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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 on-line partners was more frequently reported as understood (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 on-line partners more often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes nearest Tsay Keh Dene. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with internet partners.

In univariate analysis, UAI was significantly more likely 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 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 organization of online dating using three different reference types, 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 online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, UAI was more common in online compared 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 variants concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat stronger (though not essential) 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 essential) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).

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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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to only one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-connected 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 risk of UAI than offline dating. Tsay Keh Dene British Columbia cheap prostitutes. Cheap Prostitutes in Tsay Keh Dene, British Columbia. 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). Only among guys who suggested they weren't conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.

Among HIV positive men, 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 implies that differences in partnership factors between online and offline partnerships are liable for the increased UAI in online established partnerships. This may be due to a mediating effect of more information on associates, (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 some of the multivariate models. Among HIV-unaware men, online dating was associated with UAI but only essential when adding associate and venture variants to the model.

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A key 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 prejudice due to potential differences between men only dating online and those simply dating offline, a weakness of numerous previous studies. British Columbia cheap prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a great number of MSM, and prevent potential differences in guys sampled through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11

Online dating wasn't correlated with UAI among HIV-negative guys, a finding in agreement with some previous studies, mainly 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 Tulameen British Columbia. Nevertheless it might also represent secular 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 now also utilize the Internet for dating.

For HIV-oblivious 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 hard to evaluate the actual risk for HIV for these guys: do they behave as HIV-negative men who want to protect themselves from HIV infection, or as HIV-positive men 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 problematic if they are HIV positive and participate 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

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Because decisions on UAI appear to be partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV negative guys and HIV status-unaware men, conclusions 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting can't be regarded as an extremely effective method 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.

Dating online may offer other chances for communicating on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. Yet, serosorting may raise the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and stimulate timely HIV testing (i.e., after risk events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.

New research should stay up to date in regards to fast shifting dating procedures as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. However these results are useful, as they reveal how net-based partner acquisition can result in more info on the sex partner, and this may influence on the frequency of UAI.

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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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