To be able to analyze the potential mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adapted the association between online/offline dating place and UAI for characteristics of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adjusted additionally for partnership sexual risk behavior (i.e., sex-related drug use and sex frequency) and venture sort (i.e., casual or anonymous). As we assumed a differential effect of dating location for HIV-positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was contained in all three models by making a new six-class variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV negative, HIV-positive, and HIV-oblivious guys. Backpage Escorts in Richibucto New Brunswick. We performed a sensitivity analysis restricted to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to miss potentially important associations. As a rather large number of statistical tests were done and reported, this strategy does lead to a heightened risk of one or more false positive organizations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features 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 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 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 online partners more frequently knew 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 online partners (50.9% vs. Backpage Escorts closest to Richibucto. 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 prone to happen 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 firmly connected 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 categories, one for each HIV status. Backpage Escorts nearby New Brunswick. Among HIV positive guys, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was evident between UAI and internet 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 ), also including variants concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner kind), the separate effect of online dating place 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 critical) for HIV-unaware men (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 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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just 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 evidence that online dating was independently related to a higher risk of UAI than offline dating. Backpage escorts near me Richibucto. 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). Backpage Escorts in Richibucto. Simply among guys who suggested they were not aware 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 frequently with on-line partners than with offline partners. When correcting for associate characteristics, 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 factors between online and also offline partnerships are responsible for the increased UAI in online established ventures. This may be because of a mediating effect of more information on associates, (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-oblivious guys, online dating was correlated with UAI but only critical when adding associate and venture variables to the model.
An integral strength of the study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted prejudice caused by potential differences between men just dating online and those simply dating offline, a weakness of numerous previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a great number of MSM, and prevent 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 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 behavior patterns within one group of guys. Yet it might also reflect 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 not as high risk MSM nowadays additionally use the Internet for dating.
For HIV-oblivious guys the impact of dating place on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's difficult to evaluate the actual risk for HIV for these guys: do they behave as HIV negative guys who want to protect themselves from HIV infection, or as HIV positive guys attempting 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 debatable if they're HIV positive and engage in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were tested HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. In HIV negative guys and HIV status-oblivious guys, 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 as well as the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't be regarded as an extremely powerful way of avoiding HIV transmission 22 Besides interventions to trigger 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. Backpage Escorts nearby Richibucto, New Brunswick.
Dating online may offer other opportunities for communicating on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may raise 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 oblivious MSM and excite timely HIV testing (i.e., after risk events 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 accelerated altering dating strategies as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will be different. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Richardson New Brunswick. Backpage Escorts Near Me Richmond New Brunswick. Yet these results are useful, as they reveal how net-based partner acquisition can 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 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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