To be able to examine the potential mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adapted the organization between online/offline dating place 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 characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted additionally for venture sexual risk behavior (i.e., sex-associated drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating location 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-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV positive, and HIV-oblivious men. Cheap Prostitutes nearest Onoway Alberta. We performed a sensitivity analysis limited to partnerships in which just 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 important associations. As a rather large number of statistical evaluations were done and reported, this strategy does lead to an increased risk of one or more false-positive organizations. Analyses were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Characteristics of online and offline partners and ventures are shown 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 frequently knew 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 online partners (50.9% vs. Cheap Prostitutes near Onoway. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more likely 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 firmly correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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 distinct reference groups, one for each HIV status. Cheap prostitutes in Alberta. Among HIV-positive guys, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online when compared with 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 variables concerning sexual behaviour in the partnership (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat stronger (though not significant) for the HIV-positive men (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 result of online dating on UAI became more powerful (and essential) 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 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 venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just 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 related to a higher danger of UAI than offline dating. Cheap Prostitutes in Onoway. 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Cheap prostitutes in Onoway. 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 partners.
Among HIV positive guys, in univariate analysis UAI was reported significantly more often with online partners than with offline associates. When correcting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became non significant; this indicates that differences in partnership factors between online and offline partnerships are in charge of the increased UAI in online established ventures. This may be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other variables. 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-unaware guys, online dating was associated with UAI but only important when adding partner and partnership variants to the model.
A vital 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 also offline casual partners. This prevented bias caused by potential differences between guys just dating online and those only dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a lot of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in certain previous studies 3 , 11
Online dating wasn't connected with UAI among HIV negative guys, a finding in agreement with some previous studies, mostly among young men 21 , but in contrast with other studies 1 - 5 This may be because of the reality that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Nonetheless it could also represent secular changes; maybe 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 today also make use of the Web for dating.
For HIV-oblivious men the impact of dating place on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's difficult to evaluate the actual risk for HIV for these guys: do they act as HIV-negative guys that want to shield themselves from HIV infection, or as HIV-positive men attempting to guard 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 are HIV-positive and engage in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the oblivious and sensed HIV-negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative guys and HIV status-oblivious men, judgements on UAI will not 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 cannot be regarded as a very powerful way of averting HIV transmission 22 Besides interventions to trigger 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. Cheap prostitutes near me Onoway Alberta.
Dating online may offer other chances for communicating on HIV status than dating in physical surroundings. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the burden 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 spark timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up-to-date when it comes to fast shifting dating strategies as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of engagements will change. Our data are 8years old and web-based dating has developed since then. Cheap Prostitutes Near Me Onefour Alberta. Cheap Prostitutes Near Me Opal Alberta. However these results are useful, as they reveal how internet-based partner acquisition may lead to more info on the sex partner, and this might 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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