Five hundred seventy-seven guys (351 HIV-negative, 153 HIV-positive, and 73 HIV-unaware) reported UAI in 26% of 878 online, and 23% of 903 offline casual partnerships. The crude OR of online dating for UAI was 1.36 (95 % CI 1.03-1.81). Backpage escorts nearest Beiseker. HIV-positive men were more likely to report UAI than HIV negative men (49% vs. 28% of ventures). Adjusted for demographic features, online dating had no significant effect on UAI among HIV negative and HIV status-unaware guys, but HIV-positive men were more likely to have UAI with online associates (aOR = 1.65 95 % CI 1.05-2.57). After correction for partner and partnership characteristics the effect of online/offline dating on UAI among HIV positive MSM was reduced and no longer significant.
Men who have sex with men (MSM) often utilize the Internet to locate sex partners. Several studies have shown that MSM are more prone to participate 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 suggests 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 risk of HIV transmission also depends upon precise knowledge of one's own and the sex partners' HIV status 7 - 10
A meta-analysis in 2006 found limited evidence that getting a sex partner online raises the risk of unprotected anal intercourse (UAI) 3 Many previous studies compared men with internet partners to men with offline partners. However, guys preferring online dating might differ in a variety of unmeasured regards 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 internet partners, which may indicate a mediating effect of more info on partners, (including perceived HIV status) on UAI 13
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 occurrence of UAI in online acquired casual partnerships to that in offline acquired 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 online, and that this effect is partly explained through better understanding of partner characteristics, including HIV status.
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 subsequent visits to the practice were related to a potential 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 analysis were men who reported sexual contact with at least one casual partner dated online as well one casual partner dated offline.
Participants completed a standardised anonymous questionnaire throughout their visit to the STI outpatient clinic while waiting for preliminary evaluation results after their consultation with a nurse or physician. 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. A detailed description of the study design and the questionnaire is provided elsewhere 15 , 18 Our main 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.
HIV status of the participant was obtained by asking the question 'Do you know whether you're HIV infected?', with five response alternatives: (1) I 'm certainly 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 am HIV-infected. We categorised this into HIV negative (1,2), unknown (3), and HIV positive (4,5) status. The survey enquired about the HIV status of every sex partner with the question: 'Do you understand whether this partner is HIV-contaminated?' with similar reply choices as above. Perceived concordance in HIV status within partnerships was categorised as; (1) concordant; (2) discordant; (3) unknown. The final group represents all partnerships where the participant did not 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.
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, together with the response choices: (1) no, (2) possibly, (3) yes. Backpage Escorts nearby Beiseker, Alberta. Sexual behaviour with each partner was dichotomised as: (1) no anal intercourse or simply shielded anal intercourse, and (2) unprotected anal intercourse. 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, substitute, drag, leather, military, sports, fashionable, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if not one of these features were appropriate, other. Concordant lifestyle was categorised as: (1) concordant; (2) discordant. Chance partner sort was categorised by the participants into (1) known traceable and (2) anonymous partners.
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). We compared features of participants, partners, and partnership sexual conduct by online or offline partnership, 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 location (online versus offline) and UAI. Odds ratio tests were used to gauge the value of a variable in a model.
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. Backpage Escorts near me Beiseker, Canada. Backpage Escorts Near Me Bellevue Alberta. Backpage Escorts Near Me Behan Alberta. of male sex partners in preceding 6months), and some were presumed to be on the causal pathway between the principal exposure of interest and outcome (age difference between participant and partner; ethnic concordance; concordance in life styles; HIV concordance; venture type; sex frequency within partnership; group sex with partner; sex-associated material use in partnership).