Background
Methods
Setting and participants
Questionnaire and variables
Statistical analysis
Results
Study participants and partnerships
Characteristics of the participants
Total | HIV-negative | HIV-positive | HIV unaware |
P
c
| |
---|---|---|---|---|---|
N(%)a | n(%)a | n(%)a | n(%)a | ||
N | 577 | 351 (60.8 %) | 153 (26.5 %) | 73 (12.7 %) | |
Demographics | |||||
Median age in years (IQR) | 37 (30–43) | 36 (30–43) | 40 (36–46) | 32 (28–41) | <0.001 |
Age in years, categorised | <0.001 | ||||
< 30 | 124 (21.5 %) | 86 (24.5 %) | 13 (8.5 %) | 25 (34.3 %) | |
30–34 | 104 (18.0 %) | 68 (19.4 %) | 20 (13.1 %) | 16 (21.9 %) | |
35–39 | 120 (20.8 %) | 71 (20.2 %) | 41 (26.8 %) | 8 (11.0 %) | |
≥ 40 | 229 (39.7 %) | 126 (35.9 %) | 79 (51.6 %) | 24 (32.9 %) | |
Ethnic groupb | 0.181 | ||||
Dutch | 412 (73.8 %) | 259 (75.5 %) | 104 (70.8 %) | 49 (72.1 %) | |
Western, non-Dutch | 72 (12.9 %) | 44 (12.8 %) | 23 (15.7 %) | 5 (7.4 %) | |
Non-western | 74 (13.3 %) | 40 (11.7 %) | 20 (13.6 %) | 14 (20.6 %) | |
Sexual behaviour | |||||
Median no. of male sex partners in preceding 6 months (IQR) | 10 (5–20) | 8 (5–15) | 12 (6–30) | 10 (5–20) | <0.001 |
No. of male sex partners in preceding 6 months | |||||
1–4 | 119 (20.6 %) | 83 (23.7 %) | 22 (14.4 %) | 14 (19.2 %) | <0.001 |
5–9 | 166 (28.8 %) | 113 (32.2 %) | 31 (20.3 %) | 22 (30.1 %) | |
10–24 | 188 (32.6 %) | 112 (31.9 %) | 53 (34.6 %) | 23 (31.5 %) | |
25–49 | 64 (11.1 %) | 31 (8.8 %) | 26 (17.0 %) | 7 (9.6 %) | |
≥ 50 | 40 (6.9 %) | 12 (3.4 %) | 21 (13.7 %) | 7 (9.6 %) |
Online and offline partner and partnership characteristics
Total | Online acquired partnerships | Offline acquired partnerships | P valueb | |
---|---|---|---|---|
n(%)e | n(%)e | n(%)e | n(%)e | |
N | 1781 | 878 | 903 | |
Demographicsa | ||||
Median age of partner in years (IQR) | 34 (28–40) | 34 (28–40) | 34 (28–39) | 0.546 |
Age of partner in years categorised | 0.148 | |||
< 30 | 540 (30.5 %) | 275 (31.5 %) | 265 (29.6 %) | |
30–34 | 371 (21.0 %) | 174 (19.9 %) | 197 (22.0 %) | |
35–39 | 392 (22.2 %) | 179 (20.5 %) | 213 (23.8 %) | |
≥ 40 | 466 (26.3 %) | 246 (28.2 %) | 220 (24.6 %) | |
Median age difference in years participant - partner (IQR)c | 4 (−2 to 10) | 3 (−3 to 10) | 4 (−2 to 10) | 0.013 |
Age difference participant - partner, categorised | 0.137 | |||
Partner >5 years older than participant | 279 (15.8 %) | 151 (17.3 %) | 128 (14.3 %) | |
Partner and participant differ ≤5 years | 767 (43.4 %) | 375 (42.9 %) | 392 (43.8 %) | |
Partner is >5 years younger than participant | 723 (40.9 %) | 348 (39.8 %) | 375 (41.9 %) | |
