To be able to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In version 1, we adapted 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 venture features (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 partnership kind (i.e., casual or anonymous). As we assumed a differential effect of dating place for HIV positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was included in all three models by making a brand 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 men. Backpage escorts nearest Abernethy Saskatchewan. 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 lose potentially significant associations. As a rather big number of statistical evaluations were done and reported, this approach does lead to an increased danger of one or more false-positive associations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of on-line 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 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 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 internet partners (50.9% vs. Backpage Escorts nearest Abernethy. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more inclined 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 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 association of online dating using three different reference classes, one for each HIV status. Backpage escorts near Saskatchewan. Among HIV-positive men, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online in comparison 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 variants concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating place 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 more powerful (and significant) 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 happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to only one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-connected 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 danger of UAI than offline dating. Backpage Escorts near Abernethy. For HIV negative men this dearth 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 in Abernethy. Only among men who suggested they weren't aware of their HIV status (a small 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 online partners than with offline associates. When correcting 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 variables between online and offline partnerships are responsible for the increased UAI in online established ventures. This could be due to 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 discovered, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but just important when adding associate and venture variants to the model.
A key 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 offline casual partners. This avoided prejudice due to potential differences between guys only dating online and those only dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a lot of MSM, and prevent potential differences in guys sampled through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not connected 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 behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. Yet it could also represent 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 not as high-risk MSM nowadays also make use of the Internet for dating.
For HIV-oblivious guys the impact of dating place on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is difficult to assess the real risk for HIV for these men: do they act as HIV-negative men that are trying to shield themselves from HIV infection, or as HIV-positive men 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'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 examined HIV-positive. The study population included the MSM reported in this study 15
Because decisions on UAI seem to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. In HIV-negative guys 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 people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating. Backpage escorts near Abernethy Saskatchewan.
Relationship online may offer other chances for communication on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, 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 excite timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up to date when it comes to accelerated shifting dating processes and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of battles will change. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me Aberdeen Saskatchewan. Backpage Escorts Near Me Ada Saskatchewan. Nevertheless these results are useful, as they reveal how internet-based partner acquisition may lead to more info 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 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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