A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men

Abstract

Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada, were recruited. Grouped by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viral-load sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72 %) and a large proportion of HIV-positive men (42 %) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM's sexual health needs.

Prevalence of and Factors Associated with the Use of HIV Serosorting and Other Biomedical Prevention Strategies Among Men Who Have Sex with Men in a US Nationwide Survey

“…Seroadaption 9–15 describes a diverse set of potentially harm-reducing behaviors that use HIV status to inform sexual decision making; examples include seropositioning/strategic positioning 14,16–18 (selectively practicing insertive or receptive anal sex based on a partner’s HIV status), selectively having only oral sex or mutual masturbation, 19–21 and serosorting. 14,15,22–27 Serosorting, specifically, describes a person choosing partners of the same HIV serostatus, including to engage in sex without condoms. 28–30…”

Social Isolation and Mortality Among People Living with HIV in British Columbia, Canada

“…Models including two to five latent classes were fit to the sample and a solution was selected using goodness-of-fit criterion. represented a better fit [44]. A three-class solution was selected based on best-fit statistical considerations [34].…”

“…Models including two to five latent classes were fit to the sample and a solution was selected using goodness-of-fit criterion. For the fit statistics considered (Akaike information criterion [AIC], Bayesian information criterion [BIC], consistent Akaike information criterion [cAIC], and adjusted Bayesian information criterion [aBIC]), the lowest value represented a better fit [ 44 ]. A three-class solution was selected based on best-fit statistical considerations [ 34 ].…”

Longitudinal Event-Level Analysis of Gay and Bisexual Men’s Anal Sex Versatility: Behavior, Roles, and Substance Use

“…modeling. An alternative approach to quantifying GBM substance use patterns employs latent class analysis (Card et al, 2018;Carter et al, 2018;Dangerfield, Carmack, Gilreath & Duncan, 2018b), which has the advantage of including and analyzing associated socio-economic and demographic variables. However, all latent class analyses known to us use individual-level substance use reports with varying time intervals.…”