Sexual seroadaptation: lessons for prevention and sex research from a cohort of HIV-positive men who have sex with men
| Autor: | Stephen Shiboski, J. Jeff McConnell, Larry Bragg, Robert M. Grant |
|---|---|
| Přispěvatelé: | Kallas, Esper Georges |
| Rok vydání: | 2010 |
| Předmět: |
Male
and promotion of well-being Public Health and Epidemiology/Infectious Diseases lcsh:Medicine HIV Infections Men who have sex with men Cohort Studies 0302 clinical medicine 030212 general & internal medicine Homosexuality Aetiology lcsh:Science media_common Multidisciplinary virus diseases Infectious Diseases/HIV Infection and AIDS Adaptation Physiological 3. Good health Infectious Diseases Sexual Partners Cohort HIV/AIDS 0305 other medical science Infection Research Article Cohort study Infectious Diseases/Epidemiology and Control of Infectious Diseases medicine.medical_specialty Sexual network General Science & Technology media_common.quotation_subject Physiological HIV superinfection 03 medical and health sciences Clinical Research Behavioral and Social Science medicine Humans Homosexuality Male Seroconversion Adaptation Gynecology 030505 public health business.industry Public health Prevention lcsh:R Prevention of disease and conditions Good Health and Well Being Sexually Transmitted Infections 3.1 Primary prevention interventions to modify behaviours or promote wellbeing lcsh:Q Public Health and Epidemiology/Epidemiology business Demography 2.4 Surveillance and distribution |
| Zdroj: | PloS one, vol 5, iss 1 PLoS ONE, Vol 5, Iss 1, p e8831 (2010) PLoS ONE |
| Popis: | Author(s): McConnell, J Jeff; Bragg, Larry; Shiboski, Stephen; Grant, Robert M | Abstract: BackgroundSurveillance data on sexually transmitted infections (STIs) and behavioral characteristics identified in studies of the risk of seroconversion are often used as to track sexual behaviors that spread HIV. However, such analyses can be confounded by "seroadaptation"--the restriction of unprotected anal intercourse (UAI), especially unprotected insertive UAI, to seroconcordant partnerships.MethodsWe utilized sexual network methodology and repeated-measures statistics to test the hypothesis that seroadaptive strategies reduce the risk of HIV transmission despite numerous partnerships and frequent UAI.Principal findingsIn a prospective cohort study of HIV superinfection including 168 HIV-positive men who have sex with men (MSM), we found extensive seroadaptation. UAI was 15.5 times more likely to occur with a positive partner than a negative one (95% confidence interval [CI], 9.1-26.4). Receptive UAI was 4.3 times more likely in seroconcordant partnerships than with negative partners (95% CI, 2.8-6.6), but insertive UAI was 13.6 times more likely with positives (95% CI, 7.2-25.6). Our estimates suggest that seroadaptation reduced HIV transmissions by 98%.ConclusionPotentially effective HIV prevention strategies, such as seroadaptation, have evolved in communities of MSM before they have been recognized in research or discussed in the public health forum. Thus, to be informative, studies of HIV risk must be designed to assess seroadaptive behaviors rather than be limited to individual characteristics, unprotected intercourse, and numbers of partners. STI surveillance is not an effective indicator of trends in HIV incidence where there are strong patterns of seroadaptation. |
| Databáze: | OpenAIRE |
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