In order to examine the potential mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adjusted the association between online/offline dating location 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 partnership characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted additionally for partnership sexual risk behaviour (i.e., sex-associated drug use and sex frequency) and partnership sort (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 new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV-negative, HIV-positive, and HIV-unaware guys. Backpage Escorts nearest Naylors Landing, Northwest Territories. We performed a sensitivity analysis confined 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 miss potentially important associations. As a fairly big number of statistical tests were done and reported, this strategy does lead to a higher danger of one or more false-positive organizations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of on-line and offline partners and partnerships 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 on-line partners was more often 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 online partners more often 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 internet partners (50.9% vs. Backpage Escorts near me Naylors Landing. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with online 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 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 different reference groups, one for each HIV status. Backpage Escorts closest to Northwest Territories. Among HIV positive guys, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was evident between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, 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 ), additionally including variables 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 guys (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 more powerful (and important) for HIV-oblivious 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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-connected multiple drug use within venture.
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 Naylors Landing. For HIV negative men this lack of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive men there was a non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Backpage escorts near Naylors Landing. Just among guys who suggested they weren't aware of their HIV status (a little group in this study), UAI was more common with on-line than offline associates.
Among HIV-positive guys, in univariate analysis UAI was reported significantly more often with online associates than with offline associates. When correcting for partner features, 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 might be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. 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 correlated with UAI but just essential when adding associate and partnership 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 also offline casual partners. This avoided prejudice brought on by potential differences between guys just dating online and those just dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and avoid potential differences in men sampled through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating was not connected with UAI among HIV negative men, a finding in agreement with some previous studies, mostly 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 behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of guys. Yet it could also represent secular changes; maybe 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 nowadays additionally use the Web for dating.
For HIV-oblivious men the effect of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is hard to assess the actual risk for HIV for these guys: do they act as HIV negative guys that are attempting to protect themselves from HIV infection, or as HIV positive guys attempting 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 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 oblivious and sensed HIV negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI appear to be partly based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-oblivious guys, conclusions 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 the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as a very powerful way 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 perceived HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts near me Naylors Landing Northwest Territories.
Relationship online may offer other opportunities for communication on HIV status than dating in physical environments. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may raise the burden of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and unaware 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 rapid changing dating processes and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will be different. Our data are 8years old and internet-based dating has developed since then. Backpage Escorts Near Me Mould Bay Northwest Territories. Backpage Escorts Near Me Netla Northwest Territories. However these results are useful, as they reveal how web-based partner acquisition can lead to more information on the sex partner, and this might 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 immunodeficiency 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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