To be able to examine the potential mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adjusted 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 venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adjusted additionally for venture sexual risk behaviour (i.e., sex-associated drug use and sex frequency) and venture 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 location was included 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 nearest Clermont Quebec. 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 lose potentially important organizations. As a fairly large number of statistical evaluations were done and reported, this approach does lead to an elevated risk of one or more false-positive associations. Analyses were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features 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 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 understood (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 often 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 Clermont. 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 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 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 types, one for each HIV status. Backpage Escorts in Quebec. 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 guys no association was evident 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 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 ), additionally including variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat stronger (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 likewise 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 happened in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to only one sex act). Other variables significantly associated with UAI were group sex within the partnership, 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 closest to Clermont. 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 closest to Clermont. Simply among men who indicated they were not conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline partners.
Among HIV-positive men, 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 non-significant; this suggests that differences in partnership factors between online and offline partnerships are responsible for the increased UAI in online established ventures. This might be because of a mediating effect of more info on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV negative guys no effect of online dating on UAI was discovered, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was connected with UAI but only significant when adding partner and venture variants to the model.
A key strength of this study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted prejudice caused by potential differences between guys just 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 lot of MSM, and avoid potential differences in men 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, mainly among young men 21 , but in comparison with other studies 1 - 5 This may be due to the reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Yet 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 less high risk MSM today additionally utilize the Web for dating.
For HIV-oblivious men the impact of dating location on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's hard to assess the real risk for HIV for these men: do they act as HIV negative guys that want to protect 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 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 Previously 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 determinations on UAI appear to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-oblivious guys, conclusions 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. So serosorting cannot be regarded as a very powerful 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 Clermont, Quebec.
Dating online may offer other opportunities for communication on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the burden of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and arouse timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up to date as it pertains to fast shifting dating approaches 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 be different. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me CléRicy Quebec. Backpage Escorts Near Me Clerval Quebec. Nevertheless these results are useful, as they reveal how internet-based partner acquisition can lead to more information on the sex partner, and this may 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 immunodeficiency 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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