Skip to main content

Advertisement

SpringerLink
Log in

Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention: Diagnoses of HIV infection in the United States and dependent areas. HIV Surveillance Supplemental Report, 2015 (2013) 25(4):1–82. http://www.cdc.gov/hiv/pdf/gl/hiv_surveillance_report_vol_25.pdf. Accessed 1 June 2015.

  2. Koblin BA, Mayer KH, Eshleman SH, et al. Correlates of HIV acquisition in a cohort of black men who have sex with men in the United States: HIV prevention trials network (HPTN) 061. PLoS One. 2013;8:e70413. doi:10.1371/journal.pone.0070413.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Levy ME, Wilton L, Phillips G 2nd, et al. Understanding structural barriers to accessing HIV testing and HIV prevention services among black men who have sex with men (BMSM) in the United States. AIDS Behav. 2014;18:972–96.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Maulsby C, Millett G, Lindsey K, et al. HIV among black men who have sex with men (MSM) in the United States: a review of the literature. AIDS Behav. 2014;18:10–25.

    Article  PubMed  Google Scholar 

  5. Millett GA, Peterson JL, Flores SA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380:341–8.

    Article  PubMed  Google Scholar 

  6. Mayer KH, Wang L, Koblin B, et al. Concomitant socioeconomic, behavioral, and biological factors associated with the disproportionate HIV infection burden among Black men who have sex with men in 6 U.S. cities. PLoS One. 2014;9:e87298. doi:10.1371/journal.pone.0087298.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Millett GA, Ding H, Mark G, et al. Mistaken assumptions and missed opportunities: correlates of undiagnosed HIV infection among black and latino men who have sex with men. J Acquir Immune Defic Syndr. 2011;58:64–71.

    Article  PubMed  Google Scholar 

  8. Eaton LA, Kalichman SC, Cherry C. Sexual partner selection and HIV risk reduction among black and white men who have sex with men. Am J Public Health. 2010;100:503–9.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Grov C, DeBusk JA, Bimbi DS, et al. Barebacking, the internet, and harm reduction: an intercept survey with gay and bisexual men in Los Angeles and New York City. AIDS Behav. 2007;11:527–36.

    Article  PubMed  Google Scholar 

  10. Parsons JT, Schrimshaw EW, Wolitski RJ, 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.

    Article  PubMed  Google Scholar 

  11. Halkitis PN, Moeller RW, Pollock JA. Sexual practices of gay, bisexual, and other nonidentified MSM attending New York City gyms: patterns of serosorting, strategic positioning, and context selection. J Sex Res. 2008;45:253–61.

    Article  PubMed  Google Scholar 

  12. Philip SS, Yu X, Donnell D, et al. Serosorting is associated with a decreased risk of HIV seroconversion in the EXPLORE study cohort. PLoS One. 2010;5:e12662. doi:10.1371/journal/pone.001266.

    Article  PubMed Central  PubMed  Google Scholar 

  13. van den Boom W, Konings R, Davidovich U, et al. Is serosorting effective in reducing the risk of HIV infection among men who have sex with men with casual sex partners? J Acquir Immune Defic Syndr. 2014;65:375–9.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Wei C, Raymond HF, Guadamuz TE, et al. Racial/ethnic differences in seroadaptive and serodisclosure behaviors among men who have sex with men. AIDS Behav. 2011;15:22–9.

    Article  PubMed  Google Scholar 

  15. Wolitski RJ, Parsons JT, Gómez CA, et al. Prevention with HIV-seropositive men who have sex with men: lessons from the Seropositive Urban Men’s Study (SUMS) and the Seropositive Urban Men’s Intervention Trial (SUMIT). J Acquir Immune Defic Syndr. 2004;37(Supplement 2):S101–9.

    Article  PubMed  Google Scholar 

  16. Eaton LA, Kalichman SC, Cain DN, et al. Serosorting sexual partners and risk for HIV among men who have sex with men. Am J Prev Med. 2007;33:479–85.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Matser A, Heijman T, Geskus R, et al. Perceived HIV status is a key determinant of unprotected anal intercourse within primary partnerships of men who have sex with men in Amsterdam. AIDS Behav. 2014;18:2442–56.

