HIV Serosorting Among HIV-Positive Men Who Have Sex With Men Is Associated With Increased Self-Reported Incidence of Bacterial Sexually Transmissible Infections

The researchers undertook to quantify the frequency of HIV serosorting among MSM in Germany, and to evaluate the association of serosorting with other sexual risk management approaches (RMA) and with the frequency of bacterial STI.

In 2006, an anonymous, self-administered questionnaire was distributed through German online sexual networking sites and medical practices. The analysis focused on 2,985 respondents who reported an HIV test result. Based on two questions relating to RMA, serosorting was classified as tactical (an event-based decision) or strategic (a premeditated search for a partner who was seroconcordant). The analysis was stratified by HIV serostatus and seroconcordant partnership status.

Different serosorting patterns were noted for HIV-positive and HIV-negative participants. Tactical serosorting ranked second after RMA based on condom use (HIV-positive: 55.1 percent; HIV-negative: 45.1 percent; P<0.001). "While the overlap of strategic and tactical HIV serosorting among HIV-positive MSM was substantial (58 percent), HIV-negative strategic and tactical serosorting were more distinct (18.1 percent overlap)," the authors wrote.

For both HIV-positive and -negative subjects, tactical serosorting was associated with reduced condom use. When compared to respondents using RMA other than serosorting, HIV-positive serosorters had a three-fold increased risk for bacterial STI (strategic: odds ratio=2.62; 95 percent confidence interval: 1.76-3.89; tactical: OR=3.19; 95 percent CI: 2.14-4.75; both for respondents without HIV seroconcordant partners).

"HIV serosorting has emerged as a common RMA among MSM," the authors concluded. "For HIV-positive MSM, it may contribute to high rates of bacterial STI that may lead to elevated per-contact risks for HIV transmission."

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