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 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 on-line partners was more frequently reported as known (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 understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap Prostitutes in Garden Plain. Participants more often reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with internet partners.
In univariate analysis, UAI was significantly more likely 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 strongly correlated 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 organization of online dating using three distinct reference types, one for each HIV status. Among HIV positive guys, UAI was more common in online in comparison to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was evident between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware 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 behaviour in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating place on UAI became somewhat more powerful (though not essential) 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 effect of online dating on UAI became stronger (and critical) 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 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 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 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 danger of UAI than offline dating. Garden Plain Alberta Cheap Prostitutes. Cheap Prostitutes nearest Garden Plain Alberta. For HIV-negative guys this lack 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). Only among guys who suggested they were not conscious of their HIV status (a small 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 adjusting for partner features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became non significant; this implies that differences in partnership variables between online and offline partnerships are responsible for 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 factors. Among HIV negative guys no effect of online dating on UAI was detected, either in univariate or in any of the multivariate models. Among HIV-oblivious men, online dating was connected with UAI but just 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 offline casual partners. This avoided prejudice caused by potential differences between men just dating online and those just dating offline, a weakness of several previous studies. Alberta Cheap Prostitutes. By recruiting participants at the biggest STI outpatient clinic in the Netherlands we could include a high number of MSM, and avoid potential differences in men tried through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not connected with UAI among HIV negative men, 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 behavior patterns within one group of guys. Cheap Prostitutes Near Me Gardenview Alberta. Nevertheless it may also represent secular changes; maybe in the beginning of online dating a more high-risk group of guys used the Internet, and over time online dating normalized and less high-risk MSM now also make use of the Internet for dating.
For HIV-unaware guys the impact of dating location on UAI didn't change by adding partner characteristics, but it improved when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these men: do they act as HIV-negative men that are attempting to protect 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 guys 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 Formerly Matser et al. reported that 1.7% of the unaware and perceived HIV-negative MSM were analyzed HIV positive. The study population comprised the MSM reported in this study 15
Because determinations on UAI seem to be partly based on perceived HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV negative men and HIV status-unaware men, judgements 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 individuals can transmit HIV but cannot be diagnosed with the commonly used HIV tests. Thus serosorting can't be regarded as an extremely powerful 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 sensed 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 environments. Easing more online HIV status disclosure during partner seeking makes serosorting simpler. Yet, 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 hazard occasions or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up to date in regards to fast changing dating procedures as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventive opportunities, the rules of battles will change. Our data are 8years old and net-based dating has developed since then. 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 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 immunodeficiency 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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