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 online 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 frequently reported as understood (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 online partners more often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes nearest Farmington. Participants more frequently 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 often 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 association of online dating using three different reference types, one for each HIV status. Among HIV positive men, 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 internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online when compared with 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 variables concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat stronger (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 result of online dating on UAI became stronger (and important) 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 likewise 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 occurred in the venture (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-connected multiple drug use within venture.
In this large study among MSM attending the STI clinic in Amsterdam, we found no evidence that online dating was independently associated with a higher risk of UAI than offline dating. Farmington, Ontario cheap prostitutes. Cheap Prostitutes nearest Farmington, 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 non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among men who suggested they weren't informed of their HIV status (a small group in this study), UAI was more common with online than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with online associates than with offline partners. When correcting for partner features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership factors between online and also offline partnerships are liable for the increased UAI in online established ventures. This might be because of a mediating effect of more info on associates, (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 any of the multivariate models. Among HIV-unaware men, online dating was connected with UAI but just important when adding partner and venture variants to the model.
A vital strength of this 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 prevented prejudice caused by potential differences between guys just dating online and those simply dating offline, a weakness of numerous previous studies. Ontario cheap prostitutes. By recruiting participants at the greatest 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 men, a finding in agreement with some previous studies, largely among young men 21 , but in comparison 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 Farnham Ontario. Yet it could also reflect secular changes; maybe in the beginning of online dating a more high risk group of men used the Internet, and over time online dating normalized and not as high-risk MSM now additionally use the Web for dating.
For HIV-oblivious guys the impact of dating location on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's difficult to evaluate the real risk for HIV for these guys: do they behave as HIV-negative guys who are attempting to shield themselves from HIV infection, or as HIV positive men trying to protect 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 are HIV positive and engage in UAI with HIV negative partners 12 Previously Matser et al. reported that 1.7% of the oblivious and sensed HIV negative MSM were examined HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV negative guys and HIV status-unaware men, decisions 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 also the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting cannot be regarded as an extremely effective way of averting 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 chances for communication on HIV status than dating in physical surroundings. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. However, 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 events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date as it pertains to rapid changing dating approaches as well as 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 internet-based dating has developed since then. Nevertheless these results are useful, as they demonstrate how web-based partner acquisition can lead to more info 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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