    Article  PubMed  Google Scholar 

  18. McFarland W, Chen YH, Raymond HF, 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;23:261–8.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Starks TJ, Gamarel KE, Johnson MO. Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships. Arch Sex Behav. 2014;43:139–47.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Snowden JM, Wei C, McFarland W, et al. Prevalence, correlates and trends in seroadaptive behaviours among men who have sex with men from serial cross-sectional surveillance in San Francisco, 2004–2011. Sex Transm Infect. 2014;90:498–504.

    Article  PubMed  Google Scholar 

  21. Marks G, Millett GA, Bingham T, et al. Prevalence and protective value of serosorting and strategic positioning among black and latino men who have sex with men. Sex Transm Dis. 2010;37:325–7.

    PubMed  Google Scholar 

  22. Irvin R, Vallabhaneni S, Scott H, et al. Examining levels of risk behaviors among Black men who have sex with men (MSM) and the association with HIV acquisition. PLoS One. 2015;10:2015. doi:10.371/journal.pone.01.0118281.

    Google Scholar 

  23. Buchbinder SP, Liu AY. CROI 2015: advances in HIV testing and prevention strategies. Top Antivir Med. 2015;23:8–27.

    PubMed  Google Scholar 

  24. Frye V, Wilton L, Hirshfield S et al. “Just because it’s out there, people aren’t going to use it”: HIV self-testing among young, Black MSM and transgender women in New York City. AIDS Patient Care STDS. 2015; in press.

  25. Grace D, Chown SA, Jollimore J, et al. HIV-negative gay men’s accounts of using context-dependent seroadaptive strategies. Cult Health Sex. 2014;16:316–30.

    Article  Google Scholar 

  26. Scott HM, Vittinghoff E, Irvin R, et al. Age, race/ethnicity, and behavioral risk factors associated with per contact risk of HIV infection among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2014;65:115–21.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Centers for Disease Control and Prevention. Serosorting among gay, bisexual and other men who have sex with men. (2014). http://www.cdc.gov/msmhealth/serosorting.htm. Accessed 4 Jan 2015.

  28. Golden MR, Dombrowski JC, Kerani RP, et al. Failure of serosorting to protect African American men who have sex with men from HIV infection. Sex Transm Dis. 2012;39:659–64.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Crepaz N, Marks G, Liau A, et al. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23:1617–29.

    Article  PubMed  Google Scholar 

  30. Centers for Disease Control and Prevention. Act against AIDS: start talking. (2014). http://www.cdc.gov/actagainstaids/campaigns/starttalking/index.html. Accessed 1 Oct 2014.

  31. Koblin BA, Bonner S, Powell B, et al. A randomized trial of a behavioral intervention for black MSM: the DISH study. AIDS. 2012;26:483–8.

    Article  PubMed  Google Scholar 

  32. Tobin K, Kuramoto SJ, German D, et al. Unity in diversity: results of a randomized clinical culturally tailored pilot HIV prevention intervention trial in Baltimore, Maryland, for African American men who have sex with men. Health Educ Behav. 2013;40:286–95.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Kamb ML, Fishbein M, Douglas JM Jr, et al. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. JAMA. 1998;280:1161–7.

    Article  CAS  PubMed  Google Scholar 

  34. Koblin BA, Husnik MJ, Colfax G. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20:731–9.

    Article  PubMed  Google Scholar 

  35. Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32:959–76.

    Article  CAS  PubMed  Google Scholar 

  36. Russell D, Peplau LA, Cutrona CE. The revised UCLA loneliness scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39:472–80.

    Article  CAS  PubMed  Google Scholar 

  37. Wulfert E, Wan CK, Backus CA. Gay men’s safer sex behavior: an integration of three models. J Behav Med. 1996;19:345–66.

    Article  CAS  PubMed  Google Scholar 

  38. Folkman S, Chesney MA, Pollack L, et al. Stress, coping, and high-risk sexual behavior. Health Psychol. 1992;11:218–22.

    Article  CAS  PubMed  Google Scholar 

  39. Wolitski RJ, Flores SA, O’Leary A, et al. Beliefs about personal and partner responsibility among HIV-seropositive men who have sex with men: measurement and association with transmission risk behavior. AIDS Behav. 2007;11:676–86.

    Article  PubMed  Google Scholar 

  40. O’Donnell L, Agronick G, San Doval A, et al. Ethnic and gay community attachments and sexual risk behaviors among urban latino young men who have sex with men. AIDS Educ Prev. 2002;14:457–71.

