In order to examine the possible 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 location 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 also for venture sexual risk behavior (i.e., sex-associated drug use and sex frequency) and venture sort (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 location was included in all three models by making a new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV-positive, and HIV-oblivious guys. Backpage escorts nearby Abney Prince Edward Island. We performed a sensitivity analysis limited to partnerships in which only 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 significant associations. As a fairly big number of statistical tests were done and reported, this strategy does lead to an increased danger of one or more false positive organizations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
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 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 on-line partners was more frequently 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 often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with internet partners (50.9% vs. Backpage Escorts nearby Abney. 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 likely to happen 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 firmly 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 organization of online dating using three different reference groups, one for each HIV status. Backpage Escorts near Prince Edward Island. 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 men no association was evident between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online compared 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 variables concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating location 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 important) 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 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 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. Backpage escorts near Abney. For HIV negative men this lack 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 nearest Abney. Simply among men 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 associates.
Among HIV positive guys, in univariate analysis UAI was reported significantly more often with on-line partners than with offline associates. When adjusting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established partnerships. This might be because of a mediating effect of more info on partners, (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 associated with UAI but only important when adding associate and partnership variants to the model.
A key strength of this study was that it explored the relationship 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 simply dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could include a high number of MSM, and avoid potential differences in guys tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not associated with UAI among HIV-negative guys, 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. Nevertheless it may also reflect secular 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 not as high-risk MSM now additionally utilize the Web 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 difficult to evaluate the real risk for HIV for these men: do they act as HIV-negative men that are attempting 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 participate 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 conclusions on UAI seem to be partly based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. 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 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. Hence serosorting cannot be regarded as a very effective method of avoiding 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. Backpage Escorts in Abney Prince Edward Island.
Dating online may offer other chances for communicating on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, 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 danger occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up to date when it comes to accelerated changing dating strategies and sero-adaptive behaviours (such as 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. Backpage Escorts Near Me 48 Road Prince Edward Island. Backpage Escorts Near Me Abram-Village Prince Edward Island. However these results are useful, as they reveal how web-based partner acquisition can lead to more information 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 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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