In order to analyze the possible mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 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 partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted additionally for venture sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership 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 location was included in all three models by making a fresh six-class variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV-negative, HIV-positive, and HIV-oblivious guys. Backpage escorts in Little Barasway Newfoundland And Labrador. We performed a sensitivity analysis limited to partnerships in which only one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to lose potentially significant organizations. As a rather large number of statistical tests were done and reported, this approach does lead to an elevated risk of one or more false positive organizations. Investigations were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of online 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 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 frequently reported as known (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 knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with online partners (50.9% vs. Backpage Escorts near Little Barasway. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more inclined 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 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 organization of online dating using three distinct reference categories, one for each HIV status. Backpage Escorts nearest Newfoundland And Labrador. Among HIV positive guys, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was evident between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, 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 venture (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat stronger (though not significant) 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 critical) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The amount 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 occurred 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 associated with a higher danger of UAI than offline dating. Backpage Escorts near me Little Barasway. 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 non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Backpage escorts nearby Little Barasway. Simply among men who suggested they were not 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 frequently with online associates 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 nonsignificant; this implies that differences in partnership variables between online and also offline partnerships are in charge of the increased UAI in online established ventures. This may be because of a mediating effect of more info on associates, (including perceived HIV status) on UAI, or to other variables. Among HIV negative men no effect of online dating on UAI was detected, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but just significant when adding associate and partnership variants 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 also offline casual partners. This prevented prejudice due to potential differences between guys just dating online and those just dating offline, a weakness of numerous previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and avoid potential differences in guys tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not connected 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 reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Yet it can also represent 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 less high-risk MSM now also make use of the Web for dating.
For HIV-oblivious men the effect of dating location on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It's hard to assess the actual risk for HIV for these men: do they behave as HIV negative guys who are trying to protect themselves from HIV infection, or as HIV-positive guys trying to guard 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 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 appear to be partially based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV-negative guys and HIV status-unaware guys, judgements on UAI WOn't 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 as well as the HIV window phase during which people 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 preventing 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage escorts closest to Little Barasway Newfoundland And Labrador.
Relationship online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may increase the weight of other STI and WOn't prevent HIV infection 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 as it pertains to rapid shifting dating strategies and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive chances, the rules of engagements will be different. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me Lewisporte Newfoundland And Labrador. Backpage Escorts Near Me Little Bay Newfoundland And Labrador. Nevertheless these results are useful, as they demonstrate how web-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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