Prevalence of Seroadaptive Behaviors of Men Who Have Sex With Men, San Francisco, 2004
The researchers set out to define and measure the prevalence of HIV seroadaptive behaviors among men who have sex with men (MSM). Time-location sampling was used to recruit a community-based, cross-sectional sample of 1,211 HIV-negative and 251 HIV-positive MSM in San Francisco in 2004.
To define seroadaptive behaviors, all episodes of anal intercourse were enumerated and characterized by partner type, partner HIV serostatus, sexual position, and condom use for up to five partners in the preceding six months.
The results showed that 37.6 percent of HIV-negative MSM engaged in some form of seroadaptive behavior: pure serosorting (24.7 percent), seropositioning (5.9 percent), condom serosorting (3.9 percent), and negotiated safety (3.1 percent). Some form of seroadaptation was noted for 43.4 percent of HIV-positive men -- including pure serosorting (19.5 percent), seropositioning (14.3 percent), and condom serosorting (9.6 percent). Consistent use of condoms was reported by 37.1 percent of HIV-negative men and 20.7 percent of HIV-positive men.
"In aggregate, seroadaptive behaviors appear to be the most common HIV prevention strategy adopted by MSM in San Francisco as of 2004," the authors concluded. "Surveillance and epidemiological studies need to precisely measure seroadaptive behaviors in order to gauge and track the true level of HIV risk in populations. Rigorous prevention research is needed to assess the efficacy of seroadaptive behaviors on individuals' risk and on the epidemic."
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