    Article  PubMed  Google Scholar 

  41. Mayfield W. The development of an internalized homonegativity inventory for gay men. J Homosex. 2001;41:53–76.

    Article  CAS  PubMed  Google Scholar 

  42. 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. 2012;24:167–73.

    PubMed Central  PubMed  Google Scholar 

  43. Vallabhaneni S, Li X, Vittinghoff E, et al. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men. PLoS One. 2012;7:2015. doi:10.1371/journal.pone.0045718.

    Article  Google Scholar 

  44. Choi KH, Ayala G, Paul J, et al. Social network characteristics and HIV risk among African American, Asian/Pacific Islander, and Latino men who have sex with men. J Acquir Immune Defic Syndr. 2013;64:496–501.

    Article  PubMed  Google Scholar 

  45. Gray KM, Cohen SM, Hu X, et al. Jurisdiction level differences in HIV diagnosis, retention in care, and viral suppression in the United States. J Acquir Immune Defic Syndr. 2014;65:129–32.

    Article  PubMed  Google Scholar 

  46. Hall HI, Holtgrave DR, Tang T, et al. HIV transmission in the United States: considerations of viral load, risk behavior, and health disparities. AIDS Behav. 2013;17:1632–6.

    Article  PubMed  Google Scholar 

  47. Latkin C, Yang C, Tobin K, et al. Differences in the social networks of African American men who have sex with men only and those who have sex with men and women. Am J Public Health. 2015;2011(101):e18–23. doi:10.2105/AJPH.2011.300281.

    Google Scholar 

  48. Sullivan PS, Carballo-Diéguez A, Coates T, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet. 2012;380:388–99.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Sullivan PS, Peterson J, Rosenberg ES, et al. Understanding racial HIV/STI disparities in black and white men who have sex with men: a multilevel approach. PLoS One. 2014;9:e90514. doi:10.371/journal.pone.0090514.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Mannheimer S, Wang L, Wilton L, et al. Infrequent HIV testing and late diagnosis are common among a cohort of black men who have sex with men in 6 US cities. J Acquir Immune Defic Syndr. 2014;67:438–45.

    Article  PubMed  Google Scholar 

  51. Frye V, Egan JE, Van Tieu H, et al. “I didn’t think I could get out of the fucking park”. Gay men’s retrospective accounts of neighborhood space, emerging sexuality and migrations. Soc Sci Med. 2014;104:6–14.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Tobin KE, Ctuchin M, Latkin CA, et al. Social geographies of African American men who have sex with men (MSM): a qualitative exploration of the social, spatial and temporal context of HIV risk in Baltimore, Maryland. Health Place. 2013;22:1–14.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  53. Mansergh G, Flores S, Koblin B, et al. Alcohol and drug use in the context of anal sex and other factors associated with sexually transmitted infections: results from a multi-city study of HIV-risk men who have sex with men in the USA. Sex Transm Infect. 2008;84:509–11.

    Article  CAS  PubMed  Google Scholar 

  54. Gorbach PM, Weiss RE, Jeffries R, 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;56:176–82.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Mizuno Y, Purcell DW, Latka MH, et al. Is sexual serosorting occurring among HIV-positive injection drug users? Comparison between those with HIV-positive partners only, HIV-negative partners only, and those with any partners of unknown status. AIDS Behav. 2010;14:92–102.

    Article  PubMed  Google Scholar 

  56. Chen YH, Vallabhaneni S, Raymond HF, McFarland W. Predictors of serosorting and intention to serosort among men who have sex with men, San Francisco. AIDS Educ Prev. 2012;24:564–73.

    Article  PubMed  Google Scholar 

  57. Fendrich M, Mackesy-Amiti ME, Johnson TP, Pollack LM. Sexual risk behavior and drug use in two Chicago samples of men who have sex with men: 1997 vs. 2002. J Urban Health. 2010;87:452–66.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Kelly JA, DiFranceisco WJ, St Lawrence JS, et al. Situational, partner, and contextual factors associated with level of risk at most recent intercourse among Black men who have sex with men. AIDS Behav. 2014;18:26–35.

