Marseille 2007
| Abstract #393 - Serosorting, negotiated safety and HIV risk reduction among London gay men | ||||
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Session: 18.7: Risk Perception (Parallel) on Monday @ 14.00-16.00 in CP Chaired by Elizabeth Brown, Yusef Azad Authors: Presenting Author: Prof Jonathan Elford - City University London, United Kingdom |
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| Additional Authors: Prof Jonathan Elford, Prof Lorraine Sherr, Prof Graham Hart, Mr Graham Bolding, | ||||
| Aim: Since AIDS was first reported a quarter of a century ago, gay men have adopted a number of strategies for reducing the risk of HIV transmission while having unprotected anal intercourse (UAI). One such strategy is to only have UAI with a partner of the same HIV status. This is known as serosorting in a casual encounter or negotiated safety in the context of a relationship. The aim of this analysis was to examine the extent to which gay men in London have adopted this risk reduction strategy and whether this has changed over time | ||||
| Method / Issue: Gay men using central London gyms were surveyed annually between 1998-2005 (total n=5416, range 498 to 834 per year). Information was collected on HIV status, UAI in the previous 3 months, type (main or casual) and HIV status of partner for UAI. Men who had never had an HIV test were excluded from the analysis since, without an HIV test result, they were not able to establish seroconcordance with a sexual partner. | ||||
| Results / Comments: Of the 5416 men, 853 (14.5%) were HIV positive and 3430 (63.9%) were HIV negative; 1133 (20.9%) had never been tested for HIV and were excluded from the analysis. Median age was 34 years. Between 1998-2005, the percentage of HIV positive men reporting UAI only with a partner of the same HIV status increased from 11.9% to 27.8% (odds ratio (OR) 1.16 per year 95% confidence interval (CI) 1.07, 1.26, p<0.01) while for HIV negative men, it increased from 14.1% to 20.2% (OR 1.04 per year, 95% CI 0.99, 1.08, p=0.08). For men who only reported UAI with a main partner of the same HIV status (negotiated safety), a significant increase was seen for both for HIV positive men (5.1%, 10.1% p<0.05) and for HIV negative men (12.4%, 19.0%, p<0.05). However, for men reporting UAI with a casual partner of the same HIV status (serosorting), the increase was seen only for HIV positive men (6.8% to 17.7%, p<0.01); among HIV negative men there was no change over time (1.7%, 1.2%, p=0.1). | ||||
| Discussion: In London, between 1998-2005 there was an increase in the percentage of HIV positive and negative gay men who reported only having UAI with a partner of the same HIV status. Among HIV positive men this increase occurred largely with casual, but also with main partners. For HIV negative men the increase was seen only with main partners. Relatively few HIV negative men reported serosorting with a casual partner, possibly because it is difficult to reliably establish HIV-negative-seroconcordance in a casual encounter. It appears that a growing number of gay men in London have adopted an HIV risk reduction strategy whereby they only have UAI a partner of the same HIV status (serosorting or negotiated safety). While this can reduce the risk of HIV transmission it presents a risk for the transmission of other sexually transmitted infections in a casual encounter as well as a risk of cross-infection for HIV-positive men themselves | ||||
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