Characteristics 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 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 frequently 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 often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes near me Saint-Stanislas-De-Kostka. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with on-line partners.
In univariate analysis, UAI was significantly more inclined to happen in on-line 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 associated with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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 categories, one for each HIV status. Among HIV positive men, UAI was more common in online compared to offline partnerships (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 men, UAI was more common in online compared to offline partnerships, 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 behavior in the partnership (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating location on UAI became somewhat stronger (though not significant) for the HIV-positive men (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 effect of online dating on UAI became more powerful (and critical) for HIV-oblivious guys (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 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 occurred in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Other factors significantly associated with UAI were group sex within the venture, and sex-related 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. Saint-Stanislas-De-Kostka Quebec cheap prostitutes. Cheap Prostitutes in Saint-Stanislas-De-Kostka, Quebec. For HIV-negative men 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 indicated they weren't aware of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with on-line associates than with offline partners. When adjusting for partner 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 factors between online and also offline partnerships are in charge of the increased UAI in online established ventures. This could be because of a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV-negative guys no effect of online dating on UAI was detected, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was associated with UAI but just essential when adding associate and venture variants to the model.
A key strength of the study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted prejudice brought on by potential differences between men only dating online and those simply dating offline, a weakness of several previous studies. Quebec Cheap Prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could comprise a great number of MSM, and avoid potential differences in guys sampled through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not correlated with UAI among HIV-negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in contrast with other studies 1 - 5 This may be due to the reality that most earlier studies compared sexual behavior of two groups of MSM rather than comparing two sexual behaviour patterns within one group of guys. Cheap Prostitutes Near Me Saint-Sulpice Quebec. Nonetheless it can also reflect lay 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 nowadays additionally use the Web for dating.
For HIV-unaware guys the effect of dating location on UAI didn't change by adding partner characteristics, 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 guys that are trying to shield themselves from HIV infection, or as HIV positive guys attempting to shield 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 examined HIV positive. The study population included the MSM reported in this study 15
Because decisions on UAI appear to be partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV-negative guys and HIV status-oblivious guys, determinations on UAI will not 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 and the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as a very effective 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.
Dating online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may raise the weight 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 stimulate timely HIV testing (i.e., after risk events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date as it pertains to accelerated changing dating processes as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative chances, the rules of engagements will be different. Our data are 8years old and web-based dating has developed since then. However these results are useful, as they demonstrate how web-based partner acquisition can 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 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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