Characteristics of on-line and offline partners and ventures 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 often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes nearest Maxstone. 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 frequently reported with internet partners.
In univariate analysis, UAI was significantly more likely to occur 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 strongly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The result of dating location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three different reference classes, one for each HIV status. Among HIV-positive guys, 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 on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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 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 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 result of online dating on UAI became more powerful (and critical) for HIV-oblivious 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 venture (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 associated with a higher risk of UAI than offline dating. Maxstone, Saskatchewan cheap prostitutes. Cheap Prostitutes closest to Maxstone, Saskatchewan. For HIV negative men this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive men there was a non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Simply among guys who suggested they weren't informed 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 online associates than with offline associates. When correcting for associate characteristics, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became non-significant; this indicates that differences in partnership variables between online and also offline partnerships are accountable for the increased UAI in online established ventures. This could be due to a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-unaware men, online dating was associated with UAI but just significant when adding partner and partnership variables to the model.
A key strength of this study was that it explored the relation 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 guys just dating online and those just dating offline, a weakness of numerous previous studies. Saskatchewan cheap prostitutes. By recruiting participants at the largest STI outpatient clinic in the Netherlands we could include a lot of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't correlated 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 fact 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 Mayberry Saskatchewan. However it could also represent lay changes; perhaps 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 nowadays additionally utilize the Web for dating.
For HIV-unaware guys the effect of dating location on UAI did not change by adding partner features, but it increased when adding lifestyle and drug use. It's hard to evaluate the actual risk for HIV for these guys: do they behave as HIV-negative guys who want to shield themselves from HIV infection, or as HIV-positive men attempting to protect 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 Previously Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were analyzed HIV-positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI seem to be partly based on perceived HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. 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 in addition 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. Hence serosorting cannot be regarded as an extremely successful way of averting 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 environments. Easing more online HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may raise the weight of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and oblivious MSM and spark timely HIV testing (i.e., after danger events 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 fast changing dating processes and 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 change. Our data are 8years old and web-based dating has developed since then. Nevertheless these results are useful, as they show how web-based partner acquisition can result in more info on the sex partner, and this might influence 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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