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 in Premier. HIV positive men were more likely to report UAI than HIV-negative men (49% vs. 28% of partnerships). Corrected 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 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 Net to discover sex partners. Several studies have shown that MSM are more inclined 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 indicates 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 on-line partners, the risk of HIV transmission also depends on precise 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 risk of unprotected anal intercourse (UAI) 3 Many previous studies compared guys with online partners to men with offline partners. However, guys preferring online dating might differ in several unmeasured regards from guys favoring offline dating, causing 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 on-line partners, which would indicate 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 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 on the internet, and that this effect is partly explained 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 might comprehend written Dutch or English. People could participate more than once, if subsequent visits to the clinic 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.
Participants completed a standardised anonymous questionnaire during their visit to the STI outpatient clinic while waiting for preliminary test results after their consultation using a nurse or doctor. The survey 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 conduct with those partners. A detailed description of the study design and the questionnaire 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 site) was obtained for every partner, and categorised into on-line (websites), and offline (physical sites) dating locations. To simplify the terminology of differentiating the partners per dating location, we refer to them as online or offline partners.
HIV status of the participant was obtained by asking the question 'Do you understand whether you are HIV infected?', with five answer options: (1) I am certainly not HIV-contaminated; (2) I believe that I am not HIV-contaminated; (3) I don't know; (4) I think I may be HIV-infected; (5) I know for sure that I am HIV-contaminated. 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 all the question: 'Do you know whether this partner is HIV-contaminated?' with similar answer choices as above. Perceived concordance in HIV status within partnerships was categorised as; (1) concordant; (2) discordant; (3) unknown. The last class 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 investigate potential disclosure of HIV status we additionally asked the participant whether the casual sex partner knew the HIV status of the participant, with the response options: (1) no, (2) possibly, (3) yes. Backpage escorts in Premier, 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 at least one of the subsequent 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 applicable, other. Concordant lifestyle was categorised as: (1) concordant; (2) discordant. Chance partner type 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-tests for dichotomous and categorical variables and using rank sum test for continuous variables). We compared characteristics of participants, partners, and partnership sexual behaviour by online or offline partnership, and computed P values predicated 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. Odds ratio tests were used to assess the importance of a variable in a model.
Prior to the evaluations 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; on-line partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. Backpage escorts near Premier Canada. Backpage Escorts Near Me Premier Lake British Columbia. Backpage Escorts Near Me Prairiedale 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; venture type; sex frequency within partnership; group sex with partner; sex-associated substance use in venture).