title: Serosorting and HIV/STI Infection among HIV-Negative MSM and Transgender People: A Systematic Review and Meta-Analysis to Inform WHO Guidelines.
abstract: We conducted a systematic review and meta-analysis to assess the association between serosorting and HIV infection, sexually transmitted infections (STIs), and quality of life among men who have sex with men (MSM) and transgender people. Two reviewers independently screened abstracts and abstracted data. Meta-analyses were conducted using random effects models. Of 310 citations reviewed, 4 observational studies, all with MSM, met inclusion criteria. Compared to consistent condom use, serosorting was associated with increased risk of HIV (3 studies, odds ratio (OR): 1.80, 95% confidence interval (CI):1.21-2.70) and bacterial STIs (1 study, OR: 1.62, 95% CI: 1.44-1.83). Compared to no condom use, serosorting was associated with reduced risk of HIV (3 studies, OR: 0.46, 95% CI: 0.25-0.83) and bacterial STIs (1 study, OR: 0.81, 95% CI: 0.73-0.91). Among HIV-negative MSM, condom use appears to be more protective against HIV and STIs than serosorting and should be encouraged. However, serosorting may be better than no condom use as a harm reduction strategy.
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA ; Social and Behavioral Interventions Program, Department of International Health, Room E5033, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors: Caitlin E
authors: CE
authors: Kennedy
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors: Laura J
authors: LJ
authors: Bernard
authors: Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
authors: Kathryn E
authors: KE
authors: Muessig
authors: Instituto de Estudios en Salud, Sexualidad y Desarrollo Humano, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Kelika A
authors: KA
authors: Konda
authors: Department of Medicine, State University of New York at Buffalo, Buffalo, NY 14214, USA ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON L8S 4L8, Canada.
authors: Elie A
authors: EA
authors: Akl
authors: Department of HIV/AIDS, World Health Organization, 1211 Geneva, Switzerland.
authors: Ying-Ru
authors: YR
authors: Lo
authors: Department of HIV/AIDS, World Health Organization, 1211 Geneva, Switzerland.
authors: Antonio
authors: A
authors: Gerbase
authors: Department of HIV/AIDS, World Health Organization, 1211 Geneva, Switzerland.
authors: Kevin R
authors: KR
authors: O'Reilly