A vital strength of this study was that it investigated the relation between online dating and UAI among MSM who had recent sexual contact with both online and offline casual partners. Cheap Prostitutes closest to Hawthorn VIC. This avoided bias 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 biggest STI outpatient clinic in the Netherlands we could contain a high number of MSM, and avoid potential differences in guys sampled through Internet or face to face interviewing, weaknesses in some previous studies 3 , 11
Among HIV positive guys, in univariate analysis UAI was reported significantly more frequently with online associates than with offline partners. When adjusting for associate characteristics, 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 in charge of the increased UAI in online established ventures. This might be because of 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 any of the multivariate models. Among HIV-unaware guys, online dating was correlated with UAI but just important when adding partner and venture 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 related to a higher danger 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 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 on-line than offline partners.
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). Hawthorn Cheap Prostitutes. 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 venture compared to only one sex act). Hawthorn VIC Cheap Prostitutes. Other factors 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 ), also including variants concerning sexual behavior in the venture (sex-associated multiple drug use, sex frequency and partner kind), the independent effect of online dating location on UAI became somewhat stronger (though not significant) 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-oblivious men (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
In univariate analysis, UAI was significantly more likely to happen 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 strongly correlated 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 distinct 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 when compared with offline partnerships, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
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 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 frequently 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 online 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 internet partners (50.9% vs. 41.3%; P 0.001). Sex-associated substance use, alcohol use, and group sex were less often reported with internet partners.
In order 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 partnership features (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In model 3, we adapted additionally for venture sexual risk behaviour (i.e., sex-related drug use and sex frequency) and venture 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 new six-category 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 only one sexual contact occurred. Statistical significance was defined as P 0.05. Hawthorn Victoria Australia cheap prostitutes. No adjustments for multiple comparisons were made, in order not to miss potentially important associations. As a fairly large number of statistical tests were done and reported, this approach does lead to a higher danger of one or more false positive organizations. Evaluations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Prior to the analyses 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. of male sex partners in preceding 6months), and some were supposed 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 sort; sex frequency within partnership; group sex with partner; sex-related substance 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). Cheap Prostitutes Near Me Darlington Victoria. We compared characteristics of participants, partners, and venture sexual behavior by on-line or offline venture, and calculated P values based 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 analyze the association between dating place (online versus offline) and UAI. Odds ratio tests were used to gauge the significance of a variable in a model.
As a way to investigate possible disclosure of HIV status we also asked the participant whether the casual sex partner understood the HIV status of the participant, with the answer alternatives: (1) no, (2) perhaps, (3) yes. Sexual behavior with each partner was dichotomised as: (1) no anal intercourse or simply protected anal intercourse, and (2) unprotected anal intercourse. Cheap Prostitutes Near Me Noble Park Victoria. To determine the subculture, we asked whether the participant characterised himself or his partners as belonging to at least one of the subsequent 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 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 are HIV infected?', with five response choices: (1) I am certainly not HIV-infected; (2) I think that I'm not HIV-infected; (3) I don't understand; (4) I believe I may be HIV-infected; (5) I know for sure that I 'm HIV-contaminated. Hawthorn, VIC, Australia cheap prostitutes. 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 together with the question: 'Do you know whether this partner is HIV-infected?' with similar response alternatives 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 didn't 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 survey throughout their visit to the STI outpatient clinic while waiting for preliminary test results after their consultation with a nurse or physician. The survey 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 conduct with those partners. Cheap Prostitutes closest to Hawthorn, VIC Australia. A thorough description of the study design and the survey is supplied elsewhere 15 , 18 Our chief 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 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 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 might comprehend written Dutch or English. Individuals could participate more than once, if subsequent visits to the clinic were related to a potential 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 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. Contained in this analysis were guys 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 raising sex frequency, the likelihood for UAI increase as well 14 - 16 We compared the incidence of UAI in online got casual partnerships to that in offline acquired casual partnerships among MSM who reported both on-line 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 online, and that this effect is partially explained through better understanding of partner features, including HIV status.
A meta-analysis in 2006 found limited evidence that acquiring a sex partner online raises the risk of unprotected anal intercourse (UAI) 3 Many previous studies compared men with online partners to men with offline partners. Nevertheless, guys preferring online dating might differ in a variety of unmeasured respects from guys preferring 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 internet partners, which may indicate a mediating effect of more info on partners, (including perceived HIV status) on UAI 13
Men who have sex with men (MSM) often make use of the Internet to find sex partners. Cheap prostitutes near Victoria. Several research have shown 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 sites (offline) 1 - 3 This implies that men 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 threat of HIV transmission also depends upon exact knowledge of one's own and the sex partners' HIV status 7 - 10