Characteristics of on-line and offline partners and ventures 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 online 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 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 near me Bar Haven. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more inclined to happen 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 impact of dating location 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 categories, one for each HIV status. Among HIV-positive men, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online compared to 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 variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (though not essential) for the HIV positive men (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV negative men (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became more powerful (and essential) 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 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 happened 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 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 signs that online dating was independently related to a higher danger of UAI than offline dating. Bar Haven, Newfoundland And Labrador Backpage Escorts. Backpage escorts in Bar Haven Newfoundland And Labrador. 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). Only among guys 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 men, 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 indicates that differences in partnership variables between online and also offline partnerships are accountable for the increased UAI in online established ventures. This may be due to 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 the multivariate models. Among HIV-unaware guys, online dating was connected with UAI but just significant when adding associate and venture variables to the model.
A key strength of the study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted bias due to potential differences between men just dating online and those simply dating offline, a weakness of numerous previous studies. Newfoundland And Labrador backpage escorts. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could comprise a high number of MSM, and prevent potential differences in men sampled through Internet or face to face interviewing, weaknesses in some 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 contrast with other studies 1 - 5 This may be due to 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 men. Backpage Escorts Near Me Barachoix Newfoundland And Labrador. However it could also reflect secular changes; perhaps 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 nowadays also utilize the Web for dating.
For HIV-oblivious guys the impact of dating location on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these men: do they behave as HIV-negative guys who are trying to shield 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 tested HIV-positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-oblivious guys, decisions 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting cannot be regarded as an extremely successful method 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.
Dating online may offer other chances for communication on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the weight of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should especially 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 in regards to fast changing dating procedures and sero-adaptive behaviours (such as 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 net-based dating has developed since then. Nevertheless these results are useful, as they show how net-based partner acquisition can lead to more info 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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