Characteristics of online and offline partners and partnerships 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 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 nearby Orange Corners. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more inclined to happen 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 firmly correlated 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 distinct reference groups, one for each HIV status. 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 online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, 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 ), also including variants concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat stronger (though not essential) 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 critical) for HIV-oblivious guys (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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other variables 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 evidence that online dating was independently related to a higher danger of UAI than offline dating. Orange Corners Ontario backpage escorts. Backpage Escorts in Orange Corners, 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 non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Only among men who indicated they were not 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 frequently with online partners than with offline associates. When correcting for associate features, 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 in charge of the increased UAI in online established partnerships. This might be due to 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 found, either in univariate or in any of the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but only essential when adding associate and partnership variants to the model.
A key 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 also offline casual partners. This avoided bias brought on by potential differences between men just dating online and those just dating offline, a weakness of numerous previous studies. Ontario backpage escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and prevent potential differences in guys tried through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't correlated 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 reality 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 Orangeville Ontario. Nevertheless it could also represent secular changes; maybe 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 also utilize the Net for dating.
For HIV-oblivious guys the impact of dating location on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It is hard to assess the real risk for HIV for these men: do they act as HIV negative men that are trying to shield themselves from HIV infection, or as HIV-positive men trying to shield 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 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 perceived HIV negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV negative men and HIV status-oblivious men, decisions 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. So serosorting cannot be regarded as a very successful method 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.
Dating online may offer other opportunities for communication on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may raise the weight of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and oblivious MSM and excite 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 in regards to accelerated altering dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive opportunities, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they reveal how internet-based partner acquisition can lead to more information 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 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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