In order to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In version 1, we adapted 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 characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted additionally for partnership sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership kind (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 included in all three models by making a 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-oblivious guys. Cheap Prostitutes near Shaw Alberta. 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 miss potentially significant associations. As a rather large number of statistical tests were done and reported, this strategy does lead to an elevated risk of one or more false positive associations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of on-line 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 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 known (61.4% vs. 49.4%; P 0.001), and in online partnerships, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their online partners more frequently 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 online partners (50.9% vs. Cheap Prostitutes nearby Shaw. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less often reported with internet 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 firmly correlated 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 association of online dating using three different reference categories, one for each HIV status. Cheap prostitutes in Alberta. Among HIV-positive guys, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was apparent between UAI and online 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 ), also including variants 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 stronger (though not critical) 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 result of online dating on UAI became stronger (and essential) for HIV-oblivious 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 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 associated with a higher danger of UAI than offline dating. Cheap Prostitutes closest to Shaw. For HIV-negative guys 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). Cheap Prostitutes nearby Shaw. Just among men who suggested they weren't 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 frequently with on-line associates than with offline partners. When adjusting for associate characteristics, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership variables between online and offline partnerships are liable for 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 guys no effect of online dating on UAI was discovered, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only critical when adding partner and partnership variants to the model.
A key strength of this 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 prejudice caused by potential differences between guys just dating online and those simply dating offline, a weakness of numerous previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and avoid potential differences in men tried through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't associated with UAI among HIV negative guys, a finding in agreement with some previous studies, mainly 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 guys. Nonetheless it could also reflect lay changes; possibly in the beginning of online dating a more high risk group of men used the Internet, and over time online dating normalized and less high-risk MSM now also utilize the Net for dating.
For HIV-oblivious men the effect of dating location on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It's difficult to assess the real risk for HIV for these men: do they act as HIV negative guys who want to protect 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're HIV-positive and engage in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the oblivious and perceived HIV-negative MSM were analyzed HIV-positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partly 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-unaware men, decisions 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 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 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 perceived HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Cheap prostitutes closest to Shaw, Alberta.
Dating online may offer other opportunities for communicating on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may increase the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should especially be directed at HIV negative and oblivious MSM and arouse timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date when it comes to rapid altering dating procedures and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of battles will change. Our data are 8years old and web-based dating has developed since then. Cheap Prostitutes Near Me Shaughnessy Alberta. Cheap Prostitutes Near Me Sheerness Alberta. However these results are useful, as they demonstrate how web-based partner acquisition can result in more info 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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