Failure of Serosorting to Protect African-American Men Who Have Sex With Men From HIV Infection

"Serosorting" refers to the practice of choosing sex partners or deciding whether to use condoms based on the perceived HIV status of a sex partner. The authors noted that the extent to which this practice protects African-American (AA) and Hispanic MSM is unknown.

The researchers analyzed data collected from MSM STD clinic patients in Seattle, Wash., from 2001 to 2010. The men were asked about the HIV status of the partners with whom they had anal sex in the previous year, and about their condom use with partners by partner HIV status. Serosorters were defined as MSM who had unprotected anal intercourse only with partners of the same HIV status. The team compared the risk of testing HIV-positive among serosorters and MSM who reported UAI with partners of opposite or unknown HIV status (nonconcordant UAI). Generalized estimating equations were used to evaluate the association of serosorting with testing positive for HIV infection.

During 13,657 visits, 6,694 MSM without a prior HIV diagnosis underwent testing; of these, 274 men tested positive. Serosorting was found to be associated with a lower risk of testing HIV-positive than nonconcordant UAI among white MSM (2.1 vs. 4.5 percent, odds ratio: 0.45, 95 percent confidence interval: 0.34-0.61), but not AA MSM (6.8 vs. 6.0 percent; OR: 1.1, 95 percent CI: 0.57-2.2). Among Hispanics, the risk of testing HIV-positive was lower among serosorters than men reporting nonconcordant UAI, although this was not significant (4.1 vs. 6.0 percent, OR: 0.67, 95 percent CI: 0.36-1.2).

"In at least some AA MSM populations, serosorting does not seem to be protective against HIV infection," the authors concluded.

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