Features 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 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 on-line partnerships, 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 Stewartfield. Participants more often 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 on-line partners.
In univariate analysis, UAI was significantly more prone to happen in online than in offline partnerships (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 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 groups, one for each HIV status. Among HIV-positive men, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was apparent between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online when compared with 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 separate effect of online dating place on UAI became somewhat stronger (though not critical) 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 effect of online dating on UAI became stronger (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 also 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 happened 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 factors significantly associated with UAI were group sex within the venture, and sex-connected multiple drug use within partnership.
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. Stewartfield, Alberta cheap prostitutes. Cheap prostitutes in Stewartfield Alberta. 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among men who indicated they weren't aware of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with on-line associates than with offline associates. When correcting for associate characteristics, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership variables between online and offline partnerships are responsible for the increased UAI in online established ventures. This may be because of 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 observed, either in univariate or in the multivariate models. Among HIV-unaware men, online dating was correlated with UAI but just critical when adding associate and partnership variables to the model.
A vital strength of this study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted bias caused by potential differences between guys only dating online and those simply dating offline, a weakness of numerous previous studies. Alberta Cheap Prostitutes. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a lot of MSM, and prevent potential differences in men sampled through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not 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 due to 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. Cheap Prostitutes Near Me Stirling Alberta. Nonetheless it might also reflect secular changes; maybe 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 now also use the Web for dating.
For HIV-unaware guys the effect of dating place on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these guys: do they behave as HIV negative men who want to shield themselves from HIV infection, or as HIV-positive guys trying to shield 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 participate in UAI with HIV negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV-negative MSM were analyzed HIV-positive. The study population included the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-unaware men, determinations on UAI will not 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 as well as the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as a very powerful method of averting 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.
Dating online may offer other chances for communication on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the weight of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and excite timely HIV testing (i.e., after hazard events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date in regards to rapid altering dating approaches as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will change. Our data are 8years old and net-based dating has developed since then. However these results are useful, as they reveal how internet-based partner acquisition can result in 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 immunodeficiency virus; i.e., id est, it's, 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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