Features of on-line and offline partners and ventures 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 often reported as known (61.4% vs. 49.4%; P 0.001), and in online partnerships, 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 near me Poplar Ridge. Participants more frequently reported multiple sexual contacts with online partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less frequently reported with online partners.
In univariate analysis, UAI was significantly more inclined to happen in online than in offline partnerships (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 result 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 partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and on-line 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 variables concerning sexual behavior in the partnership (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 men (aOR = 0.94 95 % CI 0.59-1.48). The result of online dating on UAI became more powerful (and critical) 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 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-connected 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. Poplar Ridge Alberta Cheap Prostitutes. Cheap prostitutes in Poplar Ridge Alberta. 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among guys who indicated they weren't informed 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 associates. When adjusting for partner features, the effect of online/offline dating on UAI among HIV positive MSM became somewhat smaller and became nonsignificant; this indicates that differences in partnership factors between online and offline partnerships are responsible for the increased UAI in online established partnerships. 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 guys no effect of online dating on UAI was observed, either in univariate or in any of the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only critical when adding partner and partnership variants to the model.
A key strength of the study was that it explored the relation between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. This averted prejudice due to potential differences between guys only dating online and those simply 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 comprise a lot of MSM, and prevent potential differences in men sampled through Internet or face-to-face interviewing, weaknesses in some previous studies 3 , 11
Online dating wasn't correlated with UAI among HIV negative guys, a finding in agreement with some previous studies, mainly among young men 21 , but in contrast with other studies 1 - 5 This may be due to the fact that most earlier studies compared sexual behaviour of two groups of MSM rather than comparing two sexual behavior patterns within one group of men. Cheap Prostitutes Near Me Prairie Echo Alberta. Nevertheless it may also reflect secular changes; perhaps 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 nowadays also make use of the Web for dating.
For HIV-oblivious men the effect of dating place on UAI didn't change by adding partner characteristics, but it increased when adding lifestyle and drug use. It's hard to evaluate the real risk for HIV for these men: do they behave as HIV negative men who want to protect themselves from HIV infection, or as HIV positive men 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 problematic 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 sensed HIV negative MSM were analyzed HIV positive. The study population comprised the MSM reported in this study 15
Because decisions on UAI appear to be partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is important. In HIV-negative guys and HIV status-oblivious guys, determinations 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. Thus serosorting can't be regarded as a very powerful method of preventing 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.
Dating online may offer other opportunities for communicating on HIV status than dating in physical surroundings. Facilitating more online HIV status disclosure during partner seeking makes serosorting easier. Nevertheless, serosorting may increase the load of other STI and will not 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 danger events or when experiencing symptoms of seroconversion illness) as well as regular testing when sexually active.
New research should stay up-to-date when it comes to accelerated shifting dating procedures and sero-adaptive behaviours (such as viral sorting and pre exposure prophylaxis). With every new way of dating and preventative opportunities, the rules of engagements will be different. Our data are 8years old and net-based dating has developed since then. Yet these results are useful, as they demonstrate how web-based partner acquisition can result in more info 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 immunodeficiency 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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