AIDS and Behavior

, Volume 21, Issue 10, pp 2835–2843 | Cite as

Quantifying the Harms and Benefits from Serosorting Among HIV-Negative Gay and Bisexual Men: A Systematic Review and Meta-analysis

  • David W. PurcellEmail author
  • Darrel Higa
  • Yuko Mizuno
  • Cynthia Lyles
Original Paper


We conducted a systematic review and meta-analysis of the association between serosorting and HIV infection among HIV-negative men who have sex with men (MSM). Compared to no condomless anal sex (i.e., consistent condom use or no anal sex), serosorting was associated with increased HIV risk (RR = 1.64, 95% CI 1.37–1.96). Compared to condomless discordant anal sex, serosorting was associated with reduced HIV risk (RR = 0.46, 95% CI 0.33–0.65). Serosorting may be an important harm reduction strategy when condoms are not consistently used, but can be harmful if HIV-negative MSM who consistently use condoms shift to using serosorting as their primary prevention strategy. The protective effects of serosorting and ways in which MSM are operationalizing serosorting are becoming more complex as additional factors affecting risk are considered (e.g., durable viral load suppression, PrEP). Understanding the potential risk and benefit of serosorting continues to be important, particularly within the context of other prevention strategies.


HIV MSM Serosorting Meta-analysis Systematic review 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

This article does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York (outside the USA) 2017

Authors and Affiliations

  • David W. Purcell
    • 1
    Email author
  • Darrel Higa
    • 1
  • Yuko Mizuno
    • 1
  • Cynthia Lyles
    • 1
  1. 1.Division of HIV/AIDS Prevention (DHAP)National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC)AtlantaUSA

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