AIDS and Behavior

, Volume 21, Issue 10, pp 2935–2944 | Cite as

Operationalizing the Measurement of Seroadaptive Behaviors: A Comparison of Reported Sexual Behaviors and Purposely-Adopted Behaviors Among Men who have Sex with Men (MSM) in Seattle

  • Christine M. Khosropour
  • Julia C. Dombrowski
  • James P. Hughes
  • Lisa E. Manhart
  • Jane M. Simoni
  • Matthew R. Golden
Original Paper

Abstract

Seroadaptive behaviors are traditionally defined by self-reported sexual behavior history, regardless of whether they reflect purposely-adopted risk-mitigation strategies. Among MSM attending an STD clinic in Seattle, Washington 2013–2015 (N = 3751 visits), we used two seroadaptive behavior measures: (1) sexual behavior history reported via clinical computer-assisted self-interview (CASI) (behavioral definition); (2) purposely-adopted risk-reduction behaviors reported via research CASI (purposely-adopted definition). Pure serosorting (i.e. only HIV-concordant partners) was the most common behavior, reported (behavioral and purposely-adopted definition) by HIV-negative respondents at 43% and 60% of visits, respectively (kappa = 0.24; fair agreement) and by HIV-positive MSM at 30 and 34% (kappa = 0.25; fair agreement). Agreement of the two definitions was highest for consistent condom use [HIV-negative men (kappa = 0.72), HIV-positive men (kappa = 0.57)]. Overall HIV test positivity was 1.4 but 0.9% for pure serosorters. The two methods of operationalizing behaviors result in different estimates, thus the choice of which to employ should depend on the motivation for ascertaining behavioral information.

Keywords

Men who have sex with men HIV Serosorting Seroadaptive behaviors 

Notes

Acknowledgements

The authors thank the men who participated in this study and the front desk staff and clinic staff at the Public Health – Seattle & King County STD clinic. We also thank Shirley Zhang for survey programming support and data management support.

Funding

This work was supported by the National Institutes of Health (Grant R21 AI098497; Grant T32 AI07140 trainee support to CMK; and grants K23MH090923 and L30 MH095060 to JCD); and the University of Washington Center for AIDS Research, an NIH-funded program (Grant P30 AI027757) which is supported by the following NIH Institutes and Centers: National Institute of Allergy and Infectious Diseases, National Cancer Institute, National Institutes of Mental Health, National Institute on Drug Abuse, National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, National Institute on Aging.

Compliance with Ethical Standards

Conflict of interest

MRG has conducted studies unrelated to this work funded by grants from Cempra and Melinta. JCD has conducted studies unrelated to this work funded by grants to the University of Washington from ELITech, Melinta Therapeutics, and Genentech. All other authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

