Gay men use many ways to moderate sexual risk

via aidsmap, by Gus Cairns

The vast majority of gay men, HIV-positive and negative, make some effort to moderate their risk of transmitting or acquiring HIV, Dr Limin Mao of the University of New South Wales in Australia told the Tenth AIDS Impact conference.

The results of three annual surveys show that the decisions faced by gay men are much more complex than the decision whether or not to use a condom. Choices range in terms of the likely degree of protection from HIV they offer: from avoiding sex or anal sex altogether to at least avoiding unprotected anal sex with someone known to have the opposite HIV status.

Using condoms 100% of the time for anal sex is still the most popular single strategy, the study found, but only a third of HIV-negative men and a quarter of HIV-positive men now do this. Taken as a whole, strategies involving basing whether to have unprotected anal sex on a partner's HIV status (serosorting) are now at least as popular as consistent condom use.

The study found a clear difference between serosorting practices according to participants' HIV status. The second most popular safer-sex strategy for HIV-negative men was to restrict unprotected sex to an HIV-negative regular partner – a strategy that has been called 'negotiated safety'.

HIV-positive men were less likely to restrict unprotected sex solely to their primary partner; instead the most popular strategies were to limit unprotected anal sex, both with regular and casual partners, to other HIV-positive partners – or at least to try and exclude having it with regular and casual partners not known to be HIV positive.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort

via PlosONE

Philip SS, Yu X, Donnell D, Vittinghoff E, Buchbinder S (2010) Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort. PLoS ONE 5(9): e12662. doi:10.1371/journal.pone.0012662

Abstract

Background

Seroadaptation strategies such as serosorting and seropositioning originated within communities of men who have sex with men (MSM), but there are limited data about their effectiveness in preventing HIV transmission when utilized by HIV-negative men.

Methodology/Principal Findings

Data from the EXPLORE cohort of HIV-negative MSM who reported both seroconcordant and serodiscordant partners were used to evaluate serosorting and seropositioning. The association of serosorting and seropositioning with HIV seroconversion was evaluated in this cohort of high risk MSM from six U.S. cities. Serosorting was independently associated with a small decrease in risk of HIV seroconversion (OR = 0.88; 95%CI, 0.81–0.95), even among participants reporting ≥10 partners. Those who more consistently practiced serosorting were more likely to be white (p = 0.01), have completed college (p = <0.0002) and to have had 10 or more partners in the six months before the baseline visit (p = 0.01) but did not differ in age, reporting HIV-infected partners, or drug use. There was no evidence of a seroconversion effect with seropositioning (OR 1.02, 95%CI, 0.92–1.14).

Significance

In high risk HIV uninfected MSM who report unprotected anal intercourse with both seroconcordant and serodiscordant partners, serosorting was associated with a modest decreased risk of HIV infection. To maximize any potential benefit, it will be important to increase accurate knowledge of HIV status, through increased testing frequency, improved test technology, and continued development of strategies to increase disclosure.

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