To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adjusted the organization 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 venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted also for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and venture kind (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 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-unaware men. Backpage Escorts near Sutherland Ontario. We performed a sensitivity analysis confined 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 miss potentially important organizations. As a fairly large number of statistical tests were done and reported, this approach does lead to a higher danger of one or more false positive associations. Investigations 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 frequently reported as known (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 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 near me Sutherland. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with internet 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 strongly correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact of dating location 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. Backpage escorts closest to Ontario. Among HIV-positive men, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was apparent between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, 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 ), also including variables 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 more powerful (though not essential) 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 effect of online dating on UAI became stronger (and essential) for HIV-unaware 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 also associated 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 venture compared to just one sex act). Other factors 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 in Sutherland. For HIV-negative guys 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). Backpage Escorts closest to Sutherland. Simply among guys who indicated they weren't conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently with online associates than with offline partners. When adjusting 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 variables between online and also offline partnerships are responsible for the increased UAI in online established partnerships. This might be due to a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was found, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but just essential when adding associate and venture variables to the model.
A key strength of this study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided prejudice due to potential differences between guys just dating online and those only dating offline, a weakness of numerous previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a lot of MSM, and prevent potential differences in guys sampled through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't associated with UAI among HIV-negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in contrast with other studies 1 - 5 This may be due to 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. Nevertheless it may also reflect secular changes; possibly in the beginning of online dating a more high risk group of men used the Internet, and over time online dating normalized and not as high-risk MSM today additionally make use of the Net for dating.
For HIV-unaware guys the effect of dating place on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is hard to evaluate the actual risk for HIV for these guys: do they behave as HIV negative guys that want 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 men who were never tested for HIV, profiled themselves online as being HIV negative, which might be problematic if they're HIV positive and engage 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 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 important. In HIV-negative guys and HIV status-unaware guys, determinations 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 as well as the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't be regarded as an extremely powerful method of averting HIV transmission 22 Besides interventions to trigger 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 in Sutherland Ontario.
Dating 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. Yet, serosorting may raise the weight of other STI and will not prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV negative and oblivious MSM and arouse timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up to date as it pertains to rapid altering dating procedures and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of engagements will change. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Sunset Corners Ontario. Backpage Escorts Near Me Sutton Ontario. However these results are useful, as they show how internet-based partner acquisition can result in more info on the sex partner, and this might 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 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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