Characteristics 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 frequently 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 online partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts near me Belfountain. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more likely 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 organization of online dating using three distinct reference types, 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 men no association was apparent between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 partnership (sex-related multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat more powerful (though not critical) for the HIV-positive men (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 result of online dating on UAI became stronger (and critical) 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 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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to only one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-connected multiple drug use within partnership.
In this large study among MSM attending the STI clinic in Amsterdam, we found no signs that online dating was independently associated with a higher risk of UAI than offline dating. Belfountain Ontario backpage escorts. Backpage escorts in Belfountain Ontario. For HIV negative men this dearth 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 suggested they were not aware of their HIV status (a small group in this study), UAI was more common with on-line than offline partners.
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with on-line partners than with offline partners. When correcting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership factors between online and offline partnerships are liable for the increased UAI in online established partnerships. This could 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 men, online dating was associated with UAI but just essential when adding partner and venture variables to the model.
An integral strength of the study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided bias due to potential differences between men only dating online and those only dating offline, a weakness of several previous studies. Ontario Backpage Escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could comprise a high number of MSM, and prevent potential differences in guys 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, 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 men. Backpage Escorts Near Me Belle River Ontario. Yet it could also represent lay 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 less high-risk MSM now also utilize the Internet for dating.
For HIV-unaware guys the impact of dating location on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's difficult to evaluate the actual risk for HIV for these guys: do they behave as HIV negative guys that are attempting to protect 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 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 Formerly Matser et al. reported that 1.7% of the oblivious and perceived HIV negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because conclusions on UAI appear to be partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-unaware men, judgements on UAI will not 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 individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as a very effective method of avoiding 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.
Dating online may offer other opportunities for communication on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase 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 risk 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 accelerated shifting dating procedures as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. However these results are useful, as they demonstrate how web-based partner acquisition can lead to 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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