Characteristics 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 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 on-line ventures, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their online partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes near me Mactier. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less frequently reported with on-line partners.
In univariate analysis, UAI was significantly more likely to occur 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 strongly 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 classes, one for each HIV status. Among HIV positive men, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online compared 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 variants concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating place on UAI became somewhat more powerful (though not critical) 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 result of online dating on UAI became stronger (and important) for HIV-unaware 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 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 partnership (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 venture, and sex-related multiple drug use within partnership.
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. Mactier Ontario cheap prostitutes. Cheap Prostitutes in Mactier, Ontario. For HIV negative men 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). Only among men who indicated they weren't informed of their HIV status (a little 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 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 non significant; this suggests that differences in partnership variables between online and also offline partnerships are in charge of the increased UAI in online established partnerships. 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 men no effect of online dating on UAI was detected, either in univariate or in some of the multivariate models. Among HIV-unaware men, online dating was associated with UAI but just significant when adding partner and partnership variants to the model.
An integral 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 also offline casual partners. This prevented bias due to 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 largest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in guys sampled 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, largely 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 men. Cheap Prostitutes Near Me Macville Ontario. Yet it may also reflect 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 nowadays additionally use the Internet for dating.
For HIV-oblivious men the impact of dating place on UAI did not change by adding partner characteristics, but it increased 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 men that are attempting to shield themselves from HIV infection, or as HIV-positive men attempting to protect 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 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 examined HIV-positive. The study population included the MSM reported in this study 15
Because conclusions on UAI seem to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative men and HIV status-unaware guys, decisions 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 also the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very effective method of averting HIV transmission 22 Besides interventions to trigger 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.
Relationship online may offer other chances for communication on HIV status than dating in physical environments. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may raise the burden of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and arouse timely HIV testing (i.e., after hazard events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date when it comes to fast shifting dating strategies as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Nevertheless these results are useful, as they show how web-based partner acquisition can lead to more info on the sex partner, and this might 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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