“Knowing Your Status and Knowing Your Partner’s Status Is Really Where It Starts”: A Qualitative Exploration of the Process by Which a Sexual Partner’s HIV Status Can Influence Sexual Decision Making

Bird, Jason D. P.; Morris, Joseph Acton; Koester, Kimberly A.; Pollack, Lance M.; Binson, Diane; Woods, William J.

doi:10.1080/00224499.2016.1202179

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…Ten studies addressed the behavioural and psychosocial interventions approach as a prevention strategy, which includes strategies for risk reduction, such as agreements with sexual partners and social protection, in addition to the use of a prevention method. These studies have gained prominence in the last ten years, and six of them 21,38,41,42,47,53 have been published as of 2016. This suggests that, in parallel to the research focused on preventive methods, there is a concern to understand other dimensions of prevention that have more to do with different experiences and needs of the individuals.…”

Section: Resultsmentioning

confidence: 99%

“…As of this period, there is a diversification of production, which coincides with the start of studies related to diagnostic tests and PrEP 23,26,27,30,31,34,36,37,41,44,46,51,65 . Furthermore, behavioural and psychosocial studies increase 21,29,35,38,39,41,42,47,53,55 , which suggests a greater influence of the "combined prevention" paradigm 78 .…”

Section: Resultsmentioning

confidence: 99%

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Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

et al. 2019

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Background: Qualitative studies on HIV prevention strategies and methods among men who have sex with men (MSM) allow identify knowledge gaps and improve preventive actions. Objective: To make a thematic synthesis of the scientific productions that use the qualitative methodology in the strategies and methods of HIV prevention area among MSM. Methods: We conducted a literature review following the guidelines of the ENTREQ protocol. The analysis included 48 empirical studies published in Portuguese, English and Spanish between 2001 and 2018 available in the Medline, Embase, Scielo, Scopus, Bireme and Web of Science databases. Results: Where an increased production in the last six years and concentration in northern countries. Seven prevention methods were part of the study, with emphasis on pre-exposure prophylaxis, testing, condoms and behavioral strategies. The main topics discussed were stigma and support and care networks. Conclusion: we notice that an increasing production on prevention in the men who have sex with men segment results from the emergence of multiple preventive methods and strategies and their combined actions beyond the star role of condoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

et al. 2019

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“…Other factors may affect the association between seroconcordance and the risk of HIV transmission. In both MSM and heterosexual women, serosorting was associated with risk compensation in the form of increased condomless sex, making the benefits of serosorting greatly dependent on the accuracy of partners HIV status perception and other behavioural strategies . At the same time, among MSM, HIV‐negative MSM who self‐report as practicing serosorting are estimated to have a 54% lower risk of HIV acquisition, compared to condomless anal sex with either HIV‐positive or unknown status partners .…”

Section: Discussionmentioning

confidence: 99%

HIV seroconcordance among heterosexual couples in rural KwaZulu‐Natal, South Africa: a population‐based analysis

et al. 2020

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Introduction High levels of HIV seroconcordance at the population level reduce the potential for effective HIV transmission. However, the level of HIV seroconcordance is largely unknown among heterosexual couples in sub‐Saharan Africa. We aimed to quantify the population level HIV seroconcordance in stable heterosexual couples in rural South Africa. Methods We followed adults (≥15 years old) using a population‐based, longitudinal and open surveillance system in KwaZulu‐Natal, South Africa, from 2003 to 2016. Sexual partnerships and HIV status were confirmed via household surveys and annual HIV surveillance. We calculated the proportions of HIV seroconcordance and serodiscordance in stable sexual partnerships and compared them to the expected proportions under the assumption of random mixing using individual‐based microsimulation models. Among unpartnered individuals, we estimated the incidence rates and hazard of sexual partnership formation with HIV‐positive or HIV‐negative partners by participants' own time‐varying HIV status. Competing risks survival regressions were fitted adjusting for sociodemographic and clinical factors. We also calculated Newman's assortativity coefficients. Results A total of 18,341 HIV‐negative and 11,361 HIV‐positive individuals contributed 154,469 person‐years (PY) of follow‐up. Overall, 28% of the participants were in stable sexual partnerships. Of the 677 newly formed stable sexual partnerships, 7.7% (95% CI: 5.8 to 10.0) were HIV‐positive seroconcordant (i.e. both individuals in the partnership were HIV‐positive), which was three times higher than the expected proportion (2.3%) in microsimulation models based on random mixing. The incidence rates of sexual partnership formation were 0.54/1000PY with HIV‐positive, 1.12/1000PY with HIV‐negative and 2.65/1000PY with unknown serostatus partners. HIV‐positive individuals had 2.39 (95% CI: 1.43 to 3.99) times higher hazard of forming a sexual partnership with an HIV‐positive partner than did HIV‐negative individuals after adjusting for age, opposite‐sex HIV prevalence (by 5‐years age groups), HIV prevalence in the surrounding community, ART coverage and other sociodemographic factors. Similarly, forming a sexual partnership with an HIV‐negative partner was 1.47 (95% CI: 1.01 to 2.14) times higher in HIV‐negative individuals in the adjusted model. Newman's coefficient also showed that assortativity by participant and partner HIV status was moderate (r = 0.35). Conclusions A high degree of population level HIV seroconcordance (both positive and negative) was observed at the time of forming new sexual partnerships. Understanding factors driving these patterns may help the development of strategies to bring the HIV epidemic under control.

