Characteristics of on-line 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 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 online partners was more often reported as known (61.4% vs. 49.4%; P 0.001), and in on-line 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). Backpage escorts near me Mcmorran. Participants more frequently 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 frequently reported with online partners.
In univariate analysis, UAI was significantly more inclined to happen 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 correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect 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 categories, one for each HIV status. Among HIV positive men, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online in comparison to 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 behavior in the venture (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat stronger (though not critical) for the HIV-positive guys (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 critical) for HIV-oblivious 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 also 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 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 partnership.
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. Mcmorran Saskatchewan backpage escorts. Backpage Escorts near Mcmorran, Saskatchewan. For HIV negative guys this lack of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive men 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 were not informed of their HIV status (a little group in this study), UAI was more common with online than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently with online partners than with offline associates. When correcting for partner characteristics, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership variables between online and offline partnerships are liable for the increased UAI in online established ventures. This might be because of 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 correlated with UAI but only essential when adding associate and venture variants to the model.
A key strength of this study was that it investigated the connection between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted bias brought on by potential differences between guys just dating online and those just 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 avoid potential differences in men sampled through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't correlated 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 fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. Backpage Escorts Near Me Mcphail Cove Saskatchewan. Yet it may also reflect lay changes; maybe 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 make use of the Web for dating.
For HIV-oblivious guys the impact of dating place on UAI did not change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is difficult to assess the actual risk for HIV for these men: do they behave as HIV-negative men that want to shield themselves from HIV infection, or as HIV positive guys trying to safeguard 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 oblivious and perceived HIV-negative MSM were analyzed HIV-positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV negative guys and HIV status-oblivious guys, judgements 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 the HIV window phase 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 averting 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 sensed HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Dating online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Nonetheless, serosorting may increase the load of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should particularly 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 remain up to date in regards to accelerated changing dating methods and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of battles will be different. Our data are 8years old and internet-based dating has developed since then. However these results are useful, as they show how net-based partner acquisition can lead to 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 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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