Features of on-line 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 on-line partners was more often reported as understood (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 often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes near Frederickton. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more prone to happen in on-line 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 associated 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 organization of online dating using three distinct reference types, one for each HIV status. Among HIV positive men, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 behaviour in the partnership (sex-associated multiple drug use, sex frequency and partner kind), the independent 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 men (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became stronger (and essential) for HIV-unaware 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 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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within partnership.
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 danger of UAI than offline dating. Frederickton Newfoundland And Labrador cheap prostitutes. Cheap Prostitutes near me Frederickton Newfoundland And Labrador. For HIV-negative guys this dearth 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 guys who suggested they weren't aware of their HIV status (a little 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 partners 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 indicates that differences in partnership factors between online and also offline partnerships are in charge of the increased UAI in online established partnerships. This may be due to a mediating effect of more information on partners, (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 the multivariate models. Among HIV-oblivious men, online dating was correlated with UAI but just significant when adding associate and partnership variants to the model.
A key strength of the 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 avoided bias caused by potential differences between men just dating online and those simply dating offline, a weakness of numerous previous studies. Newfoundland And Labrador cheap prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain a great number of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not associated with UAI among HIV negative men, 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 fact 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 Frenchmans Cove Newfoundland And Labrador. Nonetheless it might also represent secular changes; perhaps in the beginning of online dating a more high risk group of guys used the Internet, and over time online dating normalized and less high-risk MSM today also utilize the Net for dating.
For HIV-unaware guys the impact of dating place on UAI did not change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's difficult to assess the actual risk for HIV for these men: do they act as HIV-negative guys that want to protect themselves from HIV infection, or as HIV positive men attempting 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 problematic if they're HIV positive and engage 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 comprised the MSM reported in this study 15
Because determinations on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious guys, decisions 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 people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as a very powerful method 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 sensed 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 environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the weight of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up-to-date as it pertains to rapid changing dating methods as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative opportunities, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they reveal how web-based partner acquisition can lead to more information on the sex partner, and this might influence 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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