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 online 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). Cheap prostitutes in Juno. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more inclined to occur in online 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 connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 different reference classes, one for each HIV status. Among HIV positive guys, 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 evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online in comparison to 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 variables concerning sexual behavior in the venture (sex-related 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 result of online dating on UAI became more powerful (and essential) for HIV-unaware 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 likewise correlated 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 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 partnership, and sex-related multiple drug use within venture.
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. Juno Alberta cheap prostitutes. Cheap prostitutes closest to Juno Alberta. 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). Only among men who suggested 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 guys, in univariate analysis UAI was reported significantly more frequently with on-line associates than with offline partners. When correcting for partner 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 offline partnerships are responsible for the increased UAI in online established ventures. This could be because of a mediating effect of more information on partners, (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-oblivious guys, online dating was associated with UAI but just critical when adding partner and venture variants 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 offline casual partners. This prevented prejudice brought on by potential differences between men only dating online and those only dating offline, a weakness of numerous previous studies. Alberta cheap prostitutes. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a great number 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 correlated 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 fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Cheap Prostitutes Near Me Kahwin Alberta. Yet it may also reflect secular changes; perhaps in the beginning of online dating a more high risk group of men used the Internet, and over time online dating normalized and not as high-risk MSM today additionally utilize the Net for dating.
For HIV-unaware guys the impact of dating place on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is hard to assess the real 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 men attempting to protect 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 unaware and sensed HIV-negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious men, determinations 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 also 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 an extremely successful way 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communication on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may increase the weight of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and spark timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up to date when it comes to accelerated changing dating procedures as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each 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 reveal how web-based partner acquisition may lead to more information on the sex partner, and this might influence 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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