Features of online 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 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 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). Backpage escorts nearest West Advocate. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated material use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more likely to happen 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 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 distinct reference classes, one for each HIV status. Among HIV positive men, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was evident between UAI and on-line ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online when compared with offline ventures, 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 venture (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat more powerful (though not critical) 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 result of online dating on UAI became stronger (and important) for HIV-oblivious guys (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 partnership compared to just one sex act). Other variables significantly associated with UAI were group sex within the partnership, 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. West Advocate Nova Scotia backpage escorts. Backpage Escorts closest to West Advocate, Nova Scotia. For HIV negative guys 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). Just 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 associates.
Among HIV positive men, in univariate analysis UAI was reported significantly more often with online partners than with offline associates. When correcting for partner features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this suggests that differences in partnership factors between online and offline partnerships are in charge of the increased UAI in online established partnerships. This could be because of a mediating effect of more information on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV negative guys no effect of online dating on UAI was observed, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was associated with UAI but just significant when adding associate and partnership variants to the model.
An integral strength of the study was that it explored the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This prevented prejudice due to potential differences between guys just dating online and those simply dating offline, a weakness of numerous previous studies. Nova Scotia backpage escorts. 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 sampled through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't 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 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. Backpage Escorts Near Me West Bay Nova Scotia. Nevertheless it may also reflect secular 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 make use of the Web for dating.
For HIV-oblivious guys the impact of dating location on UAI did not change by adding partner characteristics, but it increased when adding lifestyle and drug use. It is difficult to assess the actual risk for HIV for these men: do they act as HIV negative men that want to shield themselves from HIV infection, or as HIV positive men trying to protect 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 Previously Matser et al. reported that 1.7% of the unaware and perceived HIV negative MSM were analyzed HIV positive. The study population included the MSM reported in this study 15
Because determinations on UAI appear to be partly based on sensed HIV concordance, accurate knowledge of one's own and the partner's HIV status is very important. 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 also 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 people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. So serosorting cannot be regarded as an extremely successful way of preventing 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 chances for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. However, serosorting may increase the load of other STI and WOn't prevent HIV disease entirely. Interventions to prevent HIV transmission should notably be directed at HIV-negative and unaware MSM and excite timely HIV testing (i.e., after risk occasions or when experiencing symptoms of seroconversion illness) as well as routine testing when sexually active.
New research should remain up-to-date when it comes to fast altering dating approaches and sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With each new way of dating and preventative 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 internet-based partner acquisition can result in more information on the sex partner, and this may 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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