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 online partners was more often reported as known (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 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 near Repentigny. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less frequently 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 associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The result 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 groups, 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 men no association was evident between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, 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 ), also including variables concerning sexual behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), 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 result of online dating on UAI became more powerful (and significant) for HIV-oblivious 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 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 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 variables 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 signs that online dating was independently related to a higher danger of UAI than offline dating. Repentigny Quebec cheap prostitutes. Cheap Prostitutes near Repentigny, 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 guys who indicated they were not aware of their HIV status (a small 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 often with on-line partners than with offline associates. When adjusting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became non significant; this implies that differences in partnership variables between online and offline partnerships are liable for the increased UAI in online established partnerships. This could be because of a mediating effect of more info on associates, (including perceived HIV status) on UAI, or to other variables. Among HIV negative guys no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was associated with UAI but only essential when adding partner and venture variables to the model.
An integral strength of the study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and 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. Quebec Cheap Prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could comprise a large 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 wasn't 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 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 guys. Cheap Prostitutes Near Me Restigouche Quebec. Yet it can 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 not as high risk MSM today additionally utilize the Internet for dating.
For HIV-unaware guys the impact of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these men: do they act as HIV-negative men who are trying to shield themselves from HIV infection, or as HIV-positive guys trying 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 are HIV-positive and participate in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the oblivious and perceived HIV-negative MSM were tested HIV positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI appear to be partially based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV negative men and HIV status-oblivious guys, judgements 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 as well as the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting can't be regarded as an extremely successful way of averting 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 perceived HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communicating on HIV status than dating in physical environments. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting easier. Yet, 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 oblivious MSM and excite timely HIV testing (i.e., after danger occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should remain up to date in regards to rapid shifting dating approaches as well as sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of engagements will vary. Our data are 8years old and web-based dating has developed since then. Yet these results are useful, as they demonstrate how internet-based partner acquisition may lead to more information 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 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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