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 online partners was more often 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 knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes closest to Farnham. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more inclined to happen in on-line 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 association of online dating using three distinct reference groups, 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 on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware 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 variables concerning sexual behavior in the venture (sex-related multiple drug use, sex frequency and partner kind), the separate effect of online dating location on UAI became somewhat stronger (though not essential) 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 result of online dating on UAI became stronger (and essential) 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 happened in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the partnership, 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 related to a higher danger of UAI than offline dating. Farnham Quebec cheap prostitutes. Cheap prostitutes nearest Farnham, 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). Only among men who suggested they were not informed of their HIV status (a little group in this study), UAI was more common with on-line than offline associates.
Among HIV positive guys, in univariate analysis UAI was reported significantly more often with on-line associates 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 nonsignificant; this implies that differences in partnership factors between online and also offline partnerships are responsible for the increased UAI in online established ventures. This may be due to a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other factors. 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-unaware men, online dating was correlated with UAI but just essential when adding partner and venture variables to the model.
An integral strength of the 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 men just dating online and those only dating offline, a weakness of numerous previous studies. Quebec Cheap Prostitutes. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a high number of MSM, and avoid potential differences in guys sampled through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Online dating wasn't connected 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 due to the fact that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of men. Cheap Prostitutes Near Me Fassett Quebec. However it may also represent 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 additionally make use of the Net for dating.
For HIV-oblivious guys 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 real risk for HIV for these guys: do they act as HIV-negative men who want to shield themselves from HIV infection, or as HIV-positive men attempting to guard 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 oblivious and sensed HIV-negative MSM were analyzed HIV positive. The study population included the MSM reported in this study 15
Because conclusions on UAI appear to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is essential. 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 as well as the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting cannot be regarded as a very successful method of avoiding HIV transmission 22 Besides interventions to stimulate 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. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may increase the load of other STI and will not prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and unaware MSM and spark timely HIV testing (i.e., after danger events or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should stay up to date when it comes to accelerated altering dating procedures as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of battles will be different. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they show how web-based partner acquisition can lead to more information on the sex partner, and this may 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'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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