Characteristics of online 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 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 frequently reported as understood (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 online partners more frequently understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes in Smeaton. 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 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 groups, one for each HIV status. Among HIV positive men, UAI was more common in online when compared with offline ventures (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-oblivious men, UAI was more common in online in comparison 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 variants concerning sexual behavior in the partnership (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 effect 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 likewise 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 occurred in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to just one sex act). Other factors significantly associated with UAI were group sex within the partnership, 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 associated with a higher danger of UAI than offline dating. Smeaton Saskatchewan Cheap Prostitutes. Cheap Prostitutes closest to Smeaton Saskatchewan. For HIV negative guys 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). Just among guys who indicated 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 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 nonsignificant; 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 may be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other factors. Among HIV negative men no effect of online dating on UAI was found, either in univariate or in some of 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 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 brought on by potential differences between men just dating online and those only dating offline, a weakness of numerous previous studies. Saskatchewan cheap prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a great number of MSM, and avoid potential differences in men sampled through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Online dating was not associated with UAI among HIV-negative guys, a finding in agreement with some previous studies, largely 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 behaviour patterns within one group of guys. Cheap Prostitutes Near Me Smiley Saskatchewan. However it could 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 today additionally use the Web for dating.
For HIV-unaware guys the effect of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is hard to evaluate the real risk for HIV for these men: do they behave as HIV-negative guys that are attempting to protect themselves from HIV infection, or as HIV-positive guys attempting to guard 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 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 examined HIV-positive. The study population comprised the MSM reported in this study 15
Because conclusions on UAI seem to be partially based on sensed HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-oblivious guys, judgements on UAI WOn't 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 phase during which individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as an extremely successful way of avoiding 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.
Dating online may offer other chances for communicating on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may raise the weight of other STI and will not prevent HIV infection completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and oblivious MSM and excite timely HIV testing (i.e., after risk 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 accelerated shifting dating methods and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With each 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 demonstrate how net-based partner acquisition can result in more info on the sex partner, and this may affect 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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