Five hundred seventy-seven men (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 closest to Blackwater. 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 important effect on UAI among HIV-negative and HIV status-unaware men, 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 associate and partnership features 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) frequently use the Net to find sex partners. Several studies have revealed 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 suggests 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 online partners, the danger 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 acquiring 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. Nevertheless, guys favoring online dating might differ in several unmeasured respects from guys preferring offline dating, resulting in 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 suggest a mediating effect of more information on partners, (including perceived HIV status) on UAI 13
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 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 partially clarified through better knowledge of partner features, 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 may understand written Dutch or English. People could participate more than once, if following visits to the practice 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 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 guys 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 during their trip 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 comprehensive description of the study design and the survey is supplied elsewhere 15 , 18 Our main determinant of interest, dating place (e.g., the name of a pub, 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 differentiating 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 are HIV infected?', with five response options: (1) I 'm definitely not HIV-contaminated; (2) I believe that I'm not HIV-contaminated; (3) I don't know; (4) I think 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 each sex partner with the question: 'Do you know whether this partner is HIV-infected?' with similar reply choices as previously. Perceived concordance in HIV status within ventures was categorised as; (1) concordant; (2) discordant; (3) unknown. The final category 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.
As a way to explore 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 reply choices: (1) no, (2) possibly, (3) yes. Backpage Escorts closest to Blackwater British Columbia. Sexual behavior with each partner was dichotomised as: (1) no anal intercourse or only protected anal intercourse, and (2) unprotected anal intercourse. To discover 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, fashionable, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if none of these features were appropriate, 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.
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 venture sexual behavior by online or offline venture, and computed P values based on logistic regression with robust standard errors, accounting for linked 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. Likelihood ratio tests were used to evaluate the value of a variable in a model.
Before the analyses 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. Backpage Escorts closest to Blackwater, Canada. Backpage Escorts Near Me Blaeberry British Columbia. Backpage Escorts Near Me Blackloam British Columbia. of male sex partners in preceding 6months), and some were assumed 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; partnership sort; sex frequency within venture; group sex with partner; sex-associated substance use in partnership).