Characteristics of on-line and offline partners and partnerships are revealed 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 often reported as known (61.4% vs. 49.4%; P 0.001), and in on-line ventures, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their on-line partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes near me Alexander Bay. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more likely 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 location 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 categories, 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 guys no association was apparent between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online in comparison 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 variants concerning sexual behaviour in the partnership (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 men (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became more powerful (and significant) for HIV-unaware 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 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 happened in the venture (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 partnership.
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. Alexander Bay Newfoundland And Labrador Cheap Prostitutes. Cheap prostitutes nearest Alexander Bay, Newfoundland And Labrador. For HIV negative men this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive guys there was a nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among guys who suggested they weren't informed 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 online associates than with offline partners. When correcting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership factors between online and offline partnerships are responsible for the increased UAI in online established ventures. This might be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative guys 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 correlated with UAI but just important when adding associate and partnership variables to the model.
A vital strength of the study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted bias due to potential differences between men only dating online and those simply dating offline, a weakness of numerous previous studies. Newfoundland And Labrador cheap prostitutes. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a great number of MSM, and prevent potential differences in guys tried through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't associated with UAI among HIV negative men, 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 behaviour patterns within one group of guys. Cheap Prostitutes Near Me Anchor Point Newfoundland And Labrador. Nevertheless it can also reflect 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 less high-risk MSM now also utilize the Web for dating.
For HIV-unaware guys the impact of dating place on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It is hard to evaluate the real risk for HIV for these men: do they behave as HIV-negative guys that are attempting 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 men 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 oblivious 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 sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV negative guys and HIV status-oblivious men, judgements on UAI will not only be based on perceived HIV status of the partner but in addition 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. So serosorting can't be regarded as a very effective way of preventing 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may increase the burden of other STI and will not prevent HIV disease entirely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and oblivious MSM and spark timely HIV testing (i.e., after risk events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up to date when it comes to rapid altering dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they demonstrate how net-based partner acquisition may lead to more info on the sex partner, and this may 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 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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