Characteristics of on-line 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 often reported as known (61.4% vs. 49.4%; P 0.001), and in online partnerships, 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 nearby Francis. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more inclined to happen 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 impact 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 categories, one for each HIV status. 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 men no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online when compared with 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-associated multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat stronger (though not critical) 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 result of online dating on UAI became more powerful (and significant) for HIV-unaware 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 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 just one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-connected 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. Francis, Saskatchewan Backpage Escorts. Backpage escorts in Francis 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among men who suggested they weren't aware of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV-positive guys, in univariate analysis UAI was reported significantly more often with online partners than with offline partners. When adjusting for associate characteristics, 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 partnerships. This may 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 some of the multivariate models. Among HIV-unaware men, 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 explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted bias due to potential differences between guys just dating online and those simply dating offline, a weakness of several previous studies. Saskatchewan backpage escorts. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a lot of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't connected with UAI among HIV negative men, 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 behaviour patterns within one group of guys. Backpage Escorts Near Me Frankslake Saskatchewan. Nonetheless it may 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 today additionally utilize the Net for dating.
For HIV-oblivious guys the effect of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's difficult to evaluate the real risk for HIV for these guys: do they behave as HIV-negative guys who are trying to shield themselves from HIV infection, or as HIV-positive guys attempting to shield 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 debatable if they're HIV-positive and engage in UAI with HIV negative partners 12 Formerly 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 partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious men, decisions 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 and also the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very successful method of preventing 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.
Relationship online may offer other opportunities for communication on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may raise the load of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and excite timely HIV testing (i.e., after hazard events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up-to-date in regards to rapid shifting dating strategies as well as 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 vary. Our data are 8years old and web-based dating has developed since then. Nevertheless these results are useful, as they show how net-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 immuno-deficiency 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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