Seroadaptive Strategies of Gay & Bisexual Men (GBM) with the Highest Quartile Number of Sexual Partners in Vancouver, Canada

Abstract

Despite continued research among men with more sexual partners, little information exists on their seroadaptive behavior. Therefore, we examined seroadaptive anal sex strategies among 719 Vancouver gay and bisexual men (GBM) recruited using respondent driven sampling (RDS). Our objectives were to (1) describe the distribution in frequency of male sexual partnering among Vancouver GBM, and (2) identify important covariates associated with the number of male sexual partners. To this aims, we provide descriptive, univariate, and multivariate adjusted statistics, stratified by HIV status, for the association between having ≥7 male anal sex partners in the past six months (Population Q3, versus <7). Sensitivity Analysis were also performed to assess the robustness of this cut-off point. Results suggest that GBM with more sexual partners are more likely to employ seroadaptive strategies than men with fewer partners. These strategies may be used in hopes of offsetting risk, assessing needs for subsequent HIV testing, and balancing personal health with sexual intimacy. Further research is needed to determine the efficacy of these strategies, assess how GBM perceive their efficacy, and understand the social and health impacts of their widespread uptake.

Social support and HIV prevention behaviors among urban HIV-negative gay, bisexual, and other men who have sex with men.

“…That is, although men with higher social support are more likely to report a larger number of male partners, they were also more likely to take steps to protect their sexual health, such as (a) seeking regular STI/HIV testing, (b) talking about HIV status with their partners, and (c) engaging in HIV risk reduction behavior such as using PrEP when engaging in CAS. Other work (see Card et al, 2017), which also used a Canadian sample, found that GBM in their highest quartile for number of sex partners were also more likely to engage in HIV prevention-related behaviors (like sero-positioning). It may be that social support is an important factor in that association.…”

Belief in Treatment as Prevention and Its Relationship to HIV Status and Behavioral Risk

“…39 Programs designed to ensure that all GBM have a basic understanding of the benefits and limitations of biomedical prevention might also have the added benefit of addressing lagging negative attitudes towards HIV-positive men, thereby helping to establish realistic risk-perceptions for those who experience significant anxiety regarding their sexual behavior. Indeed, because disclosure of serostatus is an important precursor of several risk reductions strategies employed by GBM, 40–42 reducing stigma for HIV may enhance disclosure self-efficacy among HIV-positive men—making these strategies more effective for all GBM. 43,44 This is especially important for contexts where risk reduction measures not dependent on sero-disclosure, such as PrEP, are not yet widely available.…”

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

“…Similarly, subsequent analysis of the same data (Card et al, 2016) indicated that both HIV-positive and HIV-negative/unknown sero-status GBM with > 7 anal sex partners in the previous 6 months were significantly more likely to report VLS. In addition, both analyses were cross-sectional.…”

“…Multivariable analysis revealed that both HIV-negative/unknown and HIV-positive group sex event attendees considered condomless anal intercourse with an HIV-positive partner on HAART and reporting an undetectable viral load as a sero-adaptive strategy. This finding, which called viral load sorting, or VLS (Card et al, 2016), has important practical and theoretical implications for HIV research and personal sexual decision-making. For HIV research, HIV-negative/unknown sero-status men having condomless anal intercourse with HIV-positive men previously would be considered “high risk” sexual behaviour since it constitutes sero-discordant sexual partnerships; just the opposite of the historic strategy of sero-sorting.…”