Characteristics of on-line and offline partners and ventures are shown 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 frequently 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 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 nearby Bothwell. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less often reported with internet 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 firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The result of dating location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization 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 men no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 ), also including variables concerning sexual behavior in the partnership (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating location on UAI became somewhat more powerful (though not critical) 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 effect of online dating on UAI became more powerful (and essential) 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 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 partnership compared to only 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 associated with a higher danger of UAI than offline dating. Bothwell, Prince Edward Island Cheap Prostitutes. Cheap prostitutes nearby Bothwell Prince Edward Island. 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). Only 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 frequently with online partners than with offline partners. When adjusting for partner characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became non-significant; this indicates that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established ventures. This might be because of a mediating effect of more information 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 some of the multivariate models. Among HIV-oblivious men, online dating was connected with UAI but only significant when adding associate and partnership variables to the model.
An integral 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 also offline casual partners. This prevented prejudice brought on by potential differences between men only dating online and those simply dating offline, a weakness of numerous previous studies. Prince Edward Island Cheap Prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a great number of MSM, and avoid potential differences in guys tried through Internet or face to face interviewing, weaknesses in a few previous studies 3 , 11
Online dating was not associated with UAI among HIV-negative men, a finding in agreement with some previous studies, mainly among young men 21 , but in comparison 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 guys. Cheap Prostitutes Near Me Brackley Prince Edward Island. Nevertheless it may also reflect lay changes; maybe 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 nowadays also use the Web for dating.
For HIV-oblivious men the impact of dating place on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these guys: do they behave as HIV negative guys who are attempting to protect 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 problematic if they are HIV positive and engage in UAI with HIV negative partners 12 Formerly 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 decisions on UAI appear to be partially based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. In HIV negative guys and HIV status-oblivious men, conclusions on UAI WOn't 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting can't be regarded as an extremely successful method 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.
Relationship online may offer other chances for communication on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the burden 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 spark timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date in regards to rapid altering 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 change. 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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