    Article  PubMed  Google Scholar 

  59. Wilson PA, Cook S, McGaskey J, et al. Situational predictors of sexual risk episodes among men with HIV who have sex with men. Sex Transm Infect. 2008;84:506–18.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Tobin KE, German D, Spikes P, et al. A comparison of the social and sexual networks of crack-using and non-crack using African American men who have sex with men. J Urban Health. 2011;88:1052–62.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Wilton L, Halkitis PN, English G, Roberson M. An exploratory study of barebacking, club drug use, and meanings of sex in Black and Latino gay and bisexual men in the age of AIDS. J Gay Lesbian Psychother. 2005;9:49–72.

    Article  Google Scholar 

  62. 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;83:682–94.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Dyer TP, Regan R, Wilton L, et al. Differences in substance use, psychosocial characteristics, and HIV-related sexual risk behavior between Black men who have sex with men only (BMSMO) and men who have sex with men and women (BMSMW) in 6 US cities. J Urban Health. 2013;90:1181–93.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Shoptaw S, Weiss RE, Munjas B, et al. Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. J Urban Health. 2009;86(suppl 1):77–92.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Wilton L. Correlates of substance use in relation to sexual risk behavior in black gay and bisexual men: implications for HIV prevention. J Black Psychol. 2008;34:70–93.

    Article  Google Scholar 

  66. Jerome RC, Halkitis PN. Stigmatization, stress, and the search for belonging in Black men who have sex with men who use methamphetamine. J Black Psychol. 2009;35:343–65.

    Article  Google Scholar 

  67. Kurtz SP, Buttram ME, Surratt HL, Stall RD. Resilience, syndemic factors, and serosorting behaviors among HIV-positive and HIV-negative substance-using MSM. AIDS Educ Prev. 2012;24:193–205.

    Article  PubMed Central  PubMed  Google Scholar 

  68. Scott HM, Pollack L, Rebchook GM, et al. Peer social support is associated with recent HIV testing among young black men who have sex with men. AIDS Behav. 2014;18:913–20.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Lauby JL, Marks G, Bingham T, et al. Having supportive social relationships is associated with reduced risk of unrecognized HIV infection among black and Latino men who have sex with men. AIDS Behav. 2012;16:508–15.

    Article  PubMed  Google Scholar 

  70. Siegler AJ, Sullivan PS, Khosropour CM, Rosenberg ES. The role of intent in serosorting behaviors among MSM sexual partnerships. J Acquir Immune Defic Syndr. 2013;64:307–14.

    Article  PubMed  Google Scholar 

  71. Herrick AL, Stall R, Goldhammer H, et al. Resilience as a research framework and a cornerstone of prevention research for gay and bisexual men: theory and evidence. AIDS Behav. 2014;18:1–9.

    Article  PubMed  Google Scholar 

  72. Golub SA, Gamarel KE. AIDS, Patient Care STDS. The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City. AIDS Patient Care STDS. 2013;27:621–7.

    Article  PubMed Central  PubMed  Google Scholar 

  73. Bird JD, Voisin DR. “You’re an open target to be abused”: a qualitative study of stigma and HIV self-disclosure among Black men who have sex with men. Am J Public Health. 2013;103:2193–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This study was supported by a cooperative agreement between the New York Blood Center (3UR6PS000437-03W1), Center for AIDS Intervention Research – Medical College of Wisconsin (3UR6PS000434-03W1), Howard Brown Health Center (3UR6PS000429-03W1), Johns Hopkins Bloomberg School of Public Health (5UR6PS000355-03) and the Centers for Disease Control and Prevention. The study teams acknowledge all of the study participants who volunteered for the projects and the study staff for their commitment to the success of the projects. Trial registration: ClinicalTrials.gov NCT00691496.

Author information

Authors and Affiliations

  1. Department of Human Development, State University of New York at Binghamton, 4400 Vestal Parkway East, Binghamton, NY, 13902, USA

    Leo Wilton

  2. Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

    Leo Wilton

  3. Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA

    Beryl Koblin, Vijay Nandi & Guozhen Xu

  4. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Carl Latkin

  5. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    David Seal

  6. National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Stephen A. Flores & Pilgrim Spikes

Authors
  1. Leo Wilton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beryl Koblin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vijay Nandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guozhen Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carl Latkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Seal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephen A. Flores
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pilgrim Spikes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leo Wilton.

Ethics declarations

Conflicts of Interest

No conflicts were declared.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilton, L., Koblin, B., Nandi, V. et al. Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities. AIDS Behav 19, 2333–2346 (2015). https://doi.org/10.1007/s10461-015-1190-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-015-1190-z

Keywords

Search

Navigation