Features of online and offline partners and ventures 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 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 often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts near Macamic. Participants more often 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 often reported with on-line partners.
In univariate analysis, UAI was significantly more inclined to occur 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 associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating place 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 classes, one for each HIV status. Among HIV positive men, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware 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 ), additionally including variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat more powerful (though not significant) for the HIV positive men (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 result of online dating on UAI became stronger (and important) for HIV-unaware men (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 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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just 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 associated with a higher risk of UAI than offline dating. Macamic, Quebec backpage escorts. Backpage escorts nearby Macamic Quebec. For HIV-negative guys 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). Just among guys who indicated they weren't aware of their HIV status (a little 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 online associates than with offline partners. 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 also offline partnerships are in charge of the increased UAI in online established ventures. This could be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other variables. Among HIV negative guys no effect of online dating on UAI was found, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but only important when adding associate and venture variables to the model.
A key strength of this study was that it explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted bias due to potential differences between guys just dating online and those simply dating offline, a weakness of numerous previous studies. Quebec backpage escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could comprise a large number of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not correlated with UAI among HIV-negative men, a finding in agreement with some previous studies, largely 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 behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Backpage Escorts Near Me Maddington Quebec. Nevertheless it could also reflect secular changes; possibly in the beginning of online dating a more high risk group of guys used the Internet, and over time online dating normalized and less high risk MSM now also use the Internet for dating.
For HIV-unaware men the effect of dating location on UAI did not change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's difficult to assess the actual risk for HIV for these men: do they behave as HIV-negative guys that want to shield themselves from HIV infection, or as HIV-positive guys trying to protect 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 Formerly 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 appear to be partly based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV negative guys and HIV status-unaware guys, conclusions 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 and the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting cannot be regarded as a very successful method of avoiding HIV transmission 22 Besides interventions to stimulate the uptake of HIV and STI testing in sexually active men, interventions to caution against UAI based on sensed HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communicating on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may increase the burden of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and spark timely HIV testing (i.e., after hazard events 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 methods and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of battles will vary. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they show how web-based partner acquisition may 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 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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