A vital strength of this 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. Cheap hookers near Windsor VIC. This avoided prejudice due to potential differences between men just dating online and those simply dating offline, a weakness of several previous studies. By recruiting participants at the greatest STI outpatient clinic in the Netherlands we could include a great number of MSM, and avoid potential differences in men tried through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Among HIV-positive guys, in univariate analysis UAI was reported significantly more frequently with on-line partners 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 nonsignificant; this suggests that differences in partnership variables between online and also offline partnerships are responsible for the increased UAI in online established partnerships. This may be because of a mediating effect of more information on associates, (including perceived HIV status) on UAI, or to other factors. Among HIV-negative men no effect of online dating on UAI was discovered, either in univariate or in the multivariate models. Among HIV-unaware guys, 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 evidence that online dating was independently related to a higher risk of UAI than offline dating. For HIV negative men this dearth of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV-positive men there was a non-significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Only among guys who indicated they weren't informed of their HIV status (a little group in this study), UAI was more common with on-line than offline associates.
The number 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). Windsor Cheap Hookers. 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 partnership compared to just one sex act). Windsor VIC cheap hookers. Other variables significantly associated with UAI were group sex within the partnership, and sex-related multiple drug use within venture.
In multivariate model 3 (Tables 4 and 5 ), additionally including variants concerning sexual behaviour in the venture (sex-related multiple drug use, sex frequency and partner type), the separate effect of online dating place 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 effect of online dating on UAI became stronger (and significant) 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 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 correlated with UAI (OR = 11.70 95 % CI 7.40-18.45). The effect 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 different reference groups, one for each HIV status. Among HIV-positive men, UAI was more common in online when compared with offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys no association was apparent between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious 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).
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 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 often 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. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with on-line partners.
In order to examine the possible 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 location and UAI for characteristics 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 adjusted also for venture sexual risk behaviour (i.e., sex-related 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-class variable. For clarity, the effects of online/offline dating on UAI are also presented individually for HIV negative, HIV-positive, and HIV-unaware men. We performed a sensitivity analysis confined to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. Windsor Victoria, Australia cheap hookers. No adjustments for multiple comparisons were made, in order not to miss potentially significant associations. As a rather big number of statistical evaluations were done and reported, this approach does lead to an elevated danger of one or more false-positive organizations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Before the investigations we developed a directed acyclic graph (DAG) representing a causal model of UAI. In this model some variants were putative causes (self-reported HIV status; online partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. of male sex partners in preceding 6months), and some were presumed to be on the causal pathway between the primary exposure of interest and result (age difference between participant and partner; ethnic concordance; concordance in life styles; HIV concordance; partnership kind; sex frequency within partnership; group sex with partner; sex-associated material use in venture).
We compared characteristics of participants by self-reported HIV status (using 2-tests for dichotomous and categorical variables and using rank sum test for continuous variables). Cheap Hookers Near Me Narre Warren Victoria. We compared features of participants, partners, and venture sexual behavior by online or offline partnership, and calculated P values predicated on logistic regression with robust standard errors, accounting for linked data. Continuous variables (i.e., age, amount 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 evaluate the value of a variable in a model.
To be able to investigate 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 answer choices: (1) no, (2) maybe, (3) yes. Sexual conduct with each partner was dichotomised as: (1) no anal intercourse or just protected anal intercourse, and (2) unprotected anal intercourse. Cheap Hookers Near Me St Kilda Victoria. To determine the subculture, we asked whether the participant characterised himself or his partners as belonging to at least one of the following subcultures/lifestyles: casual, formal, alternative, drag, leather, military, sports, fashionable, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if not one of these characteristics were related, other. Concordant lifestyle was categorised as: (1) concordant; (2) discordant. Chance partner kind 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 answer alternatives: (1) I am certainly not HIV-infected; (2) I believe that I am not HIV-infected; (3) I don't know; (4) I believe I may be HIV-contaminated; (5) I know for sure that I am HIV-contaminated. Windsor VIC Australia Cheap Hookers. 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 the question: 'Do you understand whether this partner is HIV-contaminated?' with similar response options as above. Perceived concordance in HIV status within partnerships was categorised as; (1) concordant; (2) discordant; (3) unknown. The final category represents all partnerships where the participant didn't understand 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 throughout their visit to the STI outpatient clinic while waiting for preliminary evaluation results after their consultation using 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. Cheap Hookers nearest Windsor, VIC Australia. A comprehensive description of the study design and the survey is provided elsewhere 15 , 18 Our chief determinant of interest, dating location (e.g., the name of a pub, park, club, or the name of a web site) was obtained for every partner, and categorised into on-line (websites), and offline (physical sites) dating places. To simplify the language of recognizing the partners per dating place, we refer to them as online 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 may comprehend written Dutch or English. People could participate more than once, if following visits to the clinic were related to a possible new STI episode. Participants were regularly screened for STI/HIV according to the standard procedures of the STI outpatient clinic 15 , 17 The study was approved by the medical ethics committee of the Academic Medical Center of Amsterdam (MEC 07/181), and written informed consent was obtained from each participant. Contained 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 chances for UAI increase as well 14 - 16 We compared the incidence of UAI in online got casual partnerships to that in offline obtained 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 understanding of partner characteristics, including HIV status.
A meta-evaluation in 2006 found limited evidence that acquiring a sex partner online raises the danger of unprotected anal intercourse (UAI) 3 Many previous studies compared guys with internet partners to men with offline partners. Nonetheless, guys favoring online dating might differ in several unmeasured respects from guys favoring offline dating, leading to incomparable behavioural profiles. A more recent meta-analysis included several studies analyzing MSM with both online and also offline acquired sex partners and found evidence for an association between UAI and online partners, which would suggest a mediating effect of more info on partners, (including perceived HIV status) on UAI 13
Men who have sex with men (MSM) frequently use the Web to discover sex partners. Cheap Hookers nearby Victoria. Several research have shown that MSM are more prone to engage in unprotected anal intercourse with sex partners they meet through the Internet (on-line) than with partners they meet at social sites (offline) 1 - 3 This indicates that guys who get 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 online partners, the risk of HIV transmission also depends on accurate knowledge of one's own and the sex partners' HIV status 7 - 10