Online Program

Seroadaptive practices by partner gender and HIV serostatus among Black men who have sex with men and women (BMSMW)

Tuesday, November 3, 2015

Anna Hotton, PhD, MPH, Division of Infectious Diseases/CORE Center, John H. Stroger Hospital of Cook County, Chicago Developmental Center for AIDS Research, Chicago, IL
Sybil Hosek, PhD, Department of Psychiatry/CORE Center, John Stroger Hospital of Cook County, Chicago, IL
M. Isabel Fernandez, PhD, Department of Public Health, Nova Southeastern University, Ft. Lauderdale, FL

Background:  Seroadaptive behaviors are used by some MSM/W to reduce HIV risk.

Methods:  Baseline data from a randomized trial of an HIV-prevention intervention for BMSMW were analyzed.  Participants reported HIV serostatus, ascertainment method and sexual practices with up to 2 main male, female, and transgender partners.  Associations were estimated from mixed-effects logistic regression.

Results:  Of 211 participants, 192 (122 HIV-positive, 63 HIV-negative, 7 HIV-unknown status) had ≥ 1 main partner (median 2; IQR 2-4) and reported on 522 partners (242 male, 209 female, 71 transgender).  HIV status was known for 406 (78%) of the partners.  Among known serostatus partners, serostatus was determined by direct assessment (testing together, direct discussion) for 76%; indirect assessment (situational factors, appearance) for 9%; and other/unknown methods for 15%.  HIV-negative men were more likely than HIV-positive men to report seroconcordant partners (OR 2.25; 95% CI 1.24-4.06) and direct methods of serostatus ascertainment (OR 2.34; 95% CI 1.02-5.37), though 40% of HIV-negative men had not been tested in > 6 months. Among HIV-positive men, seroconcordance was associated with unprotected insertive anal intercourse with male (OR 3.17; 95% CI 1.47-6.81) and female (OR 4.17; 95% CI 1.68-10.4) partners.  Unprotected vaginal intercourse was not significantly associated with female partner seroconcordance (OR 2.51; 95% CI 0.79-7.96). Among HIV-negative men, sexual practices did not vary by partner serostatus.

Conclusions:  Strategic positioning with male partners appears among HIV-positive BMSMW.  Infrequent testing among HIV-negative men and indirect assessment of partner serostatus may limit the effectiveness of risk-reduction strategies, even with main partners. 

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe HIV risk assessment and seroadaptive strategies among Black men who have sex with men and women (BMSMW).

Keyword(s): HIV/AIDS, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over eight years of public health research experience and have been a principal investigator or co-investigator on several grants related to HIV/STI prevention in special populations, including youth and MSM.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.