To be able to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 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 model 3, we adjusted additionally for partnership sexual risk behaviour (i.e., sex-associated 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 closest to Raglan Ontario. We performed a sensitivity analysis restricted 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 lose potentially important associations. As a rather large number of statistical evaluations were done and reported, this strategy does lead to an increased risk of one or more false positive organizations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of online and offline partners and ventures 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 on-line partners was more often reported as known (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 online 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 internet partners (50.9% vs. Backpage Escorts nearby Raglan. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more likely to occur 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 strongly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 different reference categories, one for each HIV status. Backpage Escorts near me Ontario. Among HIV positive guys, UAI was more common in online when compared with offline partnerships (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-unaware guys, UAI was more common in online when compared with 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 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 stronger (though not critical) for the HIV positive guys (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV-negative men (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became stronger (and significant) 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 also correlated 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 variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within venture.
In this large study among MSM attending the STI clinic in Amsterdam, we found no signs that online dating was independently related to a higher danger of UAI than offline dating. Backpage escorts nearby Raglan. For HIV-negative guys 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 near Raglan. Just among men who indicated they weren't aware of their HIV status (a little 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 often with on-line partners than with offline partners. 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 variables between online and also offline partnerships are responsible for the increased UAI in online established partnerships. This might 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-unaware men, online dating was associated with UAI but just critical when adding associate and venture variants to the model.
An integral strength of this study was that it investigated the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This prevented bias caused by potential differences between men 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 comprise a lot 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 was not associated with UAI among HIV negative men, a finding in agreement with some previous studies, largely among young men 21 , but in comparison 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 guys. Yet it could also represent secular changes; perhaps 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 make use of the Net for dating.
For HIV-oblivious guys the impact of dating location on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is hard to assess the actual risk for HIV for these men: do they act as HIV-negative men who are trying to shield themselves from HIV infection, or as HIV-positive men 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 are HIV positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and perceived HIV-negative MSM were tested 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 important. In HIV-negative guys and HIV status-oblivious guys, conclusions on UAI WOn't 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as an extremely successful way of averting 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 sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage escorts closest to Raglan, Ontario.
Relationship online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the load of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and arouse 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 stay up-to-date in regards to accelerated changing dating methods as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Quorn Ontario. Backpage Escorts Near Me Rainy River Ontario. Nevertheless these results are useful, as they reveal how net-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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