Sexual Practice Changes Post-HIV Diagnosis Among Men Who Have Sex with Men in the United States: A Systematic Review and Meta-analysis

Details

• Alternative Title:
  AIDS Behav
• Personal Author:
  Malekinejad, Mohsen ; Jimsheleishvili, Sopiko ; Barker, Erin K. ; Hutchinson, Angela B. ; Shrestha, Ram K. ; Volberding, Paul ; Kahn, James G.
• Description:
  Men who have sex with men (MSM) often change sexual behaviors following HIV diagnosis. This systematic review examined such changes, including sero-