In order to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the organization between online/offline dating location and UAI for characteristics 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 version 3, we adjusted additionally for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and venture sort (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 location was included in all three models by making a brand new six-class variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV-positive, and HIV-unaware men. Backpage escorts near me Totzke, Saskatchewan. We performed a sensitivity analysis limited 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 fairly big number of statistical evaluations were done and reported, this strategy does lead to a heightened danger of one or more false positive organizations. Investigations were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
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 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 on-line partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. Backpage Escorts in Totzke. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less frequently 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 firmly 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 types, one for each HIV status. Backpage escorts nearest Saskatchewan. Among HIV-positive men, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was evident between UAI and internet partnerships (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 ), also including variants 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 stronger (though not essential) 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 stronger (and critical) 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 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 venture 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 risk of UAI than offline dating. Backpage escorts near me Totzke. For HIV negative guys this dearth 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). Backpage escorts closest to Totzke. Simply among men who suggested they weren't conscious 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 associates than with offline partners. When adjusting 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 offline partnerships are responsible for the increased UAI in online established partnerships. This might 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 observed, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but only critical when adding partner and partnership variants to the model.
An integral strength of this study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted bias caused by potential differences between men just dating online and those simply dating offline, a weakness of numerous previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could include a large number 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 wasn't connected with UAI among HIV-negative men, a finding in agreement with some previous studies, mostly 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 behaviour patterns within one group of men. Yet it can also reflect secular changes; perhaps 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 additionally make use of the Web 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 evaluate the real risk for HIV for these men: do they behave as HIV negative men who are attempting to protect themselves from HIV infection, or as HIV-positive guys trying 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 problematic if they're 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 comprised the MSM reported in this study 15
Because decisions on UAI seem to be partially based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-oblivious 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore 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. Backpage Escorts nearby Totzke Saskatchewan.
Dating online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may raise the weight of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and oblivious MSM and spark timely HIV testing (i.e., after risk 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 accelerated shifting dating processes and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will be different. Our data are 8years old and net-based dating has developed since then. Backpage Escorts Near Me Totnes Saskatchewan. Backpage Escorts Near Me Tramping Lake Saskatchewan. Yet these results are useful, as they demonstrate how web-based partner acquisition may 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 immuno deficiency virus; i.e., id est, it is, 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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