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Abstract
BackgroundSerosorting is practiced by men who have sex with men (MSM) to reduce human immunodeficiency virus (HIV) transmission. This study evaluates the prevalence of serosorting with casual partners, and analyses the characteristics and estimated numbers of serosorters in Switzerland 2007-2009.MethodsData were extracted from cross-sectional surveys conducted in 2007 and 2009 among self-selected MSM recruited online, through gay newspapers, and through gay organizations. Nested models were fitted to ascertain the appropriateness of pooling the datasets. Multiple logistic regression analysis was performed on pooled data to determine the association between serosorting and demographic, lifestyle-related, and health-related factors. Extrapolations were performed by applying proportions of various types of serosorters to Swiss population data collected in 2007.ResultsA significant and stable number of MSM (approximately 39% in 2007 and 2009) intentionally engage in serosorting with casual partners in Switzerland. Variables significantly associated with serosorting were: gay organization membership (aOR = 1.67), frequent internet use for sexual encounters (aOR = 1.71), having had a sexually transmitted infection (STI) at any time in the past 12 months (aOR = 1.70), HIV-positive status (aOR = 0.52), regularly frequenting sex-on-premises venues (aOR = 0.42), and unprotected anal intercourse (UAI) with partners of different or unknown HIV status in the past 12 months (aOR = 0.22). Approximately one-fifth of serosorters declared HIV negativity without being tested in the past 12 months; 15.8% reported not knowing their own HIV status.ConclusionThe particular risk profile of serosorters having UAI with casual partners (multiple partners, STI history, and inadequate testing frequency) requires specific preventive interventions tailored to HIV status.
Highlights
Serosorting is practiced by men who have sex with men (MSM) to reduce human immunodeficiency virus (HIV) transmission
In Switzerland, between 1994 and 2009, we observed a stable proportion of respondents reporting having been tested during the last 12 months, and an increase of 10 points in respondents having had at least one incident of unprotected anal intercourse (UAI) during the past 12 months with a partner of different or unknown HIV status [4]
Respondents are recruited online with banners published on the main gay websites within the Switzerland Internet domain (“ch”), and through gay newspapers and gay or HIV/AIDS nongovernmental organizations
Summary
Serosorting is practiced by men who have sex with men (MSM) to reduce human immunodeficiency virus (HIV) transmission. A renewal of the human immunodeficiency virus (HIV) epidemic has been observed among men who have sex with men (MSM) in developed countries [1]. Serosorting - choosing to have UAI with partners of the same HIV status–has been studied [10,11,12,13,14,15], and has been considered to have a protective effect or convey a lower risk of HIV transmission in populations with a high prevalence and frequency of HIV testing [16,17,18,19]. The limits of this approach have been demonstrated: serosorting may increase HIV transmission in populations with high rates of unrecognized and/or acute infection [10,20]
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