To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the organization between online/offline dating place 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 features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted additionally for partnership sexual risk behavior (i.e., sex-associated drug use and sex frequency) and partnership kind (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 location 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 separately for HIV-negative, HIV-positive, and HIV-oblivious guys. Cheap prostitutes in Erith, Alberta. We performed a sensitivity analysis restricted to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to lose potentially important organizations. As a fairly large number of statistical tests were done and reported, this strategy does lead to an increased danger of one or more false-positive associations. Analyses were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Features 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 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 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 knew 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 internet partners (50.9% vs. Cheap Prostitutes near Erith. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with on-line 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 effect 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 types, one for each HIV status. Cheap Prostitutes nearby Alberta. Among HIV positive men, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious men, UAI was more common in online compared to 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 variables concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place 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 guys (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became more powerful (and important) for HIV-oblivious 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 happened 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 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. Cheap prostitutes near me Erith. 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). Cheap Prostitutes closest to Erith. Simply among men who indicated they were not aware of their HIV status (a small group in this study), UAI was more common with online than offline partners.
Among HIV positive men, in univariate analysis UAI was reported significantly more often 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 indicates that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established ventures. This may be due to a mediating effect of more info on partners, (including perceived HIV status) on UAI, or to other variables. Among HIV-negative guys no effect of online dating on UAI was detected, either in univariate or in the multivariate models. Among HIV-oblivious men, online dating was associated with UAI but only significant when adding partner and partnership variables to the model.
An integral strength of the study was that it investigated the relationship between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This avoided bias caused by potential differences between men only dating online and those simply dating offline, a weakness of numerous previous studies. 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 men, a finding in agreement with some previous studies, largely among young men 21 , but in contrast with other studies 1 - 5 This may be because of 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. Nonetheless it might 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 today also use the Net for dating.
For HIV-unaware guys the impact of dating location on UAI didn't change by adding partner features, but it increased when adding lifestyle and drug use. It is hard to evaluate the real risk for HIV for these guys: do they behave as HIV-negative guys that are attempting to protect themselves from HIV infection, or as HIV-positive men 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 problematic if they are HIV-positive and engage in UAI with HIV-negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV-negative MSM were examined HIV positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI appear to be partially based on perceived HIV concordance, exact knowledge of one's own and the partner's HIV status is important. In HIV-negative men and HIV status-oblivious men, determinations 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 period during which people can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Consequently serosorting cannot be regarded as an extremely successful way of avoiding HIV transmission 22 Besides interventions to trigger 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 Erith Alberta.
Dating online may offer other opportunities for communication on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting simpler. However, serosorting may increase the weight of other STI and WOn't prevent HIV disease completely. Interventions to prevent HIV transmission should notably be directed at HIV negative and oblivious MSM and stimulate timely HIV testing (i.e., after hazard 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 rapid altering dating approaches as well as sero-adaptive behaviours (like 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. Cheap Prostitutes Near Me Erin Lodge Alberta. Cheap Prostitutes Near Me Ervick Alberta. However these results are useful, as they show how web-based partner acquisition can lead to more info on the sex partner, and this may 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 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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