In order to examine the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adapted 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 model 3, we adapted additionally for partnership sexual risk behavior (i.e., sex-associated drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating location 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 brand new 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 guys. Backpage Escorts nearby Economy Nova Scotia. 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 miss potentially significant organizations. As a rather large number of statistical evaluations were done and reported, this approach does lead to an increased danger of one or more false-positive associations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics 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 online partners was more frequently reported as known (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 online partners more frequently understood 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 Economy. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with internet partners.
In univariate analysis, UAI was significantly more prone to occur in online than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly associated 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 association of online dating using three different reference groups, one for each HIV status. Backpage Escorts in Nova Scotia. Among HIV-positive guys, 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 evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online when compared with offline ventures, 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 separate effect of online dating place on UAI became somewhat more powerful (though not critical) 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 significant) 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 also 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 occurred 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 factors significantly associated with UAI were group sex within the partnership, 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 associated with a higher danger of UAI than offline dating. Backpage escorts near Economy. 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 nearby Economy. Simply among guys who indicated they were not aware of their HIV status (a small group in this study), UAI was more common with online than offline associates.
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with on-line 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 indicates that differences in partnership factors 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 partners, (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 any of the multivariate models. Among HIV-unaware men, online dating was connected with UAI but only critical when adding associate and venture variants to the model.
An integral strength of this study was that it investigated the connection between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This prevented prejudice due to potential differences between guys only dating online and those just dating offline, a weakness of several previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a great number of MSM, and prevent 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 comparison 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 behaviour patterns within one group of men. Nonetheless it can also reflect secular changes; possibly 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 now additionally make use of the Web for dating.
For HIV-oblivious guys the effect of dating location on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these men: do they act as HIV-negative men who are attempting to protect 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 men who were never tested for HIV, profiled themselves online as being HIV-negative, which might be problematic if they're HIV-positive and participate in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI seem to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious men, decisions 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. Consequently serosorting can't be regarded as a very powerful way of preventing HIV transmission 22 Besides interventions to stimulate 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. Backpage Escorts in Economy, Nova Scotia.
Dating 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. Yet, serosorting may increase the weight of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware 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 stay up to date when it comes to rapid changing dating methods 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 battles will be different. Our data are 8years old and internet-based dating has developed since then. Backpage Escorts Near Me Eatonville Nova Scotia. Backpage Escorts Near Me Ecum Secum Nova Scotia. However these results are useful, as they show how net-based partner acquisition can result in 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's, 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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