AIDS and Behavior

, Volume 17, Issue 5, pp 1862–1872 | Cite as

Seroadaptation in a Sample of Very Poor Los Angeles Area Men Who Have Sex with Men

  • Ryan D. Murphy
  • Pamina M. Gorbach
  • Robert E. Weiss
  • Christopher Hucks-Ortiz
  • Steven J. Shoptaw
Original Paper

Abstract

Data from 635 very poor men who have sex with men (MSM) were used to identify seroadaptation with 1,102 male partners reported between 2005 and 2007 in Los Angeles as part of the Sexual Acquisition and Transmission of HIV Cooperative Agreement Program. The mean age of the sample was 41.7 years; 53 % had experienced homelessness in the past year. Condoms were reported in 51 % of sexual events involving anal intercourse. HIV seroconcordance was reported in 41 % of sexual partnerships among HIV-positive participants. HIV-positive men were more likely to have oral-only or unprotected receptive anal intercourse and less likely to have unprotected insertive anal intercourse with HIV-negative or unknown partners compared to HIV-positive partners. Even in the face of poverty, HIV-positive MSM report mitigating risks of HIV-transmission though seroadaptation in the context of modest rates of condom use.

Keywords

Serosorting Seropositioning Oral-only sex Poverty 

References

  1. 1.
    Snowden JM, Raymond HF, McFarland W. Prevalence of seroadaptive behaviours of men who have sex with men, San Francisco, 2004. Sex Transm Infect. 2009;85(6):469–76.PubMedCrossRefGoogle Scholar
  2. 2.
    Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Snowden JM, Raymond HF, McFarland W. Seroadaptive behaviours among men who have sex with men in San Francisco: the situation in 2008. Sex Transm Infect. 2011;87(2):162–4.PubMedCrossRefGoogle Scholar
  4. 4.
    HIV Epidemiology Program, Los Angeles County Department of Public Health. An Epidemiologic Profile of HIV and AIDS in Los Angeles County, 2009. http://publichealth.lacounty.gov/wwwfiles/ph/hae/hiv/2009-epi.pdf. Accessed 22 March 2012.
  5. 5.
    Siconolfi DE, Moeller RW. Serosorting. BETA. 2007;19(2):45–9.PubMedGoogle Scholar
  6. 6.
    Van de Ven P, Kippax S, Crawford J, Rawstorne P, Prestage G, Grulich A, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care. 2002;14(4):471–80.PubMedGoogle Scholar
  7. 7.
    Kippax S, Race K. Sustaining safe practice: twenty years on. Soc Sci Med. 2003;57(1):1–12.PubMedCrossRefGoogle Scholar
  8. 8.
    Vittinghoff E, Douglas J, Judson F, McKirnan D, MacQueen K, Buchbinder SP. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. Am J Epidemiol. 1999;150(3):306–11.PubMedCrossRefGoogle Scholar
  9. 9.
    Parsons JT, Schrimshaw EW, Wolitski RJ, Halkitis PN, Purcell DW, Hoff CC, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19(Suppl 1):S13–25.PubMedCrossRefGoogle Scholar
  10. 10.
    van den Boom W, Stolte I, Sandfort T, Davidovich U. Serosorting and sexual risk behaviour according to different casual partnership types among MSM: the study of one-night stands and sex buddies. AIDS Care. 2011;27(12):1311–6.Google Scholar
  11. 11.
    McFarland W, Chen YH, Nguyen B, Grasso M, Levine D, Stall R, et al. Behavior, intention or chance? A longitudinal study of HIV seroadaptive behaviors, abstinence and condom use. AIDS Behav. 2011;16(1):121–31.CrossRefGoogle Scholar
  12. 12.
