Skip to main content

Advertisement

SpringerLink
Log in

Sexual Serosorting among Women with or at Risk of HIV Infection

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Serosorting, the practice of selectively engaging in unprotected sex with partners of the same HIV serostatus, has been proposed as a strategy for reducing HIV transmission risk among men who have sex with men (MSM). However, there is a paucity of scientific evidence regarding whether women engage in serosorting. We analyzed longitudinal data on women’s sexual behavior with male partners collected in the Women’s Interagency HIV Study from 2001 to 2005. Serosorting was defined as an increasing trend of unprotected anal or vaginal sex (UAVI) within seroconcordant partnerships over time, more frequent UAVI within seroconcordant partnerships compared to non-concordant partnerships, or having UAVI only with seroconcordant partners. Repeated measures Poisson regression models were used to examine the associations between serostatus partnerships and UAVI among HIV-infected and HIV-uninfected women. The study sample consisted of 1,602 HIV-infected and 664 HIV-uninfected women. Over the follow-up period, the frequency of seroconcordant partnerships increased for HIV-uninfected women but the prevalence of UAVI within seroconcordant partnerships remained stable. UAVI was reported more frequently within HIV seroconcordant partnerships than among serodiscordant or unknown serostatus partnerships, regardless of the participant’s HIV status or types of partners. Among women with both HIV-infected and HIV-uninfected partners, 41% (63 HIV-infected and 9 HIV-uninfected) were having UAVI only with seroconcordant partners. Our analyses suggest that serosorting is occurring among both HIV-infected and HIV-uninfected women in this cohort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Suarez TP, Kelly JA, Pinkerton SD, Stevenson YL, Hayat M, Smith MD, et al. Influence of a partner’s HIV serostatus, use of highly active antiretroviral therapy, and viral load on perceptions of sexual risk behavior in a community sample of men who have sex with men. J Acquir Immune Defic Syndr. 2001;28(5):471–7.

    CAS  PubMed  Google Scholar 

  2. Suarez T, Miller J. Negotiating risks in context: a perspective on unprotected anal intercourse and barebacking among men who have sex with men—where do we go from here? Arch Sex Behav. 2001;30(3):287–300.

    Article  CAS  PubMed  Google Scholar 

  3. Truong HM, Kellogg T, Klausner JD, Katz MH, Dilley J, Knapper K, et al. Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect. 2006;82(6):461–6.

    Article  CAS  PubMed  Google Scholar 

  4. Mao L, Crawford JM, Hospers HJ, Prestage GP, Grulich AE, Kaldor JM, et al. “Serosorting” in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. Aids. 2006;20(8):1204–6.

    Article  PubMed  Google Scholar 

  5. Elford J, Bolding G, Sherr L, Hart G. No evidence of an increase in serosorting with casual partners among HIV-negative gay men in London, 1998–2005. Aids. 2007;21(2):243–5.

    Article  PubMed  Google Scholar 

  6. Parsons JT, Schrimshaw EW, Wolitski RJ, Halkitis PN, Purcell DW, Hoff CC, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. Aids. 2005;19(Suppl 1):S13–25.

    Article  PubMed  Google Scholar 

  7. Xia Q, Molitor F, Osmond DH, Tholandi M, Pollack LM, Ruiz JD, et al. Knowledge of sexual partner’s HIV serostatus and serosorting practices in a California population-based sample of men who have sex with men. Aids. 2006;20(16):2081–9.

    Article  PubMed  Google Scholar 

  8. Van der Bij AK, Kolader ME, de Vries HJ, Prins M, Coutinho RA, Dukers NH. Condom use rather than serosorting explains differences in HIV incidence among men who have sex with men. J Acquir Immune Defic Syndr. 2007;45(5):574–80.

    Article  PubMed  Google Scholar 

  9. Osmond DH, Pollack LM, Paul JP, Catania JA. Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997 2002. Am J Public Health. 2007;97(9):1677–83.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Golden MR, Wood RW, Buskin SE, Fleming M, Harrington RD. Ongoing risk behavior among persons with HIV in medical care. AIDS Behav. 2007;11(5):726–35.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. Eaton LA, West TV, Kenny DA, Kalichman SC. HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection. AIDS Behav. 2008 Oct 25.

  15. Parsons JT, Severino J, Nanin J, Punzalan JC, von Sternberg K, Missildine W, et al. Positive, negative, unknown: assumptions of HIV status among HIV-positive men who have sex with men. AIDS Educ Prev. 2006;18(2):139–49.

