Quantifying the Harms and Benefits from Serosorting Among HIV-Negative Gay and Bisexual Men: A Systematic Review and Meta-analysis

We conducted a systematic review and meta-analysis of the association between serosorting and HIV infection among HIV-negative men who have sex with men (MSM). Compared to no condomless anal sex (i.e., consistent condom use or no anal sex), serosorting was associated with increased HIV risk (RR = 1....

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Bibliographic Details
Published inAIDS and behavior Vol. 21; no. 10; pp. 2835 - 2843
Main Authors Purcell, David W., Higa, Darrel, Mizuno, Yuko, Lyles, Cynthia
Format Journal Article
LanguageEnglish
Published New York Springer US 01.10.2017
Springer Nature B.V
Subjects
Acquired immune deficiency syndrome
AIDS
Anal intercourse
Anal sex
Bisexuality
Condoms
Evidence-based medicine
Gays & lesbians
Harm reduction
Health Psychology
Health risk assessment
Health risks
HIV
Homosexuality
Human immunodeficiency virus
Infectious Diseases
Medicine
Medicine & Public Health
Men who have sex with men
Mens health
Meta-analysis
Operational definitions
Original Paper
Prevention
Public Health
Risk factors
Risk reduction
Sex
Systematic review
Systematic review
Serosorting
HIV
MSM
Meta-analysis
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Summary:We conducted a systematic review and meta-analysis of the association between serosorting and HIV infection among HIV-negative men who have sex with men (MSM). Compared to no condomless anal sex (i.e., consistent condom use or no anal sex), serosorting was associated with increased HIV risk (RR = 1.64, 95% CI 1.37–1.96). Compared to condomless discordant anal sex, serosorting was associated with reduced HIV risk (RR = 0.46, 95% CI 0.33–0.65). Serosorting may be an important harm reduction strategy when condoms are not consistently used, but can be harmful if HIV-negative MSM who consistently use condoms shift to using serosorting as their primary prevention strategy. The protective effects of serosorting and ways in which MSM are operationalizing serosorting are becoming more complex as additional factors affecting risk are considered (e.g., durable viral load suppression, PrEP). Understanding the potential risk and benefit of serosorting continues to be important, particularly within the context of other prevention strategies.
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ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-017-1800-z