HIV negative men who 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 guys 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 Formerly Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were analyzed 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, exact knowledge of one's own and the partner's HIV status is essential. In HIV negative men and HIV status-oblivious men, judgements on UAI will not 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting can't be regarded as a very successful way 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.
Dating online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may raise the load of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and oblivious MSM and arouse timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date when it comes to rapid changing dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of battles will be different. 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 can result in 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 immuno deficiency 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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