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 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 online partners more often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes nearest Somme. 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 frequently reported with on-line partners.
In univariate analysis, UAI was significantly more prone 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 result 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 distinct reference groups, one for each HIV status. Among HIV-positive men, UAI was more common in online in comparison to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 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 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 more powerful (and significant) for HIV-oblivious men (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The amount of sex partners in the preceding 6months of the index was also associated 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 only one sex act). Other factors significantly associated with UAI were group sex within the venture, 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. Somme, Manitoba cheap prostitutes. Cheap Prostitutes in Somme 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just 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 men, in univariate analysis UAI was reported significantly more often with on-line associates than with offline associates. When adjusting 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 variables between online and also offline partnerships are liable for the increased UAI in online established ventures. This might be because of 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 observed, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but just essential when adding partner and partnership variables 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 averted prejudice brought on by potential differences between men just dating online and those simply dating offline, a weakness of several previous studies. Manitoba cheap prostitutes. 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 guys tried 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 because of 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 men. Cheap Prostitutes Near Me Souris Manitoba. Nevertheless it may also represent lay changes; perhaps 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 today also utilize the Web for dating.
For HIV-unaware men the impact of dating location on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these guys: do they behave as HIV negative guys who are trying to protect themselves from HIV infection, or as HIV positive men attempting to protect 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 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 analyzed HIV positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious men, judgements 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 and also the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting cannot be regarded as an extremely effective way 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 opportunities for communication on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the weight 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 excite timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up to date in regards to rapid altering dating methods as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of battles will vary. Our data are 8years old and web-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 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'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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