HIV seroadaptation among individuals, within sexual dyads, and by sexual episodes, men who have sex with men, San Francisco, 2008

Abstract

Abstract"Seroadaptation" comprises sexual behaviors to reduce the risk of HIV acquisition and transmission based on knowing one's own and one's sexual partners' serostatus. We measured the prevalence of seroadaptive behaviors among men who have sex with men (MSM) recruited through time-location sampling (TLS) across three perspectives: by individuals (N=1,207 MSM), among sexual dyads (N=3,746 partnerships), and for sexual episodes (N=63,789 episodes) in the preceding six months. Seroadaptation was more common than 100% condom use when considering the consistent behavioral pattern of individuals (adopted by 39.1% vs. 25.0% of men, respectively). Among sexual dyads 100% condom use was more common than seroadaptation (33.1% vs. 26.4%, respectively). Considering episodes of sex, not having anal intercourse (65.0%) and condom use (16.0%) were the most common risk reduction behaviors. Sex of highest acquisition and transmission risks (unprotected anal intercourse with a HIV serodiscordant or unknown status partner in the riskier position) occurred in only 1.6% of sexual episodes. In aggregate, MSM achieve a high level of sexual harm reduction through multiple strategies. Detailed measures of seroadaptive behaviors are needed to effectively target HIV risk and gauge the potential of serosorting and related sexual harm reduction strategies on the HIV epidemic.

Gay and bisexual men engage in fewer risky sexual behaviors while traveling internationally: a cross-sectional study in San Francisco

“…One-third of participants reported having UAI while staying locally, a prevalence that was comparable with the 31% reported by a study of sexual behaviours among MSM in San Francisco 20. The level of UAI reported by participants poses a risk for transmission of HIV and other sexually transmitted infections.…”

Reaching black men who have sex with men: a comparison between respondent-driven sampling and time-location sampling

“…), a cross-sectional survey was conducted of men attending MSM venues in San Francisco previously described in detail 13 14. TLS was used to recruit participants.…”

Prevalence, correlates and trends in seroadaptive behaviours among men who have sex with men from serial cross-sectional surveillance in San Francisco, 2004–2011

“…There is also little known about which behavioural and health-related factors may be correlated with seroadaptive behaviours 17 18. Richer detail on the predictors and current practice of seroadaptive behaviours will aid in the continuing effort to establish the prevalence of seroadaptive practices, their intentionality19 20 and their efficacy in preventing HIV 21.…”