title: Changes in seroadaptive practices from before to after diagnosis of recent HIV infection among men who have sex with men.
abstract: OBJECTIVE
  We assessed changes in sexual behavior among men who have sex with men (MSM), before and for several years after HIV diagnosis, accounting for adoption of a variety of seroadaptive practices.
  
  
  METHODS
  We collected self-reported sexual behavior data every 3 months from HIV-positive MSM at various stages of HIV infection. To establish population level trends in sexual behavior, we used negative binomial regression to model the relationship between time since diagnosis and several sexual behavior variables: numbers of (a) total partners, (b) potentially discordant partners (PDP; i.e., HIV-negative or unknown-status partners), (c) PDPs with whom unprotected anal intercourse (UAI) occurred, and (d) PDPs with whom unprotected insertive anal intercourse (uIAI) occurred.
  
  
  RESULTS
  A total of 237 HIV-positive MSM contributed 502 interviews. UAI with PDPs occurred with a mean of 4.2 partners in the 3 months before diagnosis. This declined to 0.9 partners/3 months at 12 months after diagnosis, and subsequently rose to 1.7 partners/3 months at 48 months, before falling again to 1.0 partners/3 months at 60 months. The number of PDPs with whom uIAI occurred dropped from 2.4 in the pre-diagnosis period to 0.3 partners/3 months (an 87.5% reduction) by 12 months after enrollment, and continued to decline over time.
  
  
  CONCLUSIONS
  Within months after being diagnosed with HIV, MSM adopted seroadaptive practices, especially seropositioning, where the HIV-positive partner was not in the insertive position during UAI, resulting in a sustained decline in the sexual activity associated with the highest risk of HIV transmission.
authors: Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA. snigdhav@gmail.com
authors: Snigdha
authors: S
authors: Vallabhaneni
authors: J Jeff
authors: JJ
authors: McConnell
authors: Lisa
authors: L
authors: Loeb
authors: Wendy
authors: W
authors: Hartogensis
authors: Fredrick M
authors: FM
authors: Hecht
authors: Robert M
authors: RM
authors: Grant
authors: Christopher D
authors: CD
authors: Pilcher
mesh_terms: D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology* / Q000635:transmission; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000523:psychology* / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult