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 on-line 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 known (61.4% vs. 49.4%; P 0.001), and in online ventures, 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). Backpage Escorts in Trout Creek. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more inclined to happen in on-line than in offline partnerships (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly connected 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 distinct reference types, one for each HIV status. 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 online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware 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 ), additionally including variables concerning sexual behaviour in the partnership (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 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 more powerful (and important) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The amount 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 variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within partnership.
In this large study among MSM attending the STI clinic in Amsterdam, we found no signs that online dating was independently associated with a higher danger of UAI than offline dating. Trout Creek Ontario Backpage Escorts. Backpage escorts in Trout Creek Ontario. 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). Simply among guys who suggested they were not aware of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
Among HIV-positive guys, 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 suggests that differences in partnership factors between online and also offline partnerships are accountable for 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 men no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-unaware men, online dating was connected with UAI but just significant when adding partner and venture variables to the model.
An integral strength of the 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 prevented bias caused by potential differences between men just dating online and those simply dating offline, a weakness of numerous previous studies. Ontario backpage escorts. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and prevent potential differences in men 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 reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Backpage Escorts Near Me Trout Mills Ontario. Nonetheless it can also reflect lay 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 less high-risk MSM today also utilize the Internet for dating.
For HIV-oblivious guys the impact of dating place on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these men: do they behave as HIV-negative men who are attempting to protect themselves from HIV infection, or as HIV-positive guys attempting to safeguard 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 sensed 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 partly based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-unaware guys, decisions 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 the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting cannot be regarded as a very effective 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 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. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may raise the load of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV negative and oblivious MSM and spark 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 stay up to date in regards to fast altering dating processes as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will change. Our data are 8years old and net-based dating has developed since then. Yet these results are useful, as they show how net-based partner acquisition can lead to more information on the sex partner, and this might 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 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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