Characteristics of on-line and offline partners and partnerships 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 understood (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 on-line partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes in Sainte-Marie-Madeleine. Participants more frequently reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less often reported with online partners.
In univariate analysis, UAI was significantly more prone to occur 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 strongly associated 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 types, one for each HIV status. Among HIV-positive men, UAI was more common in online in comparison to 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-unaware guys, 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 ), additionally including variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat more powerful (though not significant) for the HIV-positive guys (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 effect of online dating on UAI became stronger (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 connected 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 partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture 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 partnership.
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. Sainte-Marie-Madeleine, Quebec Cheap Prostitutes. Cheap Prostitutes near Sainte-Marie-Madeleine, 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among men who suggested they were not conscious of their HIV status (a little 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 frequently with on-line partners than with offline partners. When correcting for partner 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 variables between online and also offline partnerships are responsible for the increased UAI in online established partnerships. This may be due to 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 found, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was connected with UAI but only significant when adding associate and partnership variables to the model.
An integral 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 avoided prejudice due to potential differences between men just dating online and those only 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 include a lot of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in certain previous studies 3 , 11
Online dating was not associated 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 reality that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Cheap Prostitutes Near Me Sainte-Marie-Salomé Quebec. However it can also reflect lay changes; possibly 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 today additionally use the Web for dating.
For HIV-unaware guys the effect of dating place on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is hard to assess the real risk for HIV for these guys: do they behave as HIV negative men who want to protect 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 men who were never tested for HIV, profiled themselves online as being HIV-negative, which might be debatable if they're HIV-positive and participate in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were analyzed HIV-positive. The study population included the MSM reported in this study 15
Because determinations on UAI seem to be partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-unaware guys, conclusions 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 also the HIV window period during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting can't be regarded as a very successful method of preventing 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 sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nonetheless, serosorting may increase the weight of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should especially be directed at HIV negative and unaware 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 remain up to date when it comes to rapid shifting dating procedures as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, 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 reveal how internet-based partner acquisition can lead to more info 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'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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