In this large study among MSM attending the STI clinic in Amsterdam, we found no evidence that online dating was independently related to a higher risk of UAI than offline dating. Backpage Escorts near Palmerston, Australian Capital Territory. Palmerston ACT, Australia backpage escorts. 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 nonsignificant association between online dating and UAI (aOR = 1.62 95 % CI 0.96-2.72). Just among guys who indicated they weren't conscious of their HIV status (a little group in this study), UAI was more common with on-line than offline partners.
The amount of sex partners in the preceding 6months of the index was also 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 partnership compared to only one sex act). Other variables significantly associated with UAI were group sex within the partnership, and sex-related multiple drug use within partnership.
In multivariate model 3 (Tables 4 and 5 ), additionally including variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner type), the independent effect of online dating location on UAI became somewhat more powerful (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). Backpage escorts near me Palmerston. The result of online dating on UAI became more powerful (and important) for HIV-unaware 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). Backpage Escorts near Palmerston, Australian Capital Territory. The result 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 groups, 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 apparent between UAI and on-line partnerships (OR = 1.07 95 % CI 0.71-1.62). Among HIV-unaware men, UAI was more common in online in comparison to offline ventures, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
Characteristics of on-line and offline partners and partnerships 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 on-line partners was more often reported as understood (61.4% vs. 49.4%; P 0.001), and in online ventures, perceived HIV concordance was higher (49.0% vs. 39.8%; P 0.001). Participants reported that their on-line partners more often understood the HIV status of the participant than offline partners (38.8% vs. Backpage Escorts near Palmerston. 27.2%; P 0.001). Participants more often reported multiple sexual contacts with internet partners (50.9% vs. 41.3%; P 0.001). Sex-related substance use, alcohol use, and group sex were less often reported with on-line partners. Palmerston, ACT Backpage Escorts.
In order to analyze the potential mediating effect of more info on partners (including perceived HIV status) on UAI, we developed three variant models. In model 1, we adapted the organization between online/offline dating location and UAI for characteristics of the participant: age, ethnicity, number of sex partners in the preceding 6months, and self-perceived HIV status. In model 2 we added the venture characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adjusted also for partnership sexual risk behaviour (i.e., sex-associated drug use and sex frequency) and partnership type (i.e., casual or anonymous). As we assumed a differential effect of dating location for HIV-positive, HIV negative and HIV status unknown MSM, an interaction between HIV status of the participant and dating place was contained in all three models by making a brand new six-category variable. For clarity, the effects of online/offline dating on UAI are also presented separately for HIV negative, HIV-positive, and HIV-unaware men. We performed a sensitivity analysis limited to partnerships in which only one sexual contact occurred. Backpage escorts near Palmerston. Statistical significance was defined as P 0.05. No adjustments for multiple comparisons were made, in order not to lose potentially significant associations. As a rather big number of statistical tests were done and reported, this approach does lead to a heightened danger of one or more false-positive associations. Investigations were done using the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
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; online partner acquisition), others were considered as confounders (participants' age, participants' ethnicity, and no. of male sex partners in preceding 6months), and some were supposed to be on the causal pathway between the principal exposure of interest and result (age difference between participant and partner; ethnic concordance; concordance in life styles; HIV concordance; venture sort; sex frequency within venture; group sex with partner; sex-associated 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 on-line or offline venture, 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 examine the association between dating location (online versus offline) and UAI. Likelihood ratio tests were used to measure the value of a variable in a model.
To be able to explore possible disclosure of HIV status we additionally asked the participant whether the casual sex partner understood the HIV status of the participant, together with the reply options: (1) no, (2) maybe, (3) yes. Sexual behavior with each partner was dichotomised as: (1) no anal intercourse or simply protected anal intercourse, and (2) unprotected anal intercourse. To ascertain the subculture, we asked whether the participant characterised himself or his partners as belonging to one or more of the subsequent subcultures/lifestyles: casual, formal, alternate, drag, leather, military, sports, trendy, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if none of these characteristics were appropriate, other. Backpage Escorts nearest Palmerston, Australian Capital Territory. 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.
HIV status of the participant was obtained by asking the question 'Do you understand whether you are HIV infected?', with five answer alternatives: (1) I 'm definitely not HIV-contaminated; (2) I think that I'm 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-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 together with the question: 'Do you know whether this partner is HIV-contaminated?' with similar reply options as above. Perceived concordance in HIV status within partnerships was categorised as; (1) concordant; (2) discordant; (3) unknown. The final category 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 during their visit to the STI outpatient clinic while waiting for preliminary test results after their consultation using 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 data on sexual conduct with those partners. A comprehensive description of the study design and also the survey is provided elsewhere 15 , 18 Our primary determinant of interest, dating location (e.g., the name of a bar, park, club, or the name of a web site) was obtained for every partner, and categorised into on-line (websites), and offline (physical sites) dating locations. Backpage Escorts in Palmerston ACT, Australia. To simplify the terminology of differentiating 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 might comprehend written Dutch or English. People could participate more than once, if subsequent 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. Backpage Escorts near Palmerston, Australian Capital Territory. 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.
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