Topic
HIV Serosorting
About: HIV Serosorting is a research topic. Over the lifetime, 39 publications have been published within this topic receiving 2215 citations.
Papers
TL;DR: ART is a potent intervention for prevention of HIV in discordant couples in which the index partner has ≤550 CD4 cells/µL, and this review confirms the suspected benefit seen in earlier observational studies and reported in more recent ones.
Abstract: Antiretroviral therapy prevents perinatal transmission of human immunodeficiency virus (HIV), 1 and several observational studies suggest that an HIV-infected patient’s sexual partner is less likely to become infected if the patient is taking antiretroviral therapy. 2 A serodiscordant couple is one in which one member is HIVinfected and the other is not. Data from Africa suggest that up to half of new infections occur in stable serodiscordant couples. 3 Understanding serodiscordancy can help clinicians better counsel their patients with HIV about transmission risk to uninfected partners and, more broadly, about the importance of antiretroviral therapy and adherence. Summary of Findings We identified 9 observational studies and the HIV Prevention Trials Network Study 052 (HPTN 052), a randomized clinical trial (RCT), that compared treated and untreated serodiscordant couples. The HPTN 052 study included asymptomatic patients with HIV who had a CD4 cell count of 350 to 550/μL and compared those who received antiretroviral therapy with those in whom treatment was delayed until their CD4 cell counts were less than 350/μL. 4 The end point was HIV transmission to the uninfected partners. The trial showed that early antiretroviral therapy was associated with a decreased risk of HIV transmission (rate ratio [RR], 0.11 [95% CI, 0.040.32]) to uninfected partners (treated couples, 4 transmissions within 1585 person-years; untreated couples, 35 within 1567 person-years). 4 Cohen and coauthors 4 conducted phylogenetic analyses of the transmitted viruses and found only 1 instance of linked transmission among treated couples compared with 27 linked transmissions among untreated couples (RR, 0.04 [95% CI, 0.000.27]).
254 citations
TL;DR: HIV incidence among MSM appears to have stabilised at a plateau following several years of resurgence, and increases in the selection of sexual partners of concordant HIV serostatus may be contributing to the stabilisation of the epidemic.
Abstract: Background: Sexually transmitted infections (STI) and unprotected anal intercourse (UAI) have been increasing among men who have sex with men (MSM) in San Francisco. However, HIV incidence has stabilised. Objectives: To describe recent trends in sexual risk behaviour, STI, and HIV incidence among MSM in San Francisco and to assess whether increases in HIV serosorting (that is, selective unprotected sex with partners of the same HIV status) may contribute to preventing further expansion of the epidemic. Methods: The study applies an ecological approach and follows the principles of second generation HIV surveillance. Temporal trends in biological and behavioural measures among MSM were assessed using multiple pre-existing data sources: STI case reporting, prevention outreach programmatic data, and voluntary HIV counselling and testing data. Results: Reported STI cases among MSM rose from 1998 through 2004, although the rate of increase slowed between 2002 and 2004. Rectal gonorrhoea cases increased from 157 to 389 while early syphilis increased from nine to 492. UAI increased overall from 1998 to 2004 (p Conclusions: HIV incidence among MSM appears to have stabilised at a plateau following several years of resurgence. Increases in the selection of sexual partners of concordant HIV serostatus may be contributing to the stabilisation of the epidemic. However, current incidence rates of STI and HIV remain high. Moreover, a strategy of risk reduction by HIV serosorting can be severely limited by imperfect knowledge of one’s own and one’s partners’ serostatus.
251 citations
TL;DR: Prevention and intervention programmes are urgently needed to alert HIV-negative gay men to the risks associated with ‘serosorting’, and remind them of the need for consistent condom use.
Abstract: This paper addresses the question of whether HIV-negative gay men engage in "serosorting" in casual encounters. Serosorting, defined as engaging in unprotected anal intercourse with casual partners who they report to be HIV negative, has been increasing among HIV-negative gay men in Sydney. Prevention and intervention programmes are urgently needed to alert HIV-negative gay men to the risks associated with "serosorting", and remind them of the need for consistent condom use.
192 citations
TL;DR: Research on serosorting for HIV risk reduction is reviewed and an evidence-based approach to serosort guidance is offered, highlighting the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.
Abstract: A common HIV/AIDS risk reduction strategy among men who have sex with men (MSM) is to limit their unprotected sex partners to those who are of the same HIV status, a practice referred to as serosorting. Decisions to serosort for HIV risk reduction are based on personal impressions and beliefs, and there is limited guidance offered on this community derived strategy from public health services. This paper reviews research on serosorting for HIV risk reduction and offers an evidence-based approach to serosorting guidance. Following a comprehensive electronic and manual literature search, we reviewed 51 studies relating to the implications of serosorting. Studies showed that HIV negative MSM who select partners based on HIV status are inadvertently placing themselves at risk for HIV. Infrequent HIV testing, lack of HIV status disclosure, co-occurring sexually transmitted infections, and acute HIV infection impede the potential protective benefits of serosorting. Public health messages should continue to encourage reductions in numbers of sexual partners and increases in condom use. Risk reduction messages should also highlight the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.
149 citations
TL;DR: Because both HIV-positive and HIV- negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection.
Abstract: We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner's seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner's status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner's status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men.
129 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 1 |
| 2020 | 2 |
| 2018 | 3 |
| 2017 | 3 |
| 2016 | 4 |
| 2015 | 4 |