title: A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men.
abstract: Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada, were recruited. Grouped by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viral-load sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72 %) and a large proportion of HIV-positive men (42 %) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM's sexual health needs.
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada. kcard@sfu.ca.|Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada. kcard@sfu.ca.
authors.forename: Kiffer G
authors.initials: KG
authors.lastname: Card
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Lachowsky
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Zishan
authors.initials: Z
authors.lastname: Cui
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.|Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Carter
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Armstrong
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Shurgold
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.|Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
authors.affiliation: Department of Anthropology, University of Victoria, Victoria, BC, Canada.|Centre for Addiction Research of British Columbia, University of Victoria, Victoria, BC, Canada.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001727:Bisexuality / Q000523:psychology*; D002170:Canada; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology; D059147:HIV Serosorting / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D000077272:Latent Class Analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D040242:Risk Reduction Behavior; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D000072339:Sexual and Gender Minorities; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Gay and bisexual men; HIV; Latent class analysis; Seroadaptation; Sexual orientation