Ethnic group partner | <0.001 | |||
Dutch | 974 (57.6 %) | 520 (61.3 %) | 454 (54.0 %) | |
Western, non-Dutch | 323 (19.1 %) | 127 (15.0 %) | 196 (23.3 %) | |
Non-western | 393 (23.3 %) | 202 (23.8 %) | 191 (22.7 %) | |
Concordance between ethnic group of participant - partner | 0.025 | |||
Concordant ethnicity | 767 (43.1 %) | 399 (45.4 %) | 368 (40.8 %) | |
Different ethnicity | 1014 (56.9 %) | 479 (54.6 %) | 535 (59.3 %) | |
Concordance in life styles participant - partner | 0.353 | |||
No difference in life styles | 703 (39.5 %) | 338 (38.5 %) | 365 (40.4 %) | |
Differences in life styles | 1078 (60.5 %) | 540 (61.5 %) | 538 (59.6 %) | |
HIV status partner | ||||
Perceived HIV status of partner | <0.001 | |||
HIV-negative | 715 (40.2 %) | 388 (44.2 %) | 327 (36.2 %) | |
HIV-positive | 270 (15.2 %) | 151 (17.2 %) | 119 (13.2 %) | |
Unaware | 796 (44.7 %) | 339 (38.6 %) | 457 (50.6 %) | |
Perceived HIV concordance participant - partner | <0.001 | |||
Same HIV status | 789 (44.3 %) | 430 (49.0 %) | 359 (39.8 %) | |
Different HIV status | 135 (7.6 %) | 72 (8.2 %) | 63 (7.0 %) | |
HIV status of participant or partner unknown | 857 (48.1 %) | 376 (42.8 %) | 481 (53.3 %) | |
Does partner know HIV status of participant? | <0.001 | |||
No | 201 (11.3 %) | 101 (11.5 %) | 100 (11.1 %) | |
Yes | 585 (32.9 %) | 340 (38.8 %) | 245 (27.2 %) | |
Possibly | 993 (55.8 %) | 436 (49.7 %) | 557 (61.8 %) | |
Sexual behaviour | ||||
Partnership type | <0.001 | |||
Known partner | 1137 (65.9 %) | 661 (77.7 %) | 476 (54.4 %) | |
Anonymous partner | 589 (34.1 %) | 190 (22.3 %) | 399 (45.6 %) | |
Sex frequency with partnerd | <0.001 | |||
Once | 961 (54.0 %) | 431 (49.1 %) | 530 (58.7 %) | |
2–5 times | 624 (35.1 %) | 344 (39.2 %) | 280 (31.0 %) | |
5–10 times | 129 (7.3 %) | 74 (8.4 %) | 55 (6.1 %) | |
> 10 times | 66 (3.7 %) | 28 (3.2 %) | 38 (4.2 %) | |
UAI | 0.082 | |||
No | 1339 (75.2 %) | 646 (73.6 %) | 693 (76.7 %) | |
Yes | 442 (24.8 %) | 232 (26.4 %) | 210 (23.3 %) | |
Group sex with partner | 0.003 | |||
No | 1518 (85.3 %) | 771 (87.9 %) | 747 (82.7 %) | |
Yes | 262 (14.5 %) | 106 (12.1 %) | 156 (17.3 %) | |
Paid sex with partner | 0.055 | |||
No | 1723 (96.9 %) | 841 (96.0 %) | 882 (97.7 %) | |
Yes | 56 (3.2 %) | 35 (4.0 %) | 21 (2.3 %) | |
Sex-related substance use in partnership | ||||
Any sex-related substance use | <0.001 | |||
No | 633 (35.5 %) | 344 (39.2 %) | 289 (32.0 %) | |
Yes | 1148 (64.5 %) | 534 (60.8 %) | 614 (68.0 %) | |
Sex-related alcohol use | <0.001 | |||
No | 1143 (64.2 %) | 627 (71.4 %) | 516 (57.1 %) | |
