Features of online 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 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 online partnerships, 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). Backpage Escorts closest to Cold Springs. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less often reported with on-line 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 connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect 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. 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 guys no association was evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online in comparison to 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 behavior in the venture (sex-associated multiple drug use, sex frequency and partner type), the separate 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 important) for HIV-oblivious 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 partnership (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 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 danger of UAI than offline dating. Cold Springs, Ontario backpage escorts. Backpage escorts closest to Cold Springs Ontario. 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). 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 partners.
Among HIV-positive men, in univariate analysis UAI was reported significantly more frequently with on-line associates than with offline partners. When adjusting for associate features, 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 variables between online and also offline partnerships are in charge of the increased UAI in online established ventures. This could be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative guys no effect of online dating on UAI was observed, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was associated with UAI but just significant when adding partner and venture variants to the model.
An integral strength of this study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided bias brought on by potential differences between men only dating online and those only dating offline, a weakness of numerous previous studies. Ontario Backpage Escorts. 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 men tried 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 comparison with other studies 1 - 5 This may be because of 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. Backpage Escorts Near Me Cole Wharf Ontario. Nevertheless it might 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 make use of the Internet for dating.
For HIV-oblivious guys the impact of dating place on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It is difficult to assess the actual risk for HIV for these men: do they act as HIV negative guys that are attempting to shield themselves from HIV infection, or as HIV positive guys trying to shield 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 problematic 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 sensed HIV-negative MSM were analyzed HIV positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI seem to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV-negative men and HIV status-oblivious guys, determinations 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting cannot be regarded as an extremely powerful way of preventing HIV transmission 22 Besides interventions to stimulate 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.
Relationship online may offer other chances for communicating on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and spark timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date as it pertains to fast changing dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive chances, the rules of battles will be different. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they show how net-based partner acquisition can 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 immunodeficiency 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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