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 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 often 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 on-line partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes nearest Salem. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more likely 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 categories, one for each HIV status. Among HIV positive men, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was evident between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, 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 variants concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat stronger (though not significant) 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 more powerful (and important) for HIV-oblivious 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 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-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. Salem, Ontario Cheap Prostitutes. Cheap prostitutes near Salem, Ontario. For HIV negative guys this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive men there was a non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among guys who suggested they were not informed of their HIV status (a little group in this study), UAI was more common with online than offline partners.
Among HIV-positive guys, in univariate analysis UAI was reported significantly more frequently with on-line associates than with offline associates. When correcting for associate characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership variables between online and offline partnerships are accountable for the increased UAI in online established partnerships. This might 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 discovered, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only essential when adding partner and partnership variables to the model.
A key strength of this 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 avoided bias caused by potential differences between men only dating online and those simply dating offline, a weakness of several previous studies. Ontario Cheap Prostitutes. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't associated 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 reality 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 Sam Lake Ontario. Nonetheless it might also represent lay 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 today also use the Internet for dating.
For HIV-oblivious men the effect of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's difficult to assess the actual risk for HIV for these guys: do they behave as HIV-negative guys who want 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 guys who were never tested for HIV, profiled themselves online as being HIV-negative, which might be problematic 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 perceived HIV negative MSM were examined HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI seem to be partly based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-unaware men, determinations 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 the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as a very powerful way of avoiding 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 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 online HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the weight of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should especially be directed at HIV-negative and oblivious MSM and arouse timely HIV testing (i.e., after risk events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date in regards to fast shifting dating methods and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. Yet these results are useful, as they reveal how net-based partner acquisition can lead to more info on the sex partner, and this may 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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