To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 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 characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted also for venture sexual risk behavior (i.e., sex-related drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating location 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-unaware guys. Cheap Prostitutes nearest Thaxted, Saskatchewan. 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 miss potentially important associations. As a fairly big number of statistical evaluations were done and reported, this strategy does lead to an increased danger of one or more false-positive associations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features 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 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). Participants more often reported multiple sexual contacts with online partners (50.9% vs. Cheap Prostitutes nearest Thaxted. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more prone to happen in online than in offline ventures (OR = 1.36 95 % CI 1.03-1.81) (Table 4 ). The self-perceived HIV status of the participant was firmly connected with UAI (OR = 11.70 95 % CI 7.40-18.45). The impact 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 different reference categories, one for each HIV status. Cheap Prostitutes in Saskatchewan. Among HIV-positive guys, UAI was more common in online when compared with offline ventures (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-oblivious men, 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 variants concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place 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 essential) for HIV-unaware 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 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 occurred in the partnership (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the partnership compared to only one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within partnership.
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 nearest Thaxted. For HIV negative men this lack 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). Cheap prostitutes closest to Thaxted. Just among guys who suggested they were not 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 often with on-line partners 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 offline partnerships are liable for the increased UAI in online established ventures. This may be due to 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 discovered, either in univariate or in any of the multivariate models. Among HIV-oblivious guys, online dating was connected with UAI but only critical when adding associate and partnership variants to the model.
An integral strength of this study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided bias brought on by potential differences between men just dating online and those simply dating offline, a weakness of several previous studies. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could contain 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 wasn't connected 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 behaviour patterns within one group of men. However it may also represent lay changes; possibly 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 also make use of the Internet for dating.
For HIV-oblivious guys the effect of dating place on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It's hard to assess the actual risk for HIV for these guys: do they behave as HIV-negative guys who are trying to shield themselves from HIV infection, or as HIV positive guys trying to safeguard 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 are HIV positive and participate in UAI with HIV-negative partners 12 Previously Matser et al. reported that 1.7% of the unaware and perceived HIV negative MSM were tested HIV-positive. The study population included 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 essential. In HIV-negative guys and HIV status-oblivious guys, judgements on UAI WOn't 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 also the HIV window phase during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Therefore serosorting can't be regarded as an extremely powerful way of averting 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 perceived HIV-negative concordant status are in order, irrespective of whether this concerns online or offline dating. Cheap Prostitutes near Thaxted Saskatchewan.
Dating online may offer other chances for communicating on HIV status than dating in physical environments. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Yet, serosorting may increase the load of other STI and will not prevent HIV infection entirely. Interventions to prevent HIV transmission should particularly be directed at HIV-negative and unaware MSM and excite timely HIV testing (i.e., after hazard occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up to date in regards to fast changing dating strategies and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventive chances, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. Cheap Prostitutes Near Me Tessier Saskatchewan. Cheap Prostitutes Near Me The Two Rivers Saskatchewan. Nevertheless these results are useful, as they demonstrate how internet-based partner acquisition can result in more information on the sex partner, and this might 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'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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