title: Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities.
abstract: We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts.
authors.affiliation: Department of Human Development, State University of New York at Binghamton, 4400 Vestal Parkway East, Binghamton, NY, 13902, USA. lwilton@binghamton.edu.|Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa. lwilton@binghamton.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Wilton
authors.affiliation: Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA.
authors.forename: Beryl
authors.initials: B
authors.lastname: Koblin
authors.affiliation: Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nandi
authors.affiliation: Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA.
authors.forename: Guozhen
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Latkin
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Seal
authors.affiliation: National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Flores
authors.affiliation: National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Pilgrim
authors.initials: P
authors.lastname: Spikes
mesh_terms: D000328:Adult; D001741:Black or African American; D002947:Cities; D015658:HIV Infections; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities; D047568:Unsafe Sex; D055815:Young Adult
keywords: Black MSM; Mental health; Serosorting; Strategic positioning; Substance use