San Francisco Department of Public Health, San Francisco, California, United States of America.
PLoS One. 2010 Sep 9;5(9):e12662. doi: 10.1371/journal.pone.0012662.
Seroadaptation strategies such as serosorting and seropositioning originated within communities of men who have sex with men (MSM), but there are limited data about their effectiveness in preventing HIV transmission when utilized by HIV-negative men.
METHODOLOGY/PRINCIPAL FINDINGS: Data from the EXPLORE cohort of HIV-negative MSM who reported both seroconcordant and serodiscordant partners were used to evaluate serosorting and seropositioning. The association of serosorting and seropositioning with HIV seroconversion was evaluated in this cohort of high risk MSM from six U.S. cities. Serosorting was independently associated with a small decrease in risk of HIV seroconversion (OR=0.88; 95%CI, 0.81-0.95), even among participants reporting ≥10 partners. Those who more consistently practiced serosorting were more likely to be white (p=0.01), have completed college (p=<0.0002) and to have had 10 or more partners in the six months before the baseline visit (p=0.01) but did not differ in age, reporting HIV-infected partners, or drug use. There was no evidence of a seroconversion effect with seropositioning (OR 1.02, 95%CI, 0.92-1.14).
In high risk HIV uninfected MSM who report unprotected anal intercourse with both seroconcordant and serodiscordant partners, serosorting was associated with a modest decreased risk of HIV infection. To maximize any potential benefit, it will be important to increase accurate knowledge of HIV status, through increased testing frequency, improved test technology, and continued development of strategies to increase disclosure.
血清学适应策略，如血清匹配和血清定位，最初起源于男男性行为者（MSM）群体，但关于 HIV 阴性男性使用这些策略预防 HIV 传播的有效性的数据有限。
方法/主要发现：本研究使用了来自六个美国城市的 HIV 阴性 MSM 的 EXPLORE 队列数据，这些参与者报告了血清一致和血清不一致的性伴侣，用于评估血清匹配和血清定位。在这个高危 MSM 队列中，评估了血清匹配和血清定位与 HIV 血清转换的关联。血清匹配与 HIV 血清转换风险的小幅度降低独立相关（OR=0.88；95%CI，0.81-0.95），即使在报告≥10 名性伴侣的参与者中也是如此。那些更一致地进行血清匹配的人更可能是白人（p=0.01），完成了大学学业（p=<0.0002），并且在基线访问前的六个月内有 10 个或更多性伴侣（p=0.01），但在年龄、报告感染 HIV 的性伴侣或药物使用方面没有差异。血清定位与血清转换之间没有证据表明存在血清转换效应（OR 1.02，95%CI，0.92-1.14）。
在报告与血清一致和血清不一致的性伴侣发生无保护肛交的高危 HIV 未感染 MSM 中，血清匹配与 HIV 感染风险适度降低相关。为了最大限度地发挥任何潜在的益处，通过增加检测频率、改进检测技术以及继续开发增加披露策略，提高对 HIV 状态的准确认识将非常重要。
