Developing a conceptual framework of seroadaptive behaviors in HIV-diagnosed men who have sex with men.
BACKGROUND
Seroadaptive behaviors are strategies employed by men who have sex with men (MSM) to reduce the transmission risk for human immunodeficiency virus (HIV). It has been suggested that they contribute to the increasing diagnoses of sexually transmitted infections in HIV-diagnosed MSM. To understand the context in which the reemerging sexually transmitted infections appear, we developed a social epidemiological model incorporating the multiple factors influencing seroadaptive behaviors.


METHODS
A literature review of seroadaptive behaviors in HIV-diagnosed MSM was conducted. The literature was synthesized using a social epidemiological perspective.


RESULTS
Seroadaptive behaviors are adopted by MSM in high-income countries and are a way for HIV-diagnosed men to manage and enjoy their sexual lives. Influences are apparent at structural, community, interpersonal, and intrapersonal levels. There is little evidence of whether and when the behavior forms part of a premeditated strategy; it seems dependent on the social context and on time since HIV diagnosis. Social rules of HIV disclosure and perception of risk depend on the setting where partners are encountered.


CONCLUSIONS
Seroadaptive behaviors are strongly context dependent and can reduce or increase transmission risk for different infectious diseases. Further data collection and mathematical modeling can help us explore the specific conditions in more detail.
Department of Infectious Disease Epidemiology.
Minttu
M
Rönn
MRC Centre for Outbreak Analysis and Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control.
Peter J
PJ
White
STI Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom.
Gwenda
G
Hughes
Department of Infectious Disease Epidemiology.
Helen
H
Ward
D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D047568:Unsafe Sex
HIV; men who have sex with men; seroadaptive