Serosorting may increase the risk of HIV acquisition among men who have sex with men

Wilson, David P., Regan, David G., Heymer, Kelly-Jean, Jin, Fengyi, Prestage, Garrett P., & Grulich, Andrew E. (2010) Serosorting may increase the risk of HIV acquisition among men who have sex with men. Sexually Transmitted Diseases, 37(1), pp. 13-17.

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Background: Serosorting, the practice of seeking to engage in unprotected anal intercourse with partners of the same HIV status as oneself, has been increasing among men who have sex with men. However, the effectiveness of serosorting as a strategy to reduce HIV risk is unclear, especially since it depends on the frequency of HIV testing.

Methods: We estimated the relative risk of HIV acquisition associated with serosorting compared with not serosorting by using a mathematical model, informed by detailed behavioral data from a highly studied cohort of gay men.

Results: We demonstrate that serosorting is unlikely to be highly beneficial in many populations of men who have sex with men, especially where the prevalence of undiagnosed HIV infections is relatively high. We find that serosorting is only beneficial in reducing the relative risk of HIV transmission if the prevalence of undiagnosed HIV infections is less than ∼20% and ∼40%, in populations of high (70%) and low (20%) treatment rates, respectively, even though treatment reduces the absolute risk of HIV transmission. Serosorting can be expected to lead to increased risk of HIV acquisition in many settings. In settings with low HIV testing rates serosorting can more than double the risk of HIV acquisition.

Conclusions: Therefore caution should be taken before endorsing the practice of serosorting. It is very important to continue promotion of frequent HIV testing and condom use, particularly among people at high risk.

Impact and interest:

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ID Code: 77900
Item Type: Journal Article
Refereed: Yes
DOI: 10.1097/OLQ.0b013e3181b35549
ISSN: 0148-5717
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Mathematical Sciences
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2009 American Sexually Transmitted Diseases Association
Deposited On: 20 Oct 2014 23:27
Last Modified: 22 Oct 2014 05:40

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