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AIDS Care
Psychological and Socio-medical Aspects of AIDS/HIV
Volume 23, 2011 - Issue 3
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ORIGINAL ARTICLE

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

, , , , , , , , & show all
Pages 261-268 | Received 04 Jan 2010, Published online: 22 Feb 2011
 

Abstract

“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.

Acknowledgements

National Institute of Mental Health (NIMH) Grant R01MH077509 supported this research.

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