Characteristics of on-line and offline partners and ventures 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 often reported as known (61.4% vs. 49.4%; P 0.001), and in online ventures, 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 in Mount Young. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less frequently reported with internet partners.
In univariate analysis, UAI was significantly more prone to occur 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 firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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 categories, one for each HIV status. Among HIV-positive guys, 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 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 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 behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat stronger (though not essential) 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 effect of online dating on UAI became stronger (and critical) 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 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 venture 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 venture.
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 risk of UAI than offline dating. Mount Young Nova Scotia cheap prostitutes. Cheap Prostitutes near Mount Young Nova Scotia. For HIV-negative men 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). Only among guys who suggested they were not aware of their HIV status (a little group in this study), UAI was more common with online than offline associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more frequently with online associates than with offline associates. When adjusting for associate features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership variables between online and also offline partnerships are responsible for the increased UAI in online established ventures. This may be because of a mediating effect of more information 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 connected with UAI but only essential when adding associate and venture variables to the model.
An integral strength of the study was that it investigated 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 numerous previous studies. Nova Scotia 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 men tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not associated 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 due to the reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Cheap Prostitutes Near Me Mulgrave Nova Scotia. Nonetheless it could also reflect lay changes; possibly 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 nowadays additionally make use of the Web for dating.
For HIV-oblivious guys the impact of dating location on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's hard to evaluate the real risk for HIV for these guys: do they behave as HIV negative guys that are attempting to shield themselves from HIV infection, or as HIV positive men attempting to guard their HIV-negative partner from HIV infection? A study by Horvath et al. reported that 72% of guys 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 Previously Matser et al. reported that 1.7% of the oblivious and perceived HIV-negative MSM were tested HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partially based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. In HIV negative men and HIV status-oblivious guys, conclusions 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 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 caution 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 opportunities for communicating on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may raise the burden of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date as it pertains to fast changing dating approaches and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of engagements will be different. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they demonstrate how internet-based partner acquisition can result in 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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