In order to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adapted the association 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 version 3, we adapted also for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and partnership 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 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 guys. Backpage escorts nearest Vernon Bridge Prince Edward Island. We performed a sensitivity analysis restricted 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 important associations. As a rather large number of statistical evaluations were done and reported, this strategy does lead to a higher risk 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 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 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). Participants more often reported multiple sexual contacts with online partners (50.9% vs. Backpage Escorts nearest Vernon Bridge. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more likely to occur 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 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 groups, one for each HIV status. Backpage Escorts near Prince Edward Island. Among HIV-positive guys, 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 apparent between UAI and internet 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 ), also including variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat more powerful (though not essential) for the HIV-positive men (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 significant) 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 partnership compared to only one sex act). Other factors 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 evidence that online dating was independently related to a higher risk of UAI than offline dating. Backpage escorts nearest Vernon Bridge. 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Backpage Escorts nearest Vernon Bridge. Simply among men who suggested they weren't informed of their HIV status (a small 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 often with online 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 non-significant; this indicates that differences in partnership factors between online and offline partnerships are accountable for the increased UAI in online established ventures. This might be because of a mediating effect of more information 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 any of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only critical when adding partner and venture variants to the model.
A vital 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 prevented bias due to potential differences between men only dating online and those only dating offline, a weakness of numerous previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and prevent potential differences in guys tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't correlated with UAI among HIV-negative men, a finding in agreement with some previous studies, mostly among young men 21 , but in comparison with other studies 1 - 5 This may be because of the fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. Nonetheless it might also represent lay 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 utilize the Net for dating.
For HIV-oblivious men the impact of dating place on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is difficult to assess the real risk for HIV for these men: do they behave as HIV-negative guys who are trying to protect themselves from HIV infection, or as HIV-positive men attempting to shield 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're HIV-positive and engage in UAI with HIV negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-oblivious men, judgements on UAI will not 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 as well as the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as a very effective way 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. Backpage escorts nearby Vernon Bridge, Prince Edward Island.
Relationship online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may raise the load of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and unaware MSM and excite timely HIV testing (i.e., after danger events 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 fast altering dating procedures 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 be different. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Valleyfield Prince Edward Island. Backpage Escorts Near Me Vernon River Prince Edward Island. Nevertheless these results are useful, as they demonstrate how internet-based partner acquisition can result in 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 immunodeficiency 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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