    Article  PubMed  Google Scholar 

  16. Butler DM, Smith DM. Serosorting can potentially increase HIV transmissions. Aids. 2007;21(9):1218–20.

    Article  PubMed  Google Scholar 

  17. CDC. HIV/AIDS Surveillance Report, 2005. Vol. 17. Revised. Atlanta: US Department of Health and Human Services, CDC: 2007:1–46. Available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed April 27, 2010.

  18. Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, et al. The women’s interagency HIV study. WIHS collaborative study group. Epidemiology. 1998;9(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  19. Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. Jama. 2004;292(2):224–36.

    Article  CAS  PubMed  Google Scholar 

  20. Phair JP, Ostrow DG. Risk-taking in the era of highly active antiretroviral therapy. Curr Infect Dis Rep. 2001;3(2):101–2.

    Article  PubMed  Google Scholar 

  21. Calvelli T, Denny TN, Paxton H, Gelman R, Kagan J. Guideline for flow cytometric immunophenotyping: a report from the National Institute of Allergy and Infectious Diseases, Division of AIDS. Cytometry. 1993;14(7):702–15.

    Article  CAS  PubMed  Google Scholar 

  22. DHHS. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. DHHS/Henry J. Kaiser family foundation panel on clinical practices for the treatment of HIV infection. April 2005 revision. Available at http://aidsinfo.nih.gov. Accessed March 1, 2006; 2005.

  23. Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.

    Article  PubMed  Google Scholar 

  24. Wilson TE, Gore ME, Greenblatt R, Cohen M, Minkoff H, Silver S, et al. Changes in sexual behavior among HIV-infected women after initiation of HAART. Am J Public Health. 2004;94(7):1141–6.

    Article  PubMed  Google Scholar 

  25. Wilson TE, Feldman J, Vega MY, Gandhi M, Richardson J, Cohen MH, et al. Acquisition of new sexual partners among women with HIV infection: patterns of disclosure and sexual behavior within new partnerships. AIDS Educ Prev. 2007;19(2):151–9.

    Article  PubMed  Google Scholar 

  26. Niccolai LM, Dorst D, Myers L, Kissinger PJ. Disclosure of HIV status to sexual partners: predictors and temporal patterns. Sex Transm Dis. 1999;26(5):281–5.

    Article  CAS  PubMed  Google Scholar 

  27. Zablotska IB, Imrie J, Prestage G, Crawford J, Rawstorne P, Grulich A, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21(4):501–10.

    Article  PubMed  Google Scholar 

  28. Snowden J, Raymond HF, McFarland W. Prevalence of seroadaptive behaviors of men who have sex with men, San Francisco, 2004. Sex Transm Infect. 2009 Jun 7.

  29. Morin SF, Shade SB, Steward WT, Carrico AW, Remien RH, Rotheram-Borus MJ, et al. A behavioral intervention reduces HIV transmission risk by promoting sustained serosorting practices among HIV-infected men who have sex with men. J Acquir Immune Defic Syndr. 2008;49(5):544–51.

    Article  PubMed  Google Scholar 

Download references

Acknolwedgements

Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases with supplemental funding from the National Cancer Institute and the National Institute on Drug Abuse (UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, and UO1-AI-42590). Funding is also provided by the National Institute of Child Health and Human Development (UO1-HD-32632) and the National Center for Research Resources (MO1-RR-00071, MO1-RR-00079, MO1-RR-00083).

Author information

Authors and Affiliations

  1. Department of Medicine, Georgetown University, 2233 Wisconsin Ave NW, Suite 214, Washington, DC, 20007, USA

    Chenglong Liu, Haihong Hu, Lakshmi Goparaju & Michael Plankey

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    Peter Bacchetti

  3. Hektoen Institute of Medicine and The CORE Center at John H. Stroger Hospital of Cook County, Chicago, IL, USA

    Kathleen Weber

  4. Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY, USA

    Nereida Correa

  5. Department of Pediatrics, University of South California, Los Angeles, CA, USA

    Marek Nowicki

  6. Department of Community Health Sciences, State University of New York, Downstate Medical Center, Brooklyn, NY, USA

    Tracey E. Wilson

Authors
  1. Chenglong Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haihong Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lakshmi Goparaju
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Plankey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Bacchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kathleen Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nereida Correa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marek Nowicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tracey E. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chenglong Liu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, C., Hu, H., Goparaju, L. et al. Sexual Serosorting among Women with or at Risk of HIV Infection. AIDS Behav 15, 9–15 (2011). https://doi.org/10.1007/s10461-010-9710-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-010-9710-3

Keywords

Search

Navigation