    McFarland W, Chen YH, Raymond HF, Nguyen B, Colfax G, Mehrtens J, et al. HIV seroadaptation among individuals, within sexual dyads, and by sexual episodes, men who have sex with men, San Francisco, 2008. AIDS Care. 2011;23(3):261–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Wei C, Raymond HF, Guadamuz TE, Stall R, Colfax GN, Snowden JM, et al. Racial/Ethnic differences in seroadaptive and serodisclosure behaviors among men who have sex with men. AIDS Behav. 2011;15(1):22–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Cassels S, Menza TW, Goodreau SM, Golden MR. HIV serosorting as a harm reduction strategy: evidence from Seattle Washington. AIDS. 2009;23(18):2497–506.PubMedCrossRefGoogle Scholar
  15. 15.
    Philip SS, Yu X, Donnell D, Vittinghoff E, Buchbinder S. Serosorting is associated with a decreased risk of HIV seroconversion in the EXPLORE study cohort. PLoS ONE. 2010;5(9):e12662.PubMedCrossRefGoogle Scholar
  16. 16.
    Heymer KJ, Wilson D. Available evidence does not support serosorting as an HIV risk reduction strategy. AIDS. 2010;24(6):935–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Eaton LA, Kalichman SC, O’Connell DA, Karchner WD. A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission. AIDS Care. 2009;21(10):1279–88.PubMedCrossRefGoogle Scholar
  18. 18.
    Golden MR, Stekler J, Hughes JP, Wood RW. HIV serosorting in men who have sex with men: is it safe? J Acquir Immune Defic Syndr. 2008;49(2):212–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Pinkerton SD, Acute HIV. Infection increases the dangers of serosorting. Am J Prev Med. 2008;35(2):184.PubMedCrossRefGoogle Scholar
  20. 20.
    Butler DM, Smith DM. Serosorting can potentially increase HIV transmissions. AIDS. 2007;21(9):1218–20.PubMedCrossRefGoogle Scholar
  21. 21.
    Marks G, Millett GA, Bingham T, Lauby J, Murrill CS, Stueve A. Prevalence and protective value of serosorting and strategic positioning among black and latino men who have sex with men. Sex Transm Dis. 2010;37(5):325–7.PubMedGoogle Scholar
  22. 22.
    McFarland W, Chen YH, Nguyen B, Grasso M, Levine D, Stall R, et al. Behavior, intention or chance? A longitudinal study of HIV seroadaptive behaviors, abstinence and condom use. AIDS Behav. 2012;16(1):121–31.PubMedCrossRefGoogle Scholar
  23. 23.
    Jin F, Prestage GP, Ellard J, Kippax SC, Kaldor JM, Grulich AE. How homosexual men believe they became infected with HIV: the role of risk-reduction behaviors. J Acquir Immune Defic Syndr. 2007;46(2):245–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Parsons JT, Severino J, Nanin J, Punzalan JC, von Sternberg K, Missildine W, et al. Positive, negative, unknown: assumptions of HIV status among HIV-positive men who have sex with men. AIDS Educ Prev. 2006;18(2):139–49.PubMedCrossRefGoogle Scholar
  25. 25.
    Zablotska IB, Imrie J, Prestage G, Crawford J, Rawstorne P, Grulich A, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21(4):501–10.PubMedCrossRefGoogle Scholar
  26. 26.
    German D, Sifakis F, Maulsby C, Towe VL, Flynn CP, Latkin CA, et al. Persistently high prevalence and unrecognized HIV infection among men who have sex with men in Baltimore: the BESURE study. JAIDS. 2011;57(1):77–87.PubMedCrossRefGoogle Scholar
  27. 27.
    Gorbach PM, Weiss RE, Jeffries R, Javanbakht M, Drumright LN, Daar ES, et al. Behaviors of recently HIV-infected men who have sex with men in the year postdiagnosis: effects of drug use and partner types. J Acquir Immune Defic Syndr. 2011;56(2):176–82.PubMedCrossRefGoogle Scholar
  28. 28.
    Marcus U, Schmidt AJ, Hamouda O. HIV serosorting among HIV-positive men who have sex with men is associated with increased self-reported incidence of bacterial sexually transmissible infections. Sex Health. 2011;8(2):184–93.PubMedCrossRefGoogle Scholar
