Characteristics 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 partnerships, 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 closest to Gaskiers-Point La Haye. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more prone 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 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 classes, one for each HIV status. 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 guys no association was apparent between UAI and internet partnerships (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 ), also including variables concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating place 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 men (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became stronger (and essential) for HIV-oblivious 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 likewise 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 only one sex act). Other factors significantly associated with UAI were group sex within the partnership, and sex-connected 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 danger of UAI than offline dating. Gaskiers-Point La Haye, Newfoundland And Labrador backpage escorts. Backpage Escorts nearest Gaskiers-Point La Haye Newfoundland And Labrador. For HIV-negative men this lack of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive guys there was a nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among guys who indicated they were not conscious 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 frequently with online partners than with offline partners. When adjusting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became non significant; this implies that differences in partnership variables between online and also offline partnerships are accountable for the increased UAI in online established ventures. This might be due to 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 detected, either in univariate or in some of the multivariate models. Among HIV-unaware men, online dating was correlated with UAI but only important when adding associate and partnership variables to the model.
A key strength of the study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided bias caused by potential differences between men just dating online and those just dating offline, a weakness of several previous studies. Newfoundland And Labrador Backpage Escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could comprise a lot of MSM, and avoid potential differences in guys sampled through Internet or face-to-face interviewing, weaknesses in certain 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 contrast 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 Gasters Newfoundland And Labrador. However it might also reflect secular changes; possibly 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 effect of dating place on UAI did not change by adding partner characteristics, but it improved 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 guys that want to shield themselves from HIV infection, or as HIV-positive men trying 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 engage in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV negative MSM were tested 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 important. In HIV negative guys and HIV status-unaware guys, conclusions on UAI will not only be based on perceived HIV status of the partner but in addition on one's own negative status. HIV serosorting is challenged by the frequency of HIV testing and the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as an extremely successful method of averting 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.
Relationship online may offer other chances for communication on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may raise the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should especially be directed at HIV negative and unaware MSM and spark 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 stay up to date when it comes to fast changing dating strategies and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every 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. Yet these results are useful, as they reveal how web-based partner acquisition can result in more information on the sex partner, and this may 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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