The number of sex partners in the preceding 6months of the index was also correlated 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). Naughty date in Wendouree, Victoria. Other variables significantly associated with UAI were group sex within the venture, and sex-related multiple drug use within partnership.
In multivariate model 3 (Tables 4 and 5 ), also including variables concerning sexual behaviour in the partnership (sex-related multiple drug use, sex frequency and partner kind), the independent effect of online dating place on UAI became somewhat more powerful (though not essential) for the HIV-positive guys (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). The result of online dating on UAI became stronger (and critical) for HIV-oblivious men (aOR = 2.55 95 % CI 1.11-5.86) (Table 5 ).
In univariate analysis, UAI was significantly more likely to happen 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). The result of dating place on UAI differed by HIV status, as can be seen best in Table 5 Table 5 shows the association of online dating using three distinct reference classes, one for each HIV status. Among HIV-positive guys, UAI was more common in online when compared with offline partnerships (OR = 1.61 95 % CI 1.03-2.50). Among HIV negative men no association was apparent between UAI and internet ventures (OR = 1.07 95 % CI 0.71-1.62). Among HIV-oblivious guys, UAI was more common in online when compared with offline ventures, though not statistically significant (OR = 1.65 95 % CI 0.79-3.44).
Characteristics of online 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 online partners was more frequently reported as known (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. 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 material use, alcohol use, and group sex were less frequently reported with internet partners.
To be able to examine the possible mediating effect of more information on partners (including perceived HIV status) on UAI, we developed three multivariable models. In version 1, we adapted the association 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 partnership characteristics (age difference, ethnic concordance, lifestyle concordance, and HIV concordance). In version 3, we adapted also for venture sexual risk behavior (i.e., sex-associated drug use and sex frequency) and venture kind (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 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 individually for HIV-negative, HIV-positive, and HIV-oblivious men. We performed a sensitivity analysis confined to partnerships in which just one sexual contact occurred. 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 large number of statistical evaluations were done and reported, this approach does lead to a heightened danger of one or more false-positive associations. Analyses were done utilizing the statistical programme STATA, version 13 (STATA Intercooled, College Station, TX, USA).
Before the investigations we developed a directed acyclic graph (DAG) representing a causal model of UAI. Naughty Date nearest Wendouree, Victoria. 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 presumed to be on the causal pathway between the principal exposure of interest and results (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 partnership).
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 features of participants, partners, and venture sexual behavior by on-line or offline partnership, and computed P values predicated 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 analyze the association between dating location (online versus offline) and UAI. Likelihood ratio tests were used to evaluate the value of a variable in a model.
To be able to explore potential disclosure of HIV status we additionally asked the participant whether the casual sex partner understood the HIV status of the participant, with the response options: (1) no, (2) perhaps, (3) yes. Sexual behavior with each partner was dichotomised as: (1) no anal intercourse or merely shielded anal intercourse, and (2) unprotected anal intercourse. To ascertain 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, alternative, drag, leather, military, sports, trendy, punk/skinhead, rubber/lycra, gothic, bear, jeans, skater, or, if not one of these characteristics 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.
HIV status of the participant was obtained by asking the question 'Do you understand whether you're HIV infected?', with five response options: (1) I 'm definitely not HIV-contaminated; (2) I believe that I'm not HIV-infected; (3) I don't know; (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 questionnaire enquired about the HIV status of every sex partner with all the question: 'Do you understand whether this partner is HIV-contaminated?' with similar answer options as previously. Naughty date nearby Wendouree Victoria, Australia. 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 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 questionnaire throughout their trip to the STI outpatient clinic while waiting for preliminary evaluation 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 behaviour with those partners. A detailed description of the study design and also the survey is supplied elsewhere 15 , 18 Our primary determinant of interest, dating location (e.g., the name of a pub, park, club, or the name of a web site) was obtained for every partner, and categorised into online (websites), and offline (physical sites) dating places. To simplify the terminology of distinguishing the partners per dating place, 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 could comprehend written Dutch or English. People could participate more than once, if subsequent visits to the practice were related to a potential 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 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 investigation were guys who reported sexual contact with at least one casual partner dated online as well one casual partner dated offline.
With increased familiarity in sexual partnerships, for example by concordant ethnicity, age, lifestyle, HIV status, and raising sex frequency, the likelihood for UAI increase as well 14 - 16 We compared the occurrence of UAI in online got casual partnerships to that in offline got 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 partly explained through better understanding of partner characteristics, including HIV status.
A meta-analysis in 2006 found limited evidence that getting a sex partner online increases the danger of unprotected anal intercourse (UAI) 3 Many previous studies compared guys with internet partners to men with offline partners. Nevertheless, guys preferring online dating might differ in several unmeasured respects from guys preferring offline dating, leading to incomparable behavioural profiles. A more recent meta-analysis included several studies examining MSM with both online and also offline acquired sex partners and found evidence for an association between UAI and internet partners, which would suggest a mediating effect of more info on partners, (including perceived HIV status) on UAI 13 Naughty date near Wendouree VIC.
Men who have sex with men (MSM) often use the Web to locate sex partners. Several studies have revealed 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 suggests that men who get 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 internet partners, the threat of HIV transmission also depends upon exact knowledge of one's own and the sex partners' HIV status 7 - 10
Five hundred seventy-seven guys (351 HIV-negative, 153 HIV-positive, and 73 HIV-oblivious) reported UAI in 26% of 878 on-line, and 23% of 903 offline casual partnerships. The crude OR of online dating for UAI was 1.36 (95 % CI 1.03-1.81). HIV positive men were more likely to report UAI than HIV-negative men (49% vs. 28% of ventures). Fixed for demographic characteristics, online dating had no major effect on UAI among HIV-negative and HIV status-oblivious guys, but HIV-positive men were more likely to have UAI with online partners (aOR = 1.65 95 % CI 1.05-2.57). After correction for partner and partnership characteristics the effect of online/offline dating on UAI among HIV positive MSM was reduced and no longer significant.
Believe it or not, I did not come out of this experiment feeling lousy about myself---just smarter about the way gay men (or perhaps guys in general) area way too much emphasis on foolish features like beards and ballcaps (hint: that is why you are all still cranky and single). And really, I actually don't believe having long hair itself is the big hang up; it's what my hair implies. Having long hair (particularly for a black man) means you are probably a bitchy spectacular queen that nobody needs to date. Naughty Date in Wendouree, VIC. Even in the event the assumption is not that extreme, the underlying anxiety is you spent too much time on your appearance and that's not manly." That's frustrating, obviously, since stereotypical masculinity requires just as much work---we simply do not think of it that way. I remember chatting with this scruffy, pretty muscular guy with tattoos and torso hair and an Instagram full of masc pics; once we got to talking, he shown his fixation with Beyonc and said yasss!" every other paragraph. But no matter---his picture is butch, so his dating life is constantly full.
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