Characteristics of online and offline partners and partnerships are shown 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 on-line partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Backpage Escorts near me Cotham. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more prone 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 associated 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 distinct reference types, one for each HIV status. Among HIV positive guys, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and on-line 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 ), additionally including variants concerning sexual behaviour in the partnership (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 critical) 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 result 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 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 venture (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 venture, 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 danger of UAI than offline dating. Cotham, Saskatchewan backpage escorts. Backpage escorts nearby Cotham Saskatchewan. 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). Only among men who indicated they weren't informed 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 frequently with on-line partners than with offline partners. When correcting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership variables between online and also offline partnerships are liable for the increased UAI in online established partnerships. 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 men no effect of online dating on UAI was found, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was connected with UAI but only significant when adding partner and partnership variants to the model.
A key strength of this study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This prevented bias caused by potential differences between men just dating online and those only dating offline, a weakness of numerous previous studies. Saskatchewan backpage escorts. 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 tried through Internet or face-to-face interviewing, weaknesses in some 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 contrast with other studies 1 - 5 This may be because of the fact 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 Courval Saskatchewan. Yet it may also represent lay 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 now additionally use the Net for dating.
For HIV-oblivious men the impact of dating location on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is difficult to evaluate the actual 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 guys attempting to guard 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 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 unaware and perceived 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 partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-unaware men, judgements 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 the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting cannot be regarded as a very effective way 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.
Dating online may offer other chances for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the burden of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and spark 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 stay up-to-date as it pertains to accelerated changing dating approaches and sero-adaptive behaviours (such as 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. Nevertheless these results are useful, as they demonstrate how internet-based partner acquisition can lead to more information on the sex partner, and this may 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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