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 on-line 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 understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts nearest Durham Bridge. 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 frequently reported with internet partners.
In univariate analysis, UAI was significantly more inclined to happen 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 firmly 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 association of online dating using three distinct reference classes, one for each HIV status. Among HIV-positive men, UAI was more common in online in comparison to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 behavior in the partnership (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat stronger (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 more powerful (and essential) for HIV-unaware 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 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 happened in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within venture.
In this large study among MSM attending the STI clinic in Amsterdam, we found no evidence that online dating was independently related to a higher risk of UAI than offline dating. Durham Bridge, New Brunswick Backpage Escorts. Backpage Escorts near Durham Bridge, New Brunswick. 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 non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Only among guys who suggested they weren't informed of their HIV status (a little group in this study), UAI was more common with online than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with on-line partners than with offline associates. When adjusting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership variables between online and offline partnerships are in charge of 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 factors. Among HIV negative guys no effect of online dating on UAI was found, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but just important when adding associate and partnership variants to the model.
A key 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 offline casual partners. This averted prejudice caused by potential differences between guys only dating online and those simply dating offline, a weakness of several previous studies. New Brunswick backpage escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a great 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 was not correlated with UAI among HIV-negative guys, a finding in agreement with some previous studies, largely 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 behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Backpage Escorts Near Me Edmundston New Brunswick. Nonetheless it might also represent lay changes; maybe 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 today additionally make use of the Net for dating.
For HIV-oblivious men the effect of dating location 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 that want to protect themselves from HIV infection, or as HIV positive men attempting to protect 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 engage in UAI with HIV negative partners 12 Previously Matser et al. reported that 1.7% of the unaware 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 partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV negative guys and HIV status-oblivious men, judgements 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting cannot be regarded as an extremely powerful way of averting 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 sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances 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 raise the load of other STI and will not prevent HIV disease entirely. Interventions to prevent HIV transmission should especially be directed at HIV negative and oblivious MSM and stimulate 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 remain up-to-date when it comes to accelerated changing dating procedures as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of battles will change. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they demonstrate how net-based partner acquisition can result in more info 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'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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