Failure of serosorting to protect African American men who have sex with men from HIV infection.
Failure of serosorting to protect African American men who have sex with men from HIV infection.
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DOI：
10.1097/olq.0b013e31825727cb
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发表时间：
2012-09
影响因子：
3.1
通讯作者：
Stekler JD
中科院分区：
文献类型：
--
作者：
Golden MR;Dombrowski JC;Kerani RP;Stekler JD
血清分类是根据性伴侣的艾滋病毒状况选择性伴侣或选择性使用避孕套的做法。血清分选在多大程度上保护非洲裔美国人（AA）和西班牙裔男性与男性发生性关系（MSM）是未知的。我们分析了2001-10年在华盛顿州西雅图的MSM性病门诊患者中收集的数据。男性被问及前一年他们肛交伴侣的艾滋病毒状况，以及他们与伴侣的安全套使用情况。我们将血清分型者定义为仅与HIV状态相同的伴侣进行无保护肛交（UAI）的MSM，并比较了血清分型者和报告与HIV状态相反或未知的伴侣（即不一致的UAI）进行UAI的男性检测HIV阳性的风险。我们使用广义估计方程来评估血清分选与检测HIV阳性之间的关联。在13，657次访问中，共有6，694名先前没有艾滋病毒诊断的男男性行为者接受了检测; 274名男性艾滋病毒检测呈阳性。在白色MSM中，血清分选与检测HIV阳性的风险低于非一致性UAI（2.1 vs. 4.5%，OR 0.45 95% CI 0.34-0.61）相关，但与AA MSM（6.8 vs. 6.0%，OR 1.1 95% CI 0.57-2.2）无关。在西班牙裔中，血清分型者检测HIV阳性的风险低于从事非一致性UAI的男性，尽管这并不显著（4.1 vs. 6.0%，OR 0.67 95%CI 0.36-1.2）。至少在一些AA MSM人群中，血清分选似乎不能预防HIV感染。
Serosorting is the practice of choosing sex partners or selectively using condoms based on a sex partner’s perceived HIV status. The extent to which serosorting protects African American (AA) and Hispanic men who have sex with men (MSM) is unknown. We analyzed data collected from MSM STD clinic patients in Seattle, WA, 2001–10. Men were asked about the HIV status of their anal sex partners in the prior year and about their condom use with partners by partner HIV status. We defined serosorters as MSM who had unprotected anal intercourse (UAI) only with partners of the same HIV status, and compared the risk of testing HIV positive among serosorters and men who reported having UAI with partners of opposite or unknown HIV status (i.e. nonconcordant UAI). We used generalized estimating equations to evaluate the association of serosorting with testing HIV positive. A total of 6694 MSM without a prior HIV diagnosis were tested during 13,657 visits; 274 men tested HIV positive. Serosorting was associated with a lower risk of testing HIV positive than nonconcordant UAI among white MSM (2.1 vs. 4.5%, OR 0.45 95% CI 0.34–0.61), but not AA MSM (6.8 vs. 6.0%, OR 1.1 95% CI 0.57–2.2). Among Hispanics, the risk of testing HIV positive was lower among serosorters than men engaging in nonconcordant UAI, though this was not significant (4.1 vs. 6.0%, OR 0.67 95% CI 0.36–1.2). In at least some AA MSM populations, serosorting does not appear to be protective against HIV infection.