To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adapted the association between online/offline dating location and UAI for features of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adjusted additionally for partnership sexual risk behavior (i.e., sex-related drug use and sex frequency) and venture kind (i.e., casual or anonymous). As we assumed a differential effect of dating place for HIV positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was included in all three models by making a fresh six-category variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV-negative, HIV-positive, and HIV-oblivious guys. Cheap Prostitutes near me Saint-Louis-De-Terrebonne, Quebec. We performed a sensitivity analysis restricted to partnerships in which only one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to lose potentially important organizations. As a fairly big number of statistical evaluations were done and reported, this approach does lead to a higher risk of one or more false positive associations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features of online 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 often reported as known (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 online partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with online partners (50.9% vs. Cheap prostitutes nearby Saint-Louis-De-Terrebonne. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more inclined to happen 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 strongly correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect of dating location 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 types, one for each HIV status. Cheap Prostitutes nearest Quebec. 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 apparent between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online in comparison to 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 variables concerning sexual behavior in the partnership (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat stronger (though not critical) 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 more powerful (and important) 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 associated 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-connected 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. Cheap prostitutes near Saint-Louis-De-Terrebonne. For HIV-negative men this lack 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). Cheap prostitutes near me Saint-Louis-De-Terrebonne. Simply among guys who suggested they were not conscious of their HIV status (a small 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 frequently with online associates 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 implies that differences in partnership factors between online and offline partnerships are liable for the increased UAI in online established partnerships. This might be because of a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other variables. Among HIV negative guys no effect of online dating on UAI was found, either in univariate or in any of the multivariate models. Among HIV-unaware guys, online dating was associated with UAI but just essential when adding partner and venture variants to the model.
A vital 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 also offline casual partners. This avoided prejudice due to potential differences between guys only dating online and those just dating offline, a weakness of numerous previous studies. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could contain a large number of MSM, and avoid potential differences in men sampled through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not associated with UAI among HIV-negative guys, 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 reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behavior patterns within one group of guys. However it may also represent secular 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 now also utilize the Internet for dating.
For HIV-oblivious men the effect of dating location on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It's hard to assess the real risk for HIV for these guys: do they behave as HIV negative men that are trying to protect themselves from HIV infection, or as HIV-positive men trying 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 debatable 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 perceived 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 partly based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Hence serosorting can't be regarded as an extremely effective method of averting 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 sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating. Cheap prostitutes in Saint-Louis-De-Terrebonne, Quebec.
Dating online may offer other chances for communicating on HIV status than dating in physical environments. Easing more online HIV status disclosure during partner seeking makes serosorting easier. Yet, serosorting may increase the load of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should particularly be directed at HIV negative and oblivious MSM and stimulate 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 stay up to date when it comes to fast altering dating approaches as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of engagements will vary. Our data are 8years old and web-based dating has developed since then. Cheap Prostitutes Near Me Saint-Louis-De-Gonzague Quebec. Cheap Prostitutes Near Me Saint-Luc-De-Vincennes Quebec. However these results are useful, as they demonstrate how web-based partner acquisition may 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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