Features of online 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 on-line partners was more often 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 on-line partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage escorts closest to Manvers. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance 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 correlated 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 categories, one for each HIV status. 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 men no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online when compared with 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 variants concerning sexual behavior in the venture (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat more powerful (though not significant) 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 stronger (and essential) for HIV-oblivious 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 likewise 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 partnership compared to just one sex act). Other factors 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 risk of UAI than offline dating. Manvers, Ontario Backpage Escorts. Backpage escorts closest to Manvers Ontario. For HIV-negative guys this lack 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). Just among guys who suggested they weren't aware of their HIV status (a small group in this study), UAI was more common with online 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 correcting for partner 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 variables between online and also offline partnerships are liable for the increased UAI in online established partnerships. This may be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative men no effect of online dating on UAI was observed, either in univariate or in any of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only essential when adding associate and venture variables to the model.
An integral strength of this study was that it explored the connection 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 guys only dating online and those only dating offline, a weakness of several previous studies. Ontario backpage escorts. 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 sampled through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating was not associated with UAI among HIV negative guys, a finding in agreement with some previous studies, mostly among young men 21 , but in contrast 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 behavior patterns within one group of men. Backpage Escorts Near Me Maple Ontario. Yet it might also represent lay changes; perhaps in the beginning of online dating a more high-risk group of men used the Internet, and over time online dating normalized and less high risk MSM nowadays additionally use the Internet for dating.
For HIV-unaware guys the impact of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's hard to assess the real risk for HIV for these guys: do they behave as HIV negative guys that are trying to protect 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 debatable if they're HIV-positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV-negative MSM were analyzed HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-oblivious guys, conclusions 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 also the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very powerful way 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.
Relationship 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 easier. However, serosorting may increase the load of other STI and will not prevent HIV disease 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 regular testing when sexually active.
New research should stay up to date as it pertains to rapid changing 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 engagements will change. Our data are 8years old and internet-based dating has developed since then. Yet these results are useful, as they reveal how net-based partner acquisition can result in more info on the sex partner, and this may influence 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 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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