title: HIV seroadaptation among individuals, within sexual dyads, and by sexual episodes, men who have sex with men, San Francisco, 2008.
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.
authors.affiliation: San Francisco Department of Public Health, USA. Willi_McFarland@hotmail.com
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Yea-Hung
authors.initials: YH
authors.lastname: Chen
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Binh
authors.initials: B
authors.lastname: Nguyen
authors.forename: Grant
authors.initials: G
authors.lastname: Colfax
authors.forename: Jason
authors.initials: J
authors.lastname: Mehrtens
authors.forename: Tyler
authors.initials: T
authors.lastname: Robertson
authors.forename: Ron
authors.initials: R
authors.lastname: Stall
authors.forename: Deb
authors.initials: D
authors.lastname: Levine
authors.forename: Hong-Ha M
authors.initials: HM
authors.lastname: Truong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017280:Condoms; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D021841:Safe Sex / Q000523:psychology*; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000635:transmission; D055815:Young Adult