Features 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 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 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 Clarkson. Participants more frequently 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 often reported with online partners.
In univariate analysis, UAI was significantly more prone to happen in on-line than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was strongly correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating place 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 guys, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 ), additionally including variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (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 result of online dating on UAI became stronger (and important) for HIV-oblivious 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 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 occurred in the partnership (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 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 related to a higher danger of UAI than offline dating. Clarkson Ontario cheap prostitutes. Cheap prostitutes nearby Clarkson, 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 were not informed of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.
Among HIV-positive men, in univariate analysis UAI was reported significantly more often 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 non significant; this suggests that differences in partnership variables between online and offline partnerships are in charge of the increased UAI in online established ventures. This might be due to 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 observed, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but only important when adding associate and venture variants to the model.
An integral 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 brought on by potential differences between men only dating online and those just dating offline, a weakness of numerous previous studies. Ontario cheap prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could comprise a lot of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't connected with UAI among HIV negative men, a finding in agreement with some previous studies, mainly 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 behavior patterns within one group of guys. Cheap Prostitutes Near Me Clay Hills Ontario. Yet it could also represent 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 less high risk MSM today also utilize the Net for dating.
For HIV-oblivious men the effect of dating location on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It's hard to assess the actual risk for HIV for these men: do they act as HIV negative guys who are trying to shield 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 guys who were never tested for HIV, profiled themselves online as being HIV-negative, which might be debatable if they're HIV positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and sensed HIV-negative MSM were tested HIV positive. The study population comprised the MSM reported in this study 15
Because determinations 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 men and HIV status-oblivious men, conclusions on UAI WOn't 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 period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very powerful method of averting HIV transmission 22 Besides interventions to stimulate the uptake of HIV and STI testing in sexually active men, interventions to warn 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 communication on HIV status than dating in physical surroundings. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may raise the weight of other STI and WOn't prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and stimulate timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date when it comes to rapid shifting dating processes as well as sero-adaptive behaviours (like 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. However these results are useful, as they demonstrate how net-based partner acquisition can result in 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 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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