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 online 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 knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes closest to Heaslip. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often 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 firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact of dating location 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 types, one for each HIV status. Among HIV-positive men, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was evident between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online compared to 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 behavior in the partnership (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating place on UAI became somewhat more powerful (though not critical) for the HIV-positive guys (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 effect of online dating on UAI became stronger (and significant) for HIV-unaware guys (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 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 venture (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 venture, and sex-connected 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 risk of UAI than offline dating. Heaslip, Manitoba Cheap Prostitutes. Cheap Prostitutes nearest Heaslip, Manitoba. 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 non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Only among men 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 partners.
Among HIV-positive guys, in univariate analysis UAI was reported significantly more frequently with online associates than with offline associates. 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 in charge of the increased UAI in online established partnerships. This might be due to a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative guys no effect of online dating on UAI was found, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but only important when adding partner and venture variables to the model.
A key strength of this study was that it explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This prevented bias due to potential differences between guys just dating online and those simply dating offline, a weakness of several previous studies. Manitoba Cheap Prostitutes. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could comprise a large number of MSM, and avoid potential differences in guys 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 comparison with other studies 1 - 5 This may be due to the reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Cheap Prostitutes Near Me Helston Manitoba. Nonetheless it may 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 additionally use the Web for dating.
For HIV-unaware guys the effect of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these men: do they behave as HIV-negative guys who want to shield themselves from HIV infection, or as HIV positive guys 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 problematic if they're HIV positive and participate in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV-negative MSM were examined HIV-positive. The study population comprised the MSM reported in this study 15
Because determinations 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 men and HIV status-unaware men, conclusions 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 phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore 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 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. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may increase the load of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and oblivious MSM and arouse 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 in regards to rapid altering dating procedures as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive chances, the rules of engagements will change. Our data are 8years old and internet-based dating has developed since then. However these results are useful, as they reveal how internet-based partner acquisition may lead to more information on the sex partner, and this might 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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