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

• Published in: AIDS care Vol. 23; no. 3; pp. 261 - 268
• Main Authors: McFarland, Willi, Chen, Yea-Hung, Raymond, H. Fisher, Nguyen, Binh, Colfax, Grant, Mehrtens, Jason, Robertson, Tyler, Stall, Ron, Levine, Deb, Truong, Hong-Ha M.
• Format: Journal Article
• Language: English
• Published: Abingdon Taylor & Francis Group 01.03.2011; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; AIDS; AIDS/HIV; Anal intercourse; Biological and medical sciences; California; Condoms; Disease transmission; Fundamental and applied biological sciences. Psychology; Gays & lesbians; Harm reduction; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Seronegativity; HIV Seropositivity - psychology; Homosexuality, Male - psychology; Homosexuals; Human immunodeficiency virus; Human viral diseases; Humans; Illness and personality; Infectious diseases; Male; Medical sciences; Men; men who have sex with men; Middle Aged; Personality, behavior and health; Personality. Affectivity; Prevalence; Prevention; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Public health; risk behavior; Risk Factors; Risk reduction; Risk Reduction Behavior; Safe Sex - psychology; San Francisco - epidemiology; serosorting; Sexual behavior; Sexual Behavior - psychology; Sexual behaviour; Sexuality. Sexual behavior; Sexually Transmitted Diseases - prevention & control; Sexually Transmitted Diseases - transmission; Social behaviour; Strategic planning; U.S.A; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; United States; North America; America; San Francisco; United States > US; San Francisco California; USA, California, San Francisco; Social environment; Human; Immunopathology; Homosexuality; risk behavior; Sexual behavior; Mental health; Retroviridae; Male; AIDS; Sexual intercourse; Risk taking; Immune deficiency; Lentivirus; men who have sex with men; Infection; Virus; serosorting; Viral disease; Sex partner; Harm reduction; Human immunodeficiency virus; Public health
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2010.507748

"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=1207 MSM), among sexual dyads (N=3746 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.