For HIV-oblivious guys the effect of dating place on UAI did not change by adding partner features, but it improved when adding lifestyle and drug use. It is difficult to evaluate the real risk for HIV for these guys: do they behave as HIV-negative men that want to shield themselves from HIV infection, or as HIV-positive men trying to protect their HIV negative partner from HIV infection? A study by Horvath et al. Backpage Escorts in New South Wales. 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 participate in UAI with HIV negative partners 12 Formerly Matser et al. reported that 1.7% of the unaware and sensed HIV negative MSM were tested HIV-positive. The study population included the MSM reported in this study 15
Online dating was not connected with UAI among HIV negative guys, a finding in agreement with some previous studies, largely among young men 21 , but in contrast with other studies 1 - 5 This may be because of 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 guys. Yet it could also reflect lay changes; perhaps in the beginning of online dating a more high-risk group of men used the Internet, and over time online dating normalized and not as high-risk MSM today additionally utilize the Web for dating.
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 also offline casual partners. Backpage Escorts near NSW. This averted prejudice caused by 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 lot of MSM, and avoid potential differences in guys tried through Internet or face-to-face interviewing, weaknesses in a few previous studies 3 , 11
Among HIV-positive men, in univariate analysis UAI was reported significantly more frequently with on-line associates than with offline associates. When adjusting for associate features, the effect of online/offline dating on UAI among HIV-positive MSM became somewhat smaller and became nonsignificant; this implies that differences in partnership factors between online and also offline partnerships are accountable for the increased UAI in online established ventures. This might 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 detected, either in univariate or in some of the multivariate models. Among HIV-oblivious guys, online dating was connected with UAI but just essential when adding associate and partnership variables to the model.
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. For HIV negative guys this lack 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). Drummoyne New South Wales backpage escorts. Only among men who suggested they were not aware of their HIV status (a small group in this study), UAI was more common with online than offline associates.
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). 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 venture compared to only one sex act). Other factors significantly associated with UAI were group sex within the partnership, and sex-connected multiple drug use within venture.
In multivariate model 3 (Tables 4 and 5 ), also including variables 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 effect 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 ).
In univariate analysis, UAI was significantly more inclined to occur 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 firmly 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 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 partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative guys 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).
Features of on-line 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 online partners was more often 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 online partners more often knew the HIV status of the participant than offline partners (38.8% vs. 27.2%; P 0.001). Participants more frequently 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 frequently reported with on-line partners.
To be able to examine the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In version 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 additionally for venture sexual risk behavior (i.e., sex-associated drug use and sex frequency) and venture kind (i.e., casual or anonymous). As we assumed a differential effect of dating place for HIV positive, HIV-negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was included in all three models by making a brand new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV negative, HIV-positive, and HIV-unaware men. Backpage Escorts nearby Drummoyne NSW. We performed a sensitivity analysis confined to partnerships in which just one sexual contact occurred. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to miss potentially important organizations. As a fairly big number of statistical evaluations were done and reported, this approach does lead to a heightened risk of one or more false positive associations. Investigations 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; online partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. Drummoyne New South Wales Backpage Escorts. Backpage Escorts Near Me North Ryde New South Wales. 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 type; sex frequency within partnership; group sex with partner; sex-related material use in partnership).
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). We compared features of participants, partners, and partnership sexual behavior by online or offline venture, and calculated P values predicated on logistic regression with robust standard errors, accounting for related 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 analyze the association between dating location (online versus offline) and UAI. Likelihood ratio tests were used to evaluate the significance of a variable in a model.
In order to investigate possible disclosure of HIV status we additionally asked the participant whether the casual sex partner knew the HIV status of the participant, together with the answer alternatives: (1) no, (2) possibly, (3) yes. Sexual conduct with each partner was dichotomised as: (1) no anal intercourse or only protected anal intercourse, and (2) unprotected anal intercourse. To ascertain 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, alternate, drag, leather, military, sports, trendy, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if not one of these features were applicable, other. Drummoyne, NSW backpage escorts. 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 understand whether you're HIV infected?', with five response alternatives: (1) I 'm definitely not HIV-contaminated; (2) I believe that I'm not HIV-infected; (3) I do not understand; (4) I think I may be HIV-contaminated; (5) I know for sure that I 'm HIV-contaminated. We categorised this into HIV negative (1,2), unknown (3), and HIV positive (4,5) status. The questionnaire enquired about the HIV status of every sex partner together with the question: 'Do you understand whether this partner is HIV-infected?' with similar reply alternatives as previously. Perceived concordance in HIV status within ventures 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 trip 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 data on sexual behavior with those partners. A comprehensive description of the study design and the questionnaire is provided elsewhere 15 , 18 Our primary determinant of interest, dating location (e.g., the name of a pub, park, club, or the name of a website) was obtained for every partner, and categorised into online (websites), and offline (physical sites) dating places. To simplify the language of distinguishing the partners per dating place, 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 understand 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 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. Included in this investigation were guys who reported sexual contact with at least one casual partner dated online as well one casual partner dated offline. Backpage Escorts Near Me Sebastopol New South Wales.
With increased acquaintance in sexual partnerships, for example by concordant ethnicity, age, lifestyle, HIV status, and raising sex frequency, the chances for UAI increase as well 14 - 16 We compared the incidence of UAI in online acquired casual partnerships to that in offline got casual partnerships among MSM who reported both on-line and offline casual partners in the preceding six months. Backpage Escorts near New South Wales. 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 partly clarified through better knowledge of partner characteristics, including HIV status.