Features of on-line and offline partners and ventures 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 on-line partnerships, 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 Aston-Jonction. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more likely to happen in online than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly 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 organization of online dating using three distinct reference classes, one for each HIV status. Among HIV positive guys, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative guys no association was apparent between UAI and internet partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, 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 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 stronger (though not significant) 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 significant) for HIV-unaware men (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
The amount 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 happened 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 partnership, 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. Aston-Jonction Quebec cheap prostitutes. Cheap prostitutes closest to Aston-Jonction Quebec. 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). Simply among guys who suggested they weren't conscious of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
Among HIV positive guys, in univariate analysis UAI was reported significantly more often with online partners than with offline partners. When adjusting for associate 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 offline partnerships are accountable for 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 found, either in univariate or in the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but only critical when adding partner and venture variants to the model.
A key strength of this study was that it explored the relation 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 men just dating online and those only dating offline, a weakness of numerous previous studies. Quebec 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 guys tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not correlated with UAI among HIV-negative men, a finding in agreement with some previous studies, mostly among young men 21 , but in contrast with other studies 1 - 5 This may be due to the fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Cheap Prostitutes Near Me Audet Quebec. Nevertheless it could also represent secular changes; perhaps in the beginning of online dating a more high-risk group of men used the Internet, and over time online dating normalized and less high-risk MSM today also use the Web for dating.
For HIV-oblivious guys the effect of dating location on UAI didn't change by adding partner features, but it improved 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 men who want to shield themselves from HIV infection, or as HIV-positive guys attempting to guard 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 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 unaware and sensed HIV negative MSM were tested HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is very important. In HIV negative guys and HIV status-oblivious guys, 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 as well as the HIV window phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as an extremely powerful method 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other opportunities for communicating on HIV status than dating in physical environments. Easing more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may increase the load of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and spark 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 remain up to date when it comes to fast altering dating processes as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they reveal how web-based partner acquisition can lead to more information on the sex partner, and this might affect 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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