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Mixed Findings Paint a Tricky Picture for HIV Serosorting and Other Seroadaptive Behaviors

April 3, 2012

Some seroadaptive behaviors appear to be even more effective than 100% condom use at reducing the risk of HIV acquisition, but with important caveats, according to a paper presented last month at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012).

Researchers from San Francisco and Seattle, led by Snigdha Vallabhaneni, M.D., analyzed data from four previous HIV prevention studies. Data was collected on 12,705 HIV-uninfected men who have sex with men (MSM) from North America, with sexual behavior self-reports and HIV testing conducted every six months for 18 to 36 months. Among the study population, 663 ended up contracting HIV.

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See Also
Fact Sheet: HIV/AIDS and Young Men Who Have Sex With Men
More on HIV Prevention Research in Gay Men

Reader Comments:

Comment by: Michael B. (Long Beach, CA) Mon., Apr. 9, 2012 at 8:16 pm UTC
"We know that, from other studies, nearly a quarter of infections among MSM can be attributed to insertive anal sex -- so having unprotected, insertive anal sex is not a good strategy. Condom use and limiting the number of partners are the most important strategies one can use."

This is so strange to consider that adding something less effective by the studies own results is the most important strategy one can use. Add to that that the number of partners was not factor, one wonders out loud what it will take to get prevention researchers to think outside the box?

If "use a condom every time" was an effective message, we wouldn't have HIV-positive numbers that rival the population of Canada. Sero-sorting--which has been adopted with gusto by gay men in the developed world--fares even worse.

According to the numbers reported, being a top or being monogamous is the most effective prevention technique. Why is it so difficult for community leaders, public health officials, and researchers to unequivocally endorse these strategies? Should we be telling negative gay men to save their ass for gay marriage? We've seen HIV spread much slower among MSM populations where cultures divide tops from bottoms rather than gay from straight.

"Use a condom" seems to be a way to let the speaker off the hook, like a host at a party that lets me leave drunk, calling out, "Drive safe!" This study is important for it's novel results. Let's start drawing some novel conclusions to match!
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