Yes | 638 (35.8 %) | 251 (28.6 %) | 387 (42.9 %) | |
Sex-related use of 2 or more substances other than alcohol | 0.576 | |||
No | 1467 (82.4 %) | 719 (82.0 %) | 748 (82.8 %) | |
Yes | 313 (17.6 %) | 158 (18.0 %) | 155 (17.2 %) |
HIV status of participant | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Negative | Positive | Unknown | |||||||||
No UAI | UAI | Total | No UAI | UAI | Total | No UAI | UAI | Total | |||
HIV status of partner | Neg | Offline | 228 (84.8 %) | 41 (15.2 %) | 269 | 32 (80.0 %) | 8 (20.0 %) | 40 | 15 (83.3 %) | 3 (16.7 %) | 18 |
Online | 267 (84.5 %) | 49 (15.5 %) | 316 | 33 (71.7 %) | 13 (28.3 %) | 46 | 21 (80.8 %) | 5 (19.2 %) | 26 | ||
Total | 495 (84.6 %) | 90 (15.4 %) | 585 | 65 (75.6 %) | 21 (24.4 %) | 86 | 36 (81.8 %) | 8 (18.2 %) | 44 | ||
Pos | Offline | 18 (78.3 %) | 5 (21.7 %) | 23 | 17 (18.9 %) | 73 (81.1 %) | 90 | 3 (50.0 %) | 3 (50.0 %) | 6 | |
Online | 20 (76.9 %) | 6 (23.1 %) | 26 | 24 (21.1 %) | 90 (79.0 %) | 114 | 2 (18.2 %) | 9 (81.8 %) | 11 | ||
Total | 38 (77.6 %) | 11 (22.5 %) | 49 | 41 (20.1 %) | 163 (79.9 %) | 204 | 5 (29.4 %) | 12 (70.6 %) | 17 | ||
Unk | Offline | 234 (91.1 %) | 23 (9.0 %) | 257 | 83 (71.6 %) | 33 (28.5 %) | 116 | 63 (75.0 %) | 21 (25.0 %) | 84 | |
Online | 171 (92.4 %) | 14 (7.6 %) | 185 | 63 (69.2 %) | 28 (30.8 %) | 91 | 45 (71.4 %) | 18 (28.6 %) | 63 | ||
Total | 405 (91.6 %) | 37 (8.4 %) | 442 | 146 (70.5 %) | 61 (29.5 %) | 207 | 108 (73.5 %) | 39 (26.5 %) | 147 |
Association between online/offline dating and UAI
Univariate | Model 1a | Model 2b | Model 3c | ||
---|---|---|---|---|---|
No. of partnerships with UAI | OR (95 % CI) | aOR (95 % CI) | aOR (95 % CI) | aOR (95 % CI) | |
n/N | |||||
Dating location | P = 0.031 | ||||
Offline | 210/903 (23.3 %) | 1 | |||
Online | 232/878 (26.4 %) | 1.36 (1.03–1.81) | |||
Self-perceived HIV status participant | P < 0.001 | ||||
HIV-negative | 138/1076 (12.8 %) | 1 | |||
HIV-positive | 245/497 (49.3 %) | 11.70 (7.40–18.45) | |||
Unaware | 59/208 (28.4 %) | 3.55 (2.02–6.22) | |||
Dating location * HIV status participant | P < 0.001 | P < 0.001 | P < 0.001 | P < 0.001 | |
Offline partner * HIV negative participant | 69/549 (12.6 %) | 1 | 1 | 1 | 1 |
Offline partner * HIV positive participant | 114/246 (46.3 %) | 9.67 (5.60–16.71) | 7.70 (4.43–13.39) | 13.02 (7.05–24.03) | 10.14 (5.32–19.30) |
Offline partner * HIV unaware participant | 27/108 (25.0 %) | 2.88 (1.40–5.89) | 2.63 (1.26–5.48) | 7.02 (3.12–15.79) | 4.30 (1.81–10.23) |
Online partner * HIV negative participant | 69/527 (13.1 %) | 1.07 (0.71–1.62) | 1.04 (0.69–1.59) | 0.93 (0.60–1.43) | 0.94 (0.59–1.48) |
