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A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men

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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.

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Acknowledgments

The authors would like to thank the Momentum Health Study participants, office staff, and community advisory board, Kirk J. Hepburn, who edited this article, as well as our community partner agencies: Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC. Momentum is funded through the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes for Health Research (MOP-107544, 143342). Dr. Lachowsky is supported by a CANFAR/CTN Postdoctoral Fellowship Award. Dr. Moore is supported by a Scholar Award from the Michael Smith Foundation for Health Research (#5209).

Funding

This study was funded by the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes for Health Research (MOP-107544, 143342).

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Authors and Affiliations

  1. BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada

    Kiffer G. Card, Nathan J. Lachowsky, Zishan Cui, Allison Carter, Heather Armstrong, Susan Shurgold, David Moore & Robert S. Hogg

  2. Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada

    Kiffer G. Card, Allison Carter & Robert S. Hogg

  3. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Nathan J. Lachowsky & David Moore

  4. Department of Anthropology, University of Victoria, Victoria, BC, Canada

    Eric A. Roth

  5. Centre for Addiction Research of British Columbia, University of Victoria, Victoria, BC, Canada

    Eric A. Roth

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  1. Kiffer G. Card
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  2. Nathan J. Lachowsky
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  3. Zishan Cui
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  4. Allison Carter
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  5. Heather Armstrong
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  7. David Moore
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  9. Eric A. Roth
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Correspondence to Kiffer G. Card.

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Kiffer G. Card, Nathan J. Lachowsky, David Moore, Robert S. Hogg, Eric A. Roth, Zishan Cui, Allison Carter, Susan Shurgold, and Heather Armstrong declare that they had no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committees at Simon Fraser University, The University of British Columbia, and the University of Victoria and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Card, K.G., Lachowsky, N.J., Cui, Z. et al. A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men. Arch Sex Behav 47, 95–106 (2018). https://doi.org/10.1007/s10508-016-0879-z

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