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 in Lemoray. 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-oblivious guys, but HIV-positive men were more likely to have UAI with on-line associates (aOR = 1.65 95 % CI 1.05-2.57). After correction for partner and partnership features the effect of online/offline dating on UAI among HIV positive MSM was reduced and no longer critical.
Men who have sex with men (MSM) often use the Internet to locate sex partners. Several studies have revealed that MSM are more prone to participate in unprotected anal intercourse with sex partners they meet through the Internet (online) than with partners they meet at social venues (offline) 1 - 3 This implies that men 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 on-line partners, the threat of HIV transmission also depends upon exact knowledge of one's own and the sex partners' HIV status 7 - 10
A meta-evaluation in 2006 found limited evidence that getting a sex partner online raises the danger of unprotected anal intercourse (UAI) 3 Many previous studies compared guys with online partners to guys with offline partners. Nevertheless, guys favoring online dating might differ in various unmeasured regards from men favoring offline dating, resulting in incomparable behavioural profiles. A more recent meta-analysis included several studies analyzing MSM with both online and offline acquired sex partners and found evidence for an association between UAI and on-line 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 likelihood for UAI increase as well 14 - 16 We compared the incidence of UAI in online acquired casual partnerships to that in offline obtained 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 on the internet, and that this effect is partially described through better knowledge 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 may understand written Dutch or English. People could participate more than once, if following visits to the clinic 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 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.
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 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 behavior with those partners. A comprehensive description of the study design and also the survey is supplied elsewhere 15 , 18 Our primary determinant of interest, dating place (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 locations. To simplify the terminology of distinguishing the partners per dating location, 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 alternatives: (1) I am definitely not HIV-infected; (2) I believe that I'm not HIV-contaminated; (3) I do not understand; (4) I think I may be HIV-infected; (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 each sex partner with the question: 'Do you understand whether this partner is HIV-infected?' with similar answer alternatives as above. 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 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.
In order to explore potential disclosure of HIV status we also asked the participant whether the casual sex partner knew the HIV status of the participant, together with the response alternatives: (1) no, (2) perhaps, (3) yes. Backpage escorts nearby Lemoray, British Columbia. Sexual behaviour with each partner was dichotomised as: (1) no anal intercourse or just 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, substitute, 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. Casual 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 partnership sexual behavior by on-line or offline venture, and calculated P values based 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 location (online versus offline) and UAI. Likelihood ratio tests were used to measure the importance of a variable in a model.
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; on-line partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. Backpage escorts closest to Lemoray Canada. Backpage Escorts Near Me Lempriere British Columbia. Backpage Escorts Near Me Lejac British Columbia. of male sex partners in preceding 6months), and some were presumed to be on the causal pathway between the main exposure of interest and outcome (age difference between participant and partner; ethnic concordance; concordance in life styles; HIV concordance; partnership kind; sex frequency within venture; group sex with partner; sex-associated material use in partnership).