McFarland Willi, Chen Yea-Hung, Raymond H Fisher, Nguyen Binh, Colfax Grant, Mehrtens Jason, Robertson Tyler, Stall Ron, Levine Deb, Truong Hong-Ha M
San Francisco Department of Public Health, USA.
AIDS Care. 2011 Mar;23(3):261-8. doi: 10.1080/09540121.2010.507748.
"Seroadaptation" comprises sexual behaviors to reduce the risk of HIV acquisition and transmission based on knowing one's own and one's sexual partners' serostatus. We measured the prevalence of seroadaptive behaviors among men who have sex with men (MSM) recruited through time-location sampling (TLS) across three perspectives: by individuals (N = 1207 MSM), among sexual dyads (N = 3746 partnerships), and for sexual episodes (N = 63,789 episodes) in the preceding six months. Seroadaptation was more common than 100% condom use when considering the consistent behavioral pattern of individuals (adopted by 39.1% vs. 25.0% of men, respectively). Among sexual dyads 100% condom use was more common than seroadaptation (33.1% vs. 26.4%, respectively). Considering episodes of sex, not having anal intercourse (65.0%) and condom use (16.0%) were the most common risk reduction behaviors. Sex of highest acquisition and transmission risks (unprotected anal intercourse with a HIV serodiscordant or unknown status partner in the riskier position) occurred in only 1.6% of sexual episodes. In aggregate, MSM achieve a high level of sexual harm reduction through multiple strategies. Detailed measures of seroadaptive behaviors are needed to effectively target HIV risk and gauge the potential of serosorting and related sexual harm reduction strategies on the HIV epidemic.
“血清适应性”包括基于了解自身及性伴侣的血清学状态而采取的降低感染和传播艾滋病毒风险的性行为。我们通过时间-地点抽样(TLS)招募男男性行为者(MSM),从三个角度测量了血清适应性行为的流行情况:个体层面(N = 1207名MSM)、性伴侣层面(N = 3746对伴侣关系)以及前六个月的性接触层面(N = 63789次性接触)。从个体的持续行为模式来看,血清适应性比100%使用避孕套更为常见(分别有39.1%和25.0%的男性采用)。在性伴侣层面,100%使用避孕套比血清适应性更为常见(分别为33.1%和26.4%)。考虑到性接触情况,不进行肛交(65.0%)和使用避孕套(16.0%)是最常见的降低风险行为。感染和传播风险最高的性行为(在风险较高的体位与艾滋病毒血清学不一致或状况不明的伴侣进行无保护肛交)仅占性接触的1.6%。总体而言,男男性行为者通过多种策略在很大程度上降低了性方面的危害。需要对血清适应性行为进行详细测量,以便有效地针对艾滋病毒风险,并评估血清分类及相关的性危害降低策略对艾滋病毒流行的潜在影响。