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 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 online partners more frequently knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes near me Bison Lake. Participants more frequently 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 internet partners.
In univariate analysis, UAI was significantly more inclined to occur 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 associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating place on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three different reference types, 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 men no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online compared to offline ventures, 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 behavior in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (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 effect of online dating on UAI became stronger (and essential) for HIV-unaware guys (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 just one sex act). Other factors significantly associated with UAI were group sex within the partnership, 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 related to a higher danger of UAI than offline dating. Bison Lake Alberta cheap prostitutes. Cheap prostitutes nearby Bison Lake Alberta. For HIV negative men 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 guys who suggested they were not aware of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with online partners than with offline associates. 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 ventures. This might be due to a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was detected, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but just important when adding associate and partnership variables to the model.
An integral strength of the study was that it investigated the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided bias caused by potential differences between men just dating online and those just dating offline, a weakness of numerous previous studies. Alberta cheap prostitutes. By recruiting participants at the biggest 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 certain previous studies 3 , 11
Online dating wasn't associated with UAI among HIV negative guys, a finding in agreement with some previous studies, largely 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 behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. Cheap Prostitutes Near Me Bittern Lake Alberta. Nonetheless it may also reflect lay 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 not as high-risk MSM nowadays additionally make use of the Net for dating.
For HIV-oblivious guys the effect of dating location on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It's hard to assess the real risk for HIV for these men: do they behave as HIV-negative men that want to protect themselves from HIV infection, or as HIV-positive men 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 debatable if they are HIV positive and engage in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were examined HIV-positive. The study population included the MSM reported in this study 15
Because conclusions on UAI appear to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys 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 also the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as a very powerful way 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 chances 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 raise the weight of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and oblivious MSM and stimulate 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 stay up to date as it pertains to accelerated altering dating procedures and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive chances, the rules of engagements will change. Our data are 8years old and internet-based dating has developed since then. However 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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