In order to analyze the possible mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adjusted the organization between online/offline dating location 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 venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adjusted also for venture sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership kind (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 place was contained in all three models by making a brand new 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 men. Backpage Escorts nearby Campbellford Ontario. We performed a sensitivity analysis confined to partnerships in which just 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 big number of statistical evaluations were done and reported, this approach does lead to an increased risk of one or more false-positive associations. Evaluations 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 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 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 closest to Campbellford. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more prone to happen 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 associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 types, one for each HIV status. Backpage Escorts in Ontario. Among HIV positive men, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was evident between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online compared to offline ventures, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
In multivariate model 3 (Tables 4 and 5 ), additionally including variants concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating location 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 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 signs that online dating was independently associated with a higher danger of UAI than offline dating. Backpage escorts near me Campbellford. 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 in Campbellford. Just among men who suggested they weren't conscious of their HIV status (a little 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 often with on-line associates than with offline associates. When correcting for associate 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 factors between online and also offline partnerships are in charge of the increased UAI in online established partnerships. This may be because of a mediating effect of more information on associates, (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-oblivious men, online dating was associated with UAI but only essential when adding associate and partnership variables to the model.
A vital strength of the 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 averted prejudice due to potential differences between men only dating online and those only dating offline, a weakness of numerous previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could comprise a great number of MSM, and avoid potential differences in men sampled through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't associated with UAI among HIV negative men, a finding in agreement with some previous studies, mainly 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 behavior patterns within one group of guys. Nevertheless it could also reflect lay 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 now additionally use the Net for dating.
For HIV-unaware men the effect of dating place on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is hard to assess the actual risk for HIV for these men: do they behave as HIV-negative guys that are trying 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 guys who were never tested for HIV, profiled themselves online as being HIV negative, which might be debatable if they are HIV positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and sensed HIV negative MSM were analyzed HIV-positive. The study population included the MSM reported in this study 15
Because decisions on UAI seem to be partially based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-oblivious men, decisions 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 also the HIV window phase during which people 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts nearest Campbellford, Ontario.
Relationship online may offer other chances for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Yet, serosorting may increase the weight of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should especially be directed at HIV negative and unaware MSM and stimulate timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date as it pertains to rapid changing dating strategies and sero-adaptive behaviours (like 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. Backpage Escorts Near Me Campbellcroft Ontario. Backpage Escorts Near Me Canfield Ontario. Nevertheless these results are useful, as they demonstrate how web-based partner acquisition may lead to 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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