  29. 29.
    Truong HM, Kellogg T, Klausner JD, Katz MH, Dilley J, Knapper K, et al. Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect. 2006;82(6):461–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Tieu HV, Xu G, Bonner S, Spikes P, Egan JE, Goodman K, et al. Sexual partner characteristics, Serodiscordant/Serostatus unknown unprotected anal intercourse and disclosure among human immunodeficiency virus-infected and uninfected black men who have sex with men in New York City. Sex Transm Dis. 2011;42(3):370–80.Google Scholar
  31. 31.
    Xia Q, Osmond DH, Tholandi M, Pollack LM, Zhou W, Ruiz JD, et al. HIV prevalence and sexual risk behaviors among men who have sex with men: results from a statewide population-based survey in California. J Acquir Immune Defic Syndr. 2006;41(2):238–45.PubMedCrossRefGoogle Scholar
  32. 32.
    Lieb S, Prejean J, Thompson DR, Fallon SJ, Cooper H, Gates GJ, et al. HIV prevalence rates among men who have sex with men in the southern United States: population-based estimates by Race/Ethnicity. AIDS Behav. 2010;23(4):210–23.Google Scholar
  33. 33.
    Robertson MJ, Clark RA, Charlebois ED, Tulsky J, Long HL, Bangsberg DR, et al. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Public Health. 2004;94(7):1207–17.PubMedCrossRefGoogle Scholar
  34. 34.
    Javanbakht M, Murphy R, Harawa NT, Smith LV, Hayes M, Chien M, et al. Sexually transmitted infections and HIV prevalence among incarcerated men who have sex with men, 2000–2005. Sex Transm Dis. 2009;36(2 Suppl):S17–21.PubMedGoogle Scholar
  35. 35.
    Arriola KR, Braithwaite RL, Kennedy S, Hammett T, Tinsley M, Wood P, et al. A collaborative effort to enhance HIV/STI screening in five county jails. Public Health Rep. 2001;116(6):520–9.PubMedGoogle Scholar
  36. 36.
    Hixson BA, Omer SB, del Rio C, Frew PM. Spatial clustering of HIV prevalence in Atlanta, Georgia and population characteristics associated with case concentrations. J Urban Health. 2011;88(1):129–41.PubMedCrossRefGoogle Scholar
  37. 37.
    Iguchi MY, Ober AJ, Berry SH, Fain T, Heckathorn DD, Gorbach PM, et al. Simultaneous recruitment of drug users and men who have sex with men in the United States and Russia using respondent-driven sampling: sampling methods and implications. J Urban Health. 2009;86(Suppl 1):5–31.PubMedCrossRefGoogle Scholar
  38. 38.
    Gorbach PM, Murphy R, Weiss RE, Hucks-Ortiz C, Shoptaw S. Bridging sexual boundaries: men who have sex with men and women in a street-based sample in Los Angeles. J Urban Health. 2009;86(Suppl 1):63–76.PubMedCrossRefGoogle Scholar
  39. 39.
    Kushel MB, Colfax G, Ragland K, Heineman A, Palacio H, Bangsberg DR. Case management is associated with improved antiretroviral adherence and CD4+ cell counts in homeless and marginally housed individuals with HIV infection. Clin Infect Dis. 2006;43(2):234–42.PubMedCrossRefGoogle Scholar
  40. 40.
    Moss AR, Hahn JA, Perry S, Charlebois ED, Guzman D, Clark RA, et al. Adherence to highly active antiretroviral therapy in the homeless population in San Francisco: a prospective study. Clin Infect Dis. 2004;39(8):1190–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Los Angeles Country Department of Public Health. An epidemiologic profile of HIV and AIDS in Los Angeles country. In: HIV Epidemiology program, Los Angeles Country Department of Public Health; 2009.Google Scholar
  42. 42.
