Features of online 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 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 on-line 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 in Barrie. 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 firmly 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 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 partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys 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 compared 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 venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat more powerful (though not significant) for the HIV-positive guys (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV-negative guys (aOR = 0.94 95 % CI 0.59-1.48). The effect of online dating on UAI became stronger (and critical) for HIV-unaware 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 also 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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to only 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 associated with a higher danger of UAI than offline dating. Barrie Ontario Cheap Prostitutes. Cheap prostitutes near me Barrie Ontario. For HIV-negative guys 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). Simply among men who indicated 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 frequently with on-line partners than with offline associates. When correcting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership factors between online and offline partnerships are responsible for the increased UAI in online established partnerships. This could be due to a mediating effect of more info 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-oblivious guys, online dating was connected with UAI but only important when adding associate and partnership variants to the model.
An integral 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 avoided prejudice due to potential differences between guys only dating online and those simply dating offline, a weakness of numerous previous studies. Ontario cheap prostitutes. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and prevent potential differences in men sampled 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 because of the fact that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Cheap Prostitutes Near Me Barwick Ontario. Yet it may also reflect secular 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 nowadays additionally utilize the Internet for dating.
For HIV-unaware men the impact of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is difficult to assess the actual risk for HIV for these men: do they act as HIV negative men who are trying to shield themselves from HIV infection, or as HIV-positive guys trying 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 are HIV-positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV-negative MSM were examined HIV positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI seem to be partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV negative men and HIV status-unaware guys, 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 and the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't be regarded as an extremely effective way of avoiding 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 environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may increase the weight of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and oblivious MSM and stimulate 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 remain up-to-date as it pertains to fast shifting dating strategies and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventive opportunities, the rules of engagements will vary. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they reveal how internet-based partner acquisition may lead to more info on the sex partner, and this might 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 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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