Characteristics of online and offline partners and partnerships are revealed 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 online 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 often understood the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Cheap prostitutes nearest Murray Park. Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related material use, alcohol use, and group sex were less often reported with internet 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 associated 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 classes, one for each HIV status. Among HIV-positive guys, UAI was more common in online compared to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men 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 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 partnership (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat stronger (though not critical) for the HIV-positive men (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-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 also 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 venture (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 evidence that online dating was independently associated with a higher danger of UAI than offline dating. Murray Park, Manitoba Cheap Prostitutes. Cheap prostitutes nearby Murray Park Manitoba. 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). Only among guys who indicated they were not aware 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 associates than with offline associates. When adjusting 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 factors between online and also offline partnerships are responsible for the increased UAI in online established ventures. This might be due to 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 found, either in univariate or in the multivariate models. Among HIV-oblivious guys, online dating was correlated with UAI but only essential when adding partner and venture variants to the model.
An integral strength of the study was that it investigated the connection between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. This avoided prejudice due to potential differences between guys just dating online and those simply dating offline, a weakness of numerous previous studies. Manitoba cheap prostitutes. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could contain a great number of MSM, and prevent potential differences in men tried through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Online dating was not correlated 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. Cheap Prostitutes Near Me Napinka Manitoba. Nevertheless it might also represent lay 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 not as high risk MSM now additionally use the Internet for dating.
For HIV-unaware men the effect of dating place on UAI didn't change by adding partner features, but it improved when adding lifestyle and drug use. It is difficult to evaluate the actual risk for HIV for these guys: do they act as HIV negative men that want to protect themselves from HIV infection, or as HIV-positive men attempting to guard 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're HIV-positive and participate in UAI with HIV-negative partners 12 Previously 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 conclusions on UAI seem to be partly based on sensed HIV concordance, precise knowledge of one's own and the partner's HIV status is essential. In HIV-negative men and HIV status-oblivious guys, judgements on UAI will not only be based on perceived HIV status of the partner but in addition 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. Thus serosorting can't be regarded as an extremely successful way of preventing HIV transmission 22 Besides interventions to stimulate the uptake of HIV and STI testing in sexually active men, interventions to warn against UAI based on sensed HIV negative concordant status are in order, irrespective of whether this concerns online or offline dating.
Relationship online may offer other chances for communication on HIV status than dating in physical surroundings. Facilitating more on-line HIV status disclosure during partner seeking makes serosorting simpler. Nevertheless, serosorting may raise the burden of other STI and WOn't prevent HIV infection completely. Interventions to prevent HIV transmission should especially be directed at HIV negative and oblivious MSM and stimulate 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 as it pertains to accelerated changing dating approaches as well as sero-adaptive behaviours (like viral sorting and pre exposure prophylaxis). With every new way of dating and preventative chances, the rules of engagements will vary. Our data are 8years old and net-based dating has developed since then. Nevertheless these results are useful, as they reveal how web-based partner acquisition may 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 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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