    Golub SA, Starks TJ, Payton G, Parsons JT. The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS Behav. 2011;15(3):509–20.PubMedCrossRefGoogle Scholar
  43. 43.
    Theodore PS, Duran RE, Antoni MH, Fernandez MI. Intimacy and sexual behavior among HIV-positive men-who-have-sex-with-men in primary relationships. AIDS Behav. 2004;8(3):321–31.PubMedCrossRefGoogle Scholar
  44. 44.
    Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.PubMedCrossRefGoogle Scholar
  45. 45.
    Davidovich U, de Wit J, Albrecht N, Geskus R, Stroebe W, Coutinho R. Increase in the share of steady partners as a source of HIV infection: a 17-year study of seroconversion among gay men. AIDS. 2001;15(10):1303–8.PubMedCrossRefGoogle Scholar
  46. 46.
    Harawa NT, Williams JK, Ramamurthi HC, Bingham TA. Perceptions towards condom use, sexual activity, and HIV disclosure among HIV-positive African American men who have sex with men: implications for heterosexual transmission. J Urban Health. 2006;83(4):682–94.PubMedCrossRefGoogle Scholar
  47. 47.
    Walls NE, Bell S. Correlates of engaging in survival sex among homeless youth and young adults. J Sex Res. 2011;48(5):423–36.PubMedCrossRefGoogle Scholar
  48. 48.
    Marshall BD, Shannon K, Kerr T, Zhang R, Wood E. Survival sex work and increased HIV risk among sexual minority street-involved youth. J Acquir Immune Defic Syndr. 2010;53(5):661–4.PubMedGoogle Scholar
  49. 49.
    Haley N, Roy E, Leclerc P, Boudreau JF, Boivin JF. HIV risk profile of male street youth involved in survival sex. Sex Transm Infect. 2004;80(6):526–30.PubMedCrossRefGoogle Scholar
  50. 50.
    Burt RD, Hagan H, Sabin K, Thiede H. Evaluating respondent-driven sampling in a major metropolitan area: comparing injection drug users in the 2005 Seattle area national HIV behavioral surveillance system survey with participants in the RAVEN and Kiwi studies. Ann Epidemiol. 2010;20(2):159–67.PubMedCrossRefGoogle Scholar
  51. 51.
    Reback CJ, Kamien JB, Amass L. Characteristics and HIV risk behaviors of homeless, substance-using men who have sex with men. Addict Behav. 2007;32(3):647–54.PubMedCrossRefGoogle Scholar
  52. 52.
    Robbins JL, Wenger L, Lorvick J, Shiboski C, Kral AH. Health and oral health care needs and health care-seeking behavior among homeless injection drug users in san francisco. J Urban Health. 2010;87(6):920–30.PubMedCrossRefGoogle Scholar
  53. 53.
    Palepu A, Milloy MJ, Kerr T, Zhang R, Wood E. Homelessness and adherence to antiretroviral therapy among a cohort of HIV-infected injection drug users. J Urban Health. 2011;88(3):545–55.PubMedCrossRefGoogle Scholar
  54. 54.
    Nelson KM, Thiede H, Hawes SE, Golden MR, Hutcheson R, Carey JW, et al. Why the wait? Delayed HIV diagnosis among men who have sex with men. J Urban Health. 2010;87(4):642–55.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ryan D. Murphy
    • 1
  • Pamina M. Gorbach
    • 2
  • Robert E. Weiss
    • 3
  • Christopher Hucks-Ortiz
    • 4
  • Steven J. Shoptaw
    • 4
  1. 1.Alcohol Research GroupEmeryvilleUSA
  2. 2.Department of Epidemiology, Fielding School of Public Health, David Geffen School of Medicine University of California-Los AngelesLos AngelesUSA
  3. 3.Department of Biostatistics, Fielding School of Public HealthUniversity of California-Los AngelesLos AngelesUSA
  4. 4.Department of Family Medicine, David Geffen School of MedicineUniversity of California-Los AngelesLos AngelesUSA

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