An integral strength of the study was that it explored the connection between online dating and UAI among MSM who had recent sexual contact with both online and also offline casual partners. Backpage Escorts in Kew VIC. This prevented prejudice due to potential differences between guys just dating online and those just dating offline, a weakness of numerous previous studies. 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
Among HIV-positive men, in univariate analysis UAI was reported significantly more frequently with online associates than with offline associates. When correcting for associate features, 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 variables between online and also offline partnerships are responsible for the increased UAI in online established partnerships. This may be due to a mediating effect of more info 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 some of the multivariate models. Among HIV-unaware men, online dating was associated with UAI but just critical when adding partner and partnership variants to the model.
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. 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 suggested they were not conscious of their HIV status (a little group in this study), UAI was more common with online than offline partners.
The amount 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). Kew backpage escorts. UAI was significantly more likely if more sex acts had happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to just one sex act). Kew VIC backpage escorts. Other factors significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within venture.
In multivariate model 3 (Tables 4 and 5 ), also including variants concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (though not significant) 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 essential) for HIV-unaware guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
In univariate analysis, UAI was significantly more prone to happen in on-line than in offline partnerships (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 impact of dating place 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 guys, UAI was more common in online compared to offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was apparent between UAI and online partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online compared to offline ventures, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
Characteristics of online 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 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 understood 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 online partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with online partners.
To be able to analyze the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three variant models. In version 1, we adapted the organization between online/offline dating location 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 venture features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted also for partnership sexual risk behaviour (i.e., sex-related drug use and sex frequency) and partnership sort (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 contained in all three models by making a brand new six-class variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV-negative, HIV-positive, and HIV-oblivious guys. We performed a sensitivity analysis limited to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. Kew Victoria, Australia backpage escorts. No adjustments for multiple comparisons were made, in order not to miss potentially significant associations. As a rather large number of statistical tests were done and reported, this approach does lead to a heightened danger of one or more false-positive associations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Prior to the investigations we developed a directed acyclic graph (DAG) representing a causal model of UAI. In this model some variables were putative causes (self-reported HIV status; on-line partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. of male sex partners in preceding 6months), and some were assumed to be on the causal pathway between the principal exposure of interest and result (age difference between participant and partner; ethnic concordance; concordance in life styles; HIV concordance; venture type; sex frequency within venture; group sex with partner; sex-related substance use in venture).
We compared characteristics of participants by self-reported HIV status (using 2-evaluations for dichotomous and categorical variables and using rank sum test for continuous variables). Backpage Escorts Near Me Camberwell Victoria. We compared characteristics of participants, partners, and partnership sexual behavior by on-line or offline partnership, and computed P values predicated on logistic regression with robust standard errors, accounting for related data. Continuous variables (i.e., age, number of sex partners) are reported as medians with an interquartile range (IQR), and were categorised for inclusion in multivariate models. Random effects logistic regression models were used to examine the association between dating place (online versus offline) and UAI. Odds ratio tests were used to measure the importance of a variable in a model.
In order to explore potential disclosure of HIV status we additionally asked the participant whether the casual sex partner understood the HIV status of the participant, together with the response choices: (1) no, (2) maybe, (3) yes. Sexual conduct with each partner was dichotomised as: (1) no anal intercourse or merely protected anal intercourse, and (2) unprotected anal intercourse. Backpage Escorts Near Me Carina Victoria. To ascertain the subculture, we asked whether the participant characterised himself or his partners as belonging to one or more of the following subcultures/lifestyles: casual, formal, alternate, drag, leather, military, sports, trendy, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if none of these characteristics were applicable, other. Concordant lifestyle was categorised as: (1) concordant; (2) discordant. Accidental partner sort was categorised by the participants into (1) known traceable and (2) anonymous partners.
HIV status of the participant was got by asking the question 'Do you know whether you're HIV infected?', with five response options: (1) I am definitely not HIV-contaminated; (2) I think that I am not HIV-infected; (3) I do not know; (4) I believe I may be HIV-contaminated; (5) I know for sure that I 'm HIV-infected. Kew VIC Australia Backpage Escorts. We categorised this into HIV negative (1,2), unknown (3), and HIV positive (4,5) status. The questionnaire enquired about the HIV status of each sex partner with all the question: 'Do you understand whether this partner is HIV-contaminated?' with similar answer options as above. Perceived concordance in HIV status within partnerships was categorised as; (1) concordant; (2) discordant; (3) unknown. The final class represents all partnerships where the participant did not know his own status, or the status of his partner, or both. In this study the HIV status of the participant is self-reported and self-perceived. The HIV status of the sexual partner is as perceived by the participant.
Participants completed a standardised anonymous questionnaire during their visit to the STI outpatient clinic while waiting for preliminary evaluation results after their consultation with a nurse or doctor. The questionnaire elicited information on socio-demographics and HIV status of the participant, the three most recent partners in the preceding six months, and information on sexual behaviour with those partners. Backpage Escorts near Kew VIC Australia. A comprehensive description of the study design as well as the survey is provided elsewhere 15 , 18 Our chief determinant of interest, dating location (e.g., the name of a bar, park, club, or the name of a site) was obtained for every partner, and categorised into online (websites), and offline (physical sites) dating locations. To simplify the terminology of distinguishing the partners per dating location, we refer to them as on-line or offline partners.
We used data from a cross sectional study focusing on spread of STI via sexual networks 15 Between July 2008 and August 2009 MSM were recruited from the STI outpatient clinic of the Public Health Service of Amsterdam, the Netherlands. Men were eligible for participation if they reported sexual contact with men during the six months preceding the STI consultation, they were at least 18years old, and could comprehend written Dutch or English. Individuals could participate more than once, if following visits to the practice were related to a possible new STI episode. Participants were routinely screened for STI/HIV according to the standard procedures of the STI outpatient clinic 15 , 17 The study was accepted by the medical ethics committee of the Academic Medical Center of Amsterdam (MEC 07/181), and written informed consent was obtained from each participant. Included in this evaluation were men who reported sexual contact with at least one casual partner dated online as well one casual partner dated offline.
With increased familiarity in sexual partnerships, for example by concordant ethnicity, age, lifestyle, HIV status, and increasing sex frequency, the odds for UAI increase as well 14 - 16 We compared the occurrence of UAI in online acquired casual partnerships to that in offline got casual partnerships among MSM who reported both online and offline casual partners in the preceding six months. We hypothesised that MSM who date sex partners both online and offline, report more UAI with the casual partners they date on the internet, and that this effect is partially clarified through better knowledge of partner features, including HIV status.
A meta-evaluation in 2006 found limited evidence that acquiring a sex partner online increases the risk of unprotected anal intercourse (UAI) 3 Many previous studies compared men with online partners to guys with offline partners. However, men preferring online dating might differ in several unmeasured regards from guys preferring offline dating, leading to incomparable behavioural profiles. A more recent meta-analysis contained several studies analyzing MSM with both online and also offline acquired sex partners and found evidence for an association between UAI and on-line partners, which might suggest a mediating effect of more info on partners, (including perceived HIV status) on UAI 13
Men who have sex with men (MSM) frequently make use of the Web to find sex partners. Backpage Escorts near Victoria. Several research have revealed that MSM are more likely to engage in unprotected anal intercourse with sex partners they meet through the Internet (on-line) than with partners they meet at social places (offline) 1 - 3 This indicates that guys who acquire partners online may be at a higher risk for sexually transmitted infections (STI) and HIV 4 - 6 Although higher rates of UAI are reported with internet partners, the risk of HIV transmission also depends upon precise knowledge of one's own and the sex partners' HIV status 7 - 10