In order to examine the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adjusted the organization between online/offline dating place and UAI for features 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 features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted also for partnership sexual risk behavior (i.e., sex-associated drug use and sex frequency) and venture type (i.e., casual or anonymous). As we assumed a differential effect of dating place 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 fresh six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV negative, HIV positive, and HIV-unaware men. Backpage Escorts in Cormack Newfoundland And Labrador. 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 significant organizations. As a rather large number of statistical tests were done and reported, this approach does lead to an elevated danger of one or more false-positive associations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features 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 on-line 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 on-line partners more frequently understood 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 nearest Cormack. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more inclined 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 firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect 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. Backpage Escorts nearby Newfoundland And Labrador. 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 guys no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware 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 behavior in the venture (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat stronger (though not significant) 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 stronger (and essential) for HIV-unaware 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 correlated 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 nearby Cormack. For HIV negative guys this lack 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 closest to Cormack. Just among men who suggested they weren't informed of their HIV status (a small 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 often with on-line associates than with offline associates. When adjusting for associate 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 also offline partnerships are liable for the increased UAI in online established partnerships. This might 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 discovered, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was associated with UAI but just significant when adding partner and partnership variables to the model.
An integral 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 also offline casual partners. This avoided prejudice caused by potential differences between men only dating online and those simply dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not correlated with UAI among HIV negative guys, 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 behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. Nevertheless it can also reflect lay 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 not as high risk MSM today additionally make use of the Web for dating.
For HIV-unaware men the effect of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's difficult to assess the real risk for HIV for these men: do they act as HIV negative guys who want to protect themselves from HIV infection, or as HIV-positive men trying to safeguard 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 debatable 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 sensed HIV negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI seem to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-unaware guys, determinations 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 individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting cannot be regarded as a very powerful method of preventing 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. Backpage escorts closest to Cormack Newfoundland And Labrador.
Dating online may offer other chances for communicating on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may raise the burden 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 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 accelerated shifting dating procedures as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventive opportunities, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Cooks Harbour Newfoundland And Labrador. Backpage Escorts Near Me Corner Brook Newfoundland And Labrador. However these results are useful, as they show how net-based partner acquisition may lead to more info on the sex partner, and this might affect 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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