References

  1. 1.
    Vallabhaneni S, Li X, Vittinghoff E, Donnell D, Pilcher CD, Buchbinder SP. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men. PLoS ONE. 2012;7(10):e45718.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Velter A, Bouyssou-Michel A, Arnaud A, Semaille C. Do men who have sex with men use serosorting with casual partners in France? Results of a nationwide survey (ANRS-EN17-Presse Gay 2004). Euro Surveill. 2009;14(47):429–33.Google Scholar
  3. 3.
    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(3):452–66.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    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.CrossRefPubMedGoogle Scholar
  5. 5.
    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.CrossRefPubMedGoogle Scholar
  6. 6.
    Snowden JM, Wei C, McFarland W, Raymond HF. 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(6):498–504.CrossRefPubMedGoogle Scholar
  7. 7.
    Jin F, Prestage GP, Templeton DJ, Poynten IM, Donovan B, Zablotska I, et al. The impact of HIV seroadaptive behaviors on sexually transmissible infections in HIV-negative homosexual men in Sydney Australia. Sex Transm Dis. 2012;39(3):191–4.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Holt M, Lea T, Mao L, Zablotska I, Lee E, de Wit JB, et al. Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay community periodic surveys. Sex Health. 2006. doi: 10.1071/SH16072.Google Scholar
  9. 9.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Jin F, Crawford J, Prestage GP, Zablotska I, Imrie J, Kippax SC, et al. Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23(2):243–52.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Khosropour CM, Dombrowski JC, Swanson F, Kerani RP, Katz DA, Barbee LA, et al. Trends in Serosorting and the Association With HIV/STI Risk Over Time Among Men Who Have Sex With Men. J Acquir Immune Defic Syndr. 2016;72(2):189–97.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    World Health Organization. Evidence and Technical Recommendations: Serosorting. Geneva: Switzerland; 2011.Google Scholar
  13. 13.
    Dubois-Arber F, Jeannin A, Lociciro S, Balthasar H. Risk reduction practices in men who have sex with men in Switzerland: serosorting, strategic positioning, and withdrawal before ejaculation. Arch Sex Behav. 2012;41(5):1263–72.CrossRefPubMedGoogle Scholar
  14. 14.
    Lociciro S, Jeannin A, Dubois-Arber F. Men having sex with men serosorting with casual partners: who, how much, and what risk factors in Switzerland, 2007–2009. BMC Public Health. 2013;13(1):839.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Siegler AJ, Sullivan PS, Khosropour CM, Rosenberg ES. The role of intent in serosorting behaviors among men who have sex with men sexual partnerships. J Acquir Immune Defic Syndr. 2013;64(3):307–14.CrossRefPubMedGoogle Scholar
  17. 17.
    Khosropour CM, Dombrowski JC, Hughes JP, Manhart LE, Golden MR. Evaluation of a computer-based recruitment system to enroll men who have sex with men (MSM) into an observational HIV behavioral risk study. Am J Epidemiol. 2016;184(6):477–83.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Golden MR, Dombrowski JC, Kerani RP, Stekler JD. Failure of serosorting to protect African American men who have sex with men from HIV infection. Sex Transm Dis. 2012;39(9):659–64.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Stekler J, Maenza J, Stevens CE, Swenson PD, Coombs RW, Wood RW, et al. Screening for acute HIV infection: lessons learned. Clin Infect Dis. 2007;44(3):459–61.CrossRefPubMedGoogle Scholar
  20. 20.
    Stekler J, Swenson PD, Wood RW, Handsfield HH, Golden MR. Targeted screening for primary HIV infection through pooled HIV-RNA testing in men who have sex with men. AIDS. 2005;19(12):1323–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Stekler JD, Baldwin HD, Louella MW, Katz DA, Golden MR. ru2hot?: a public health education campaign for men who have sex with men to increase awareness of symptoms of acute HIV infection. Sex Transm Infect. 2013;89(5):409–14.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Stekler JD, Swenson PD, Coombs RW, Dragavon J, Thomas KK, Brennan CA, et al. HIV testing in a high-incidence population: is antibody testing alone good enough? Clin Infect Dis. 2009;49(3):444–53.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Landis J, Koch G. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefPubMedGoogle Scholar
  24. 24.
    Ostergren JE, Rosser BR, Horvath KJ. Reasons for non-use of condoms among men who have sex with men: a comparison of receptive and insertive role in sex and online and offline meeting venue. Cult Health Sex. 2011;13(2):123–40.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Prestage G, Brown G, Down IA, Jin F, Hurley M. “It’s hard to know what is a risky or not a risky decision”: gay men’s beliefs about risk during sex. AIDS Behav. 2013;17(4):1352–61.CrossRefPubMedGoogle Scholar
  26. 26.
    Ronn M, White PJ, Hughes G, Ward H. Developing a conceptual framework of seroadaptive behaviors in HIV-diagnosed men who have sex with men. J Infect Dis. 2014;1(210 Suppl 2):S586–93.CrossRefGoogle Scholar
  27. 27.
    Prestage G, Down IA, Bradley J, McCann PD, Brown G, Jin F, et al. Is optimism enough? Gay men’s beliefs about HIV and their perspectives on risk and pleasure. Sex Transm Dis. 2012;39(3):167–72.CrossRefPubMedGoogle Scholar
  28. 28.
    Eaton LA, Kalichman SC, Cain DN, Cherry C, Stearns HL, Amaral CM, et al. Serosorting sexual partners and risk for HIV among men who have sex with men. Am J Prev Med. 2007;33(6):479–85.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Christine M. Khosropour
    • 1
  • Julia C. Dombrowski
    • 2
    • 6
  • James P. Hughes
    • 3
  • Lisa E. Manhart
    • 1
    • 4
  • Jane M. Simoni
    • 5
  • Matthew R. Golden
    • 1
    • 2
    • 6
  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Department of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of BiostatisticsUniversity of WashingtonSeattleUSA
  4. 4.Department of Global HealthUniversity of WashingtonSeattleUSA
  5. 5.Department of PsychologyUniversity of WashingtonSeattleUSA
  6. 6.Public Health – Seattle and King County HIV/STD ProgramSeattleUSA

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