To be able to examine the potential mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adjusted the association 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 partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted also for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and partnership type (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 contained in all three models by making a fresh six-class 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 nearby Gordon Landing, Yukon. We performed a sensitivity analysis confined 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 approach does lead to an elevated danger of one or more false-positive associations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of online 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 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 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 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 Gordon Landing. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more likely 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 firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 distinct reference classes, one for each HIV status. Backpage Escorts nearest Yukon. Among HIV-positive guys, UAI was more common in online in comparison to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was apparent between UAI and online 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 partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat more powerful (though not significant) 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 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 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 occurred 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 signs that online dating was independently associated with a higher danger of UAI than offline dating. Backpage Escorts nearby Gordon Landing. 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). Backpage escorts near me Gordon Landing. Simply among men who indicated they were not conscious 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 often with on-line partners than with offline partners. When adjusting for associate features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership factors between online and also offline partnerships are liable for the increased UAI in online established partnerships. This might be due to a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was discovered, either in univariate or in any of the multivariate models. Among HIV-oblivious men, online dating was associated with UAI but just significant when adding partner and venture variables to the model.
An integral 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 prejudice caused by potential differences between guys only dating online and those only dating offline, a weakness of numerous previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a lot of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not associated 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 due to 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 men. Nonetheless it might also represent lay 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 today additionally utilize the Net for dating.
For HIV-oblivious men the effect of dating place on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It's difficult to evaluate the real risk for HIV for these men: do they act as HIV negative men that are attempting 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 Previously Matser et al. reported that 1.7% of the oblivious and perceived HIV negative MSM were examined HIV-positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV-negative guys and HIV status-oblivious guys, 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting cannot be regarded as a very powerful way of preventing 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. Backpage escorts nearest Gordon Landing Yukon.
Relationship online may offer other opportunities for communication on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, 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 unaware MSM and arouse timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date as it pertains to accelerated altering dating strategies 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 vary. Our data are 8years old and web-based dating has developed since then. Backpage Escorts Near Me Gold Run Yukon. Backpage Escorts Near Me Grand Forks Yukon. Yet these results are useful, as they show how internet-based partner acquisition can lead to more info on the sex partner, and this may 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 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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