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 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 online partners was more frequently reported as known (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 frequently knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes nearest Green Creek. 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 often reported with online 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 distinct reference classes, one for each HIV status. Among HIV positive men, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was apparent between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 behavior in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat more powerful (though not essential) 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-oblivious 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 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 venture (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-connected 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 associated with a higher risk of UAI than offline dating. Green Creek Nova Scotia Cheap Prostitutes. Cheap prostitutes in Green Creek Nova Scotia. 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). Simply 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 guys, in univariate analysis UAI was reported significantly more frequently with online partners 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 non-significant; this suggests that differences in partnership variables between online and offline partnerships are liable for the increased UAI in online established ventures. This may be because of a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV-negative guys no effect of online dating on UAI was observed, either in univariate or in some of the multivariate models. Among HIV-unaware men, online dating was correlated with UAI but only important when adding associate and venture variables to the model.
A key strength of this study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This averted prejudice brought on by potential differences between men only dating online and those only dating offline, a weakness of several previous studies. Nova Scotia Cheap Prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a lot 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 correlated with UAI among HIV-negative guys, 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 behavior patterns within one group of guys. Cheap Prostitutes Near Me Green Oaks Nova Scotia. Nonetheless it might also represent lay 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 not as high-risk MSM today also make use of the Internet for dating.
For HIV-unaware men the impact of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It's hard to evaluate the real risk for HIV for these men: do they behave as HIV-negative guys who want to protect themselves from HIV infection, or as HIV positive guys trying to safeguard 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 analyzed HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI seem to be partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-unaware guys, 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 the HIV window period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as an extremely powerful method of avoiding 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.
Dating online may offer other opportunities for communicating on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may raise the weight of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should particularly 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 routine testing when sexually active.
New research should stay up-to-date when it comes to accelerated changing dating approaches as well as sero-adaptive behaviours (like 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 web-based dating has developed since then. Nevertheless these results are useful, as they demonstrate how net-based partner acquisition can lead to more information 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 immunodeficiency 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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