In order to examine the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the association 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 characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted additionally for venture sexual risk behaviour (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 place 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 fresh 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 nearest Letterbreen Ontario. 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 rather big number of statistical evaluations were done and reported, this approach does lead to an elevated danger of one or more false-positive organizations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics of on-line and offline partners and ventures are revealed 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 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). Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. Backpage Escorts near Letterbreen. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more likely to occur in on-line than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was strongly connected 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. Backpage Escorts closest to Ontario. 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 apparent between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, 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 ), also including variants concerning sexual behaviour in the partnership (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat more powerful (though not significant) 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 effect of online dating on UAI became more powerful (and essential) for HIV-unaware men (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The number 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 variables significantly associated with UAI were group sex within the partnership, and sex-related 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 in Letterbreen. For HIV negative men this dearth 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 in Letterbreen. Only among men who indicated they were not informed of their HIV status (a small group in this study), UAI was more common with online than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently 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 indicates that differences in partnership factors between online and also offline partnerships are in charge of the increased UAI in online established ventures. This could 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 correlated with UAI but just important when adding partner and venture variants to the model.
An integral strength of this study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided bias caused by potential differences between guys only dating online and those just dating offline, a weakness of several previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a high number of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't correlated with UAI among HIV-negative guys, 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 fact that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. However it could 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 utilize the Web for dating.
For HIV-oblivious guys the effect of dating place on UAI did not change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's hard to assess the actual risk for HIV for these guys: do they act as HIV-negative men that are trying 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 perceived HIV negative MSM were tested HIV positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI appear to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious men, judgements on UAI WOn't 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 people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as an extremely effective method of preventing 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 sensed HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage Escorts in Letterbreen Ontario.
Relationship online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the load of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and stimulate timely HIV testing (i.e., after risk occasions 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 altering dating methods and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative 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 Leslieville Ontario. Backpage Escorts Near Me Levack Ontario. 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 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'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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