Online partner * HIV positive participant | 131/251 (52.2 %) | 15.55 (8.86–27.30) | 12.67 (7.20–22.29) | 18.65 (10.00–34.80) | 16.41 (8.55–31.52) |
Online partner * HIV unaware participant | 32/100 (32.0 %) | 4.73 (2.34–9.57) | 4.87 (2.38–9.96) | 12.99 (5.86–28.77) | 11.00 (4.76–25.33) |
Demographics of the participant | |||||
Age in years categorised | P = 0.004 | P = 0.219 | P =0.230 | P = 0.222 | |
< 25 | 10/134 (7.5 %) | 0.23 (0.08–0.70) | 0.45 (0.16–1.22) | 0.40 (0.14–1.12) | 0.40 (0.13–1.19) |
25–29 | 57/243 (23.5 %) | 1.30 (0.61–2.75) | 1.39 (0.70–2.78) | 1.29 (0.63–2.64) | 1.32 (0.62–2.82) |
30–34 | 62/309 (20.1 %) | 1 | 1 | 1 | 1 |
35–39 | 100/362 (27.6 %) | 1.51 (0.77–2.98) | 1.37 (0.74–2.55) | 1.34 (0.71–2.55) | 1.36 (0.69–2.66) |
40–44 | 98/353 (27.8 %) | 1.57 (0.79–3.12) | 1.18 (0.63–2.22) | 1.06 (0.55–2.05) | 0.87 (0.43–1.75) |
≥ 45 | 115/380 (30.3 %) | 2.09 (1.06–4.11) | 1.39 (0.75–2.59) | 1.31 (0.67–2.57) | 1.16 (0.57–2.35) |
Ethnic group | P = 0.311 | P = 0.151 | P = 0.321 | P = 0.470 | |
Dutch | 316/1285 (24.6 %) | 1 | 1 | 1 | 1 |
Western, non-Dutch | 45/221 (20.4 %) | 0.89 (0.45–1.73) | 0.71 (0.39–1.28) | 0.76 (0.40–1.42) | 0.68 (0.35–1.31) |
Non-western | 67/221 (30.3 %) | 1.60 (0.83–3.06) | 1.49 (0.85–2.63) | 1.37 (0.74–2.53) | 1.05 (0.55–2.01) |
Sexual behaviour of the participant | |||||
No. of male sex partners in preceding 6 months, categorized | P < 0.001 | P = 0.255 | P = 0.345 | P = 0.570 | |
< 5 | 62/333 (18.6 %) | 1 | 1 | 1 | 1 |
5–9 | 107/528 (20.3 %) | 1.34 (0.74–2.43) | 1.16 (0.67–2.00) | 1.22 (0.69–2.14) | 1.11 (0.62–2.01) |
10–24 | 149/574 (26.0 %) | 1.79 (0.99–3.22) | 1.27 (0.75–2.18) | 1.27 (0.73–.2.20) | 1.09 (0.61–1.95) |
25–49 | 63/211 (30.0 %) | 2.27 (1.08–4.76) | 1.40 (0.71–2.78) | 1.36 (0.67–2.77) | 1.18 (0.56–2.48) |
≥ 50 | 61/135 (45.2 %) | 6.79 (2.86–16.13) | 2.48 (1.12–5.50) | 2.43 (1.06–5.56) | 2.08 (0.86–5.00) |
Characteristics of the partnership | |||||
Age difference (yrs) participant - partner, categorised | P = 0.482 | P = 0.121 | P = 0.109 | ||
Partner is >5 years older than participant | 72/279 (25.8 %) | 1 | 1 | 1 | |
Partner & participant differ ≤5 years in age | 180/767 (23.5 %) | 0.74 (0.45–1.21) | 0.63 (0.37–1.07) | 0.68 (0.39–1.19) | |
Partner is >5 years younger than participant | 187/723 (25.9 %) | 0.79 (0.46–1.35) | 0.85 (0.47–1.56) | 1.01 (0.53–1.92) | |
Etnic concordance participant - partner | P = 0.60 | P = 0.609 | P = 0.320 | ||
Concordant ethnicity | 193/767 (25.2 %) | 1 | 1 | 1 | |
Different ethnicity | 249/1014 (24.6 %) | 0.96 (0.68–1.34) | 1.10 (0.76–1.60) | 1.22 (0.82–1.81) | |
Concordance in life styles participant - partner | P = 0.115 | P = 0.023 | P = 0.015 | ||
No difference in life styles | 186/703 (26.5 %) | 1 | 1 | 1 | |
Differences in life styles | 256/1078 (23.8 %) | 0.75 (0.52–1.07) | 0.66 (0.46–0.95) | 0.63 (0.43–0.92) | |
HIV concordance participant -partner | P <0.001 | P < 0.001 | P < 0.001 | ||
Same HIV status | 253/789 (32.1 %) | 1 | 1 | 1 | |
Different HIV status | 32/135 (23.7 %) | 0.24 (0.12–0.47) | 0.14 (0.07–0.27) | 0.15 (0.08–0.30) | |
HIV status unknown of participant or partner | 157/857 (18.3 %) | 0.29 (0.20–0.43) | 0.19 (0.12–0.29) | 0.25 (0.16–0.40) | |
Partnership type | P = 0.055 | P = 0.413 | |||
Known partner | 289/1137 (25.4 %) | 1 | 1 | ||
Anonymous partner | 135/589 (22.9 %) | 0.70 (0.49–1.01) | 1.20 (0.77–1.88) | ||
Sex frequency with partnerd | P < 0.001 | P < 0.001 | |||
Once | 186/961 (19.4 %) | 1 | 1 | ||
2–5 times | 167/624 (26.8 %) | 1.98 (1.40–2.80) | 1.74 (1.17–2.58) | ||
5–10 times | 50/129 (38.8 %) | 3.58 (1.99–6.45) | 2.10 (1.09–4.08) | ||
> 10 times | 39/66 (59.1 %) | 16.29 (7.07–37.52) | 10.38 (4.29–25.15) | ||
Group sex with partner | P < 0.001 | P = 0.077 | |||
No | 337/1518 (22.2 %) | 1 | 1 | ||
Yes | 105/262 (40.1 %) | 2.54 (1.65–3.89) | 1.55 (0.95–2.52) | ||
Sex-related substance use in partnership | |||||
Sex-related use of at least 2 substances other than alcohol | P < 0.001 | P < 0.001 | |||
No | 288/1467 (19.6 %) | 1 | 1 | ||
Yes | 154/313 (49.2 %) | 5.37 (3.51–8.21) | 2.32 (1.44–3.75) |
Univariate | Model 1 | Model 2 | Model 3 | ||
---|---|---|---|---|---|
No. of partnerships with UAI | OR (95 % CI) | aOR (95 % CI) | aOR (95 % CI) | aOR (95 % CI) | |
n/N (%) | |||||
Dating location * HIV status participant | P = 0.754 | P = 0.843 | P = 0.727 | P = 0.778 | |
Offline partner * HIV negative participant | 69/549 (12.6 %) | 1 | 1 | 1 | 1 |
Online partner * HIV negative participant | 69/527 (13.1 %) | 1.07 (0.71–1.62) | 1.04 (0.69–1.59) | 0.93 (0.60–1.43) | 0.94 (0.59–1.48) |
P = 0.035 | P = 0.029 | P = 0.140 | P = 0.069 | ||
Offline partner * HIV positive participant | 114/246 (46.3 %) | 1 | 1 | 1 | 1 |
Online partner * HIV positive participant | 131/251 (52.2 %) | 1.61 (1.03–2.50) | 1.65 (1.05–2.57) | 1.43 (0.89–2.31) | 1.62 (0.96–2.72) |
P = 0.187 | P = 0.113 | P = 0.118 | P = 0.027 | ||
Offline partner * HIV unaware participant | 27/108 (25.0 %) | 1 | 1 | 1 | 1 |
Online partner * HIV unaware participant | 32/100 (32.0 %) | 1.65 (0.79–3.44) | 1.85 (0.86–3.98) | 1.85 (0.86–4.00) | 2.55 (1.11–5.86) |