In this large study among MSM attending the STI clinic in Amsterdam, we found no signs that online dating was independently associated with a higher danger of UAI than offline dating. Cheap hookers nearest Darlington Victoria. Darlington, VIC Australia Cheap Hookers. For HIV negative guys this lack of assocation was clear (aOR = 0.94 95 % CI 0.59-1.48); among HIV positive guys there was a non significant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among guys who indicated they were not conscious of their HIV status (a small group in this study), UAI was more common with on-line than offline associates.
The amount of sex partners in the preceding 6months of the index was likewise associated 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). UAI was significantly more likely if more sex acts had happened in the venture (OR = 16.29 95 % CI 7.07-37.52 for >10 sex acts within the venture compared to only one sex act). Other variables significantly associated with UAI were group sex within the venture, and sex-connected multiple drug use within venture.
In multivariate model 3 (Tables 4 and 5 ), additionally including variables concerning sexual behavior in the venture (sex-associated multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat stronger (though not essential) for the HIV positive men (aOR = 1.62 95 % CI; 0.96-2.72), but remained similar for HIV-negative guys (aOR = 0.94 95 % CI 0.59-1.48). Cheap hookers near me Darlington. The result of online dating on UAI became more powerful (and essential) for HIV-oblivious guys (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
In univariate analysis, UAI was significantly more likely to occur 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). Cheap Hookers in Darlington Victoria. The effect of dating location on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the organization of online dating using three distinct reference types, one for each HIV status. Among HIV positive men, UAI was more common in online in comparison to offline ventures (OR = 1.61 95 % CI 1.03-2.50). Among HIV-negative men no association was evident between UAI and online ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware guys, UAI was more common in online when compared with offline partnerships, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
Features of on-line and offline partners and ventures are shown 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 online partners was more frequently reported as known (61.4% vs. 49.4%; P 0.001), and in on-line ventures, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their on-line partners more frequently knew the HIV status of the participant than offline partners (38.8% vs. Cheap Hookers near Darlington. 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 online partners. Darlington VIC Cheap Hookers.
To be able to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three multivariable models. In model 1, we adapted the association between online/offline dating place 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 adjusted also for partnership sexual risk behavior (i.e., sex-related drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating place 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-class variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV-negative, HIV positive, and HIV-oblivious men. We performed a sensitivity analysis confined to partnerships in which just one sexual contact occurred. Cheap Hookers nearest Darlington. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to lose potentially significant organizations. As a fairly large number of statistical evaluations were done and reported, this approach does lead to a heightened 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 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; online partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. of male sex partners in preceding 6months), and some were presumed to be on the causal pathway between the primary exposure of interest and results (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-related substance use in venture).
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 conduct by online or offline venture, and computed P values based on logistic regression with robust standard errors, accounting for correlated 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 place (online versus offline) and UAI. Likelihood ratio tests were used to gauge the significance of a variable in a model.
As a way to investigate potential 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 options: (1) no, (2) potentially, (3) yes. Sexual behavior with each partner was dichotomised as: (1) no anal intercourse or simply shielded 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 following subcultures/lifestyles: casual, formal, alternative, drag, leather, military, sports, fashionable, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if not one of these features were applicable, other. Cheap Hookers closest to Darlington Victoria. 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 answer choices: (1) I am definitely not HIV-contaminated; (2) I believe that I'm not HIV-contaminated; (3) I don't understand; (4) I think I may be HIV-contaminated; (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 survey enquired about the HIV status of every sex partner with the question: 'Do you understand whether this partner is HIV-infected?' with similar answer options as previously. Perceived concordance in HIV status within ventures was categorised as; (1) concordant; (2) discordant; (3) unknown. The last class represents all partnerships where the participant did not 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 trip to the STI outpatient clinic while waiting for preliminary test 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 conduct with those partners. A thorough description of the study design as well as the survey is provided elsewhere 15 , 18 Our chief determinant of interest, dating location (e.g., the name of a bar, 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. Cheap Hookers near me Darlington VIC Australia. To simplify the terminology of distinguishing the partners per dating location, we refer to them as online 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 may understand written Dutch or English. Individuals 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 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. Cheap Hookers near me Darlington Victoria. 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.
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