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The impact of HIV seroadaptive behaviors on sexually transmissible infections in HIV-negative homosexual men in Sydney, Australia.
Open accessAbstract
BACKGROUND: Human immunodeficiency virus (HIV) seroadaptive behaviors, such as serosorting and strategic positioning, are being increasingly practised by homosexual men; however, their impact on sexually transmissible infections is unclear. METHODS: Participants were 1427 initially HIV-negative men enrolled from 2001 to 2004 and followed to June 2007. Participants were tested annually for anal and urethral gonorrhoea and chlamydia, herpes simplex virus, and syphilis. In addition, they reported diagnoses of these conditions, and of genital and anal warts between annual visits, and sexual risk behaviors. RESULTS: Compared with men who reported no unprotected anal intercourse (UAI), serosorting was associated with an increased risk of urethral (incidence: 6.06 vs. 3.56 per 100 person-years (PY), hazard ratio (HR) = 1.97, 95% confidence interval [CI]: 1.43-2.72) and anal (incidence 3.95 vs. 2.80 per 100 PY, HR = 1.62, 95% CI: 1.11-2.36) chlamydia. Compared with men who reported UAI with HIV nonconcordant partners, men who practised serosorting had significantly lower risk of incident syphilis (incidence 0.18 vs. 1.00 per 100 PY, HR = 0.21, 95% CI: 0.05-0.81) and urethral gonorrhoea (incidence 2.15 vs. 5.52 per 100 PY, HR = 0.61, 95% CI: 0.39-0.96). Compared with men who reported no UAI, strategic positioning was associated with an increased risk of urethral gonorrhoea (incidence 4.11 vs. 2.10 per 100 PY, HR = 1.72, 95% CI: 1.05-2.83) and chlamydia (incidence 8.71 vs. 3.56 per 100 PY, HR = 2.22, 95% CI: 1.55-3.18). Compared with men who reported receptive UAI, the incidence of anal gonorrhoea (incidence 1.48 vs. 3.83 per 100 PY, HR = 0.38, 0.20-0.74) and chlamydia (incidence 3.10 vs. 6.30 per 100 PY, HR = 0.44, 95% CI: 0.27-0.69) was significantly lower in those who practised strategic positioning. CONCLUSION: For men who reported seroadaptive behaviors, rates of some bacterial sexually transmissible infections were higher than in men who reported no UAI. However, rates were lower than for men who reported higher HIV risk behaviors.
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Serosorting practices have been associated with increased risk for STIs, including chlamydia and gonorrhea.
“Serosorting practices have been associated with increased risk for STIs, including chlamydia and gonorrhea (102,103).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [102]
The Results (Serosorting) associate serosorting with increased urethral and anal chlamydia risk compared with no unprotected anal intercourse. They do not show increased gonorrhoea risk from serosorting; compared with non-seroconcordant unprotected anal intercourse, gonorrhoea risk was lower. The reported increase in urethral gonorrhoea risk concerned strategic positioning, a different practice. (LLM, conf=0.89)
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Sexually Transmitted Infections in Western Europe Among HIV-Positive Men Who Have Sex With Men
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HIV Serosorting in Men Who Have Sex With Men: Is It Safe?
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Self-citationSexual risk behaviour of men who have sex with men: emerging patterns and new challenges
Hart, G. J., & Elford, J. (2009) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0b013e328334feb1 · Cited by 102
Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK
McDaid, L. M., Dodds, J. P., Mercey, D., et al. (2008) · AIDS · doi:10.1097/qad.0b013e3282f8af9b · Cited by 98
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Self-citationImprovements in sexual health testing among gay men in Sydney, Australia, 2003–2007
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
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Simms, I., Field, N., Jenkins, C., Childs, T., Gilbart, V. L., Dallman, T. J., Mook, P., Crook, P. D., & Hughes, G. (2015) · Eurosurveillance · doi:10.2807/1560-7917.es2015.20.15.21097 · Cited by 95
Metadata
- Authors
- Jin, F., Prestage, G. P., Templeton, D. J., Poynten, I. M., Donovan, B., Zablotska, I., Kippax, S. C., Mindel, A., & Grulich, A. E.
- Affiliations
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Royal Prince Alfred Hospital (AU)
- Sydney Hospital (AU)
- Corresponding author
- Jin, Fengyi
- Prestage, Garrett P.
- Templeton, David J.
- Poynten, I. Mary
- Donovan, Basil
- Zablotska, Iryna
- Grulich, Andrew E.
- ORCID
- Venue
- Sexually Transmitted Diseases
- Published
- 2012-03
- Volume
- 39
- Issue
- 3
- Pages
- 191-194
- ISSN
- 0148-5717 (ISSN-L)
- PMC
- PMC3282017
- OpenAlex
- W2087440321
- Cited by
- 45
- References
- 16
- Citations by year
- 2022: 1 · 2021: 5 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 9 · 2014: 6 · 2013: 3 · 2012: 3
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01ai005395-000)
- National Institute of Allergy and Infectious Diseases (N01 AI005395)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- serosorting, strategic positioning, sexually transmitted infections, HIV-negative men who have sex with men, unprotected anal intercourse, syphilis, herpes simplex virus, genital warts, anal warts, sexual risk behavior, HIV prevention
- MeSH terms
- Adolescent, Adult, Aged, Australia, HIV Seropositivity, Humans, Male, Middle Aged, Risk-Taking, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases, HIV Infections, Proportional Hazards Models, HIV Seronegativity, Homosexuality, Male, Unsafe Sex, Young Adult, HIV Serosorting
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