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“…HIV prevention strategies are not static and change over time and so does their influence on partner selection practices. Diverse strategies intended to reduce HIV transmission and acquisition have emerged from communities most impacted by the epidemic ( 12 , 13 , 32 , 33 ). Over the last 20 years, use of HIV serostatus to inform decisions around sexual behavior, including partner selection and risk negotiation, has become an important area of research [see for example, ( 5 , 8 , 34 – 39 ).…”

Section: Literature Reviewmentioning

confidence: 99%

“…The emergence of PrEP and TasP, two highly effective bio-behavioral HIV prevention strategies that work with or without concurrent condom use, present an opportunity to consider the social ramifications of certain frameworks for understanding sexuality and risk and the consequences these frames have in perpetuating the separation of people based on serostatus ( 33 , 80 , 96 – 104 ). However, self-imposed restrictions on sex and dating between people infected with or uninfected with HIV may be diminishing.…”

Section: Literature Reviewmentioning

confidence: 99%

“Losing the Phobia:” Understanding How HIV Pre-exposure Prophylaxis Facilitates Bridging the Serodivide Among Men Who Have Sex With Men

Koester

Erguera

Dufour

et al. 2018

Front. Public Health

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The use of HIV serostatus information has played a pivotal role in partner selection norms. A phenomenon known as serosorting is the practice of selecting a partner based on a perception that they are of the same HIV status in order to avoid transmission from one partner to the other. An understudied aspect of serosorting is that it has a divisive effect—one accepts or rejects a potential partner based on a singular characteristic, the partner's HIV status, and thus excludes all others. This division has been formally referred to as the HIV serodivide. In this study, we explored partner selection strategies among a group of HIV-negative, young men who have sex with men (n = 29) enrolled in a PrEP demonstration project in Northern California. We found that trends in serosorting were in fact shifting, and that a new and opposite phenomenon was emerging, something we labeled “seromixing” and that PrEP use played a part in why norms were changing. We present three orientations in this regard: (1) maintaining the phobia: in which men justified the continued vigilance and exclusion of people living with HIV as viable sex or romantic partners, (2) loosening/relaxation of phobia: among men who were reflecting on their stance on serosorting and its implications for future sexual and/or romantic partnerships, and (3) losing the phobia: among men letting go of serosorting practices and reducing sentiments of HIV-related stigma. The majority of participants spoke of changing or changed attitudes about intentionally accepting rather than rejecting a person living with HIV as a sex partner. For those who maintained strict serosorting practices, their understandings of HIV risk were not erased as a result of PrEP use. These overarching themes help explain how PrEP use is contributing to a closing of the HIV serodivide.

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“Knowing Your Status and Knowing Your Partner’s Status Is Really Where It Starts”: A Qualitative Exploration of the Process by Which a Sexual Partner’s HIV Status Can Influence Sexual Decision Making

Cited by 7 publications

References 18 publications

Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

HIV seroconcordance among heterosexual couples in rural KwaZulu‐Natal, South Africa: a population‐based analysis

“Losing the Phobia:” Understanding How HIV Pre-exposure Prophylaxis Facilitates Bridging the Serodivide Among Men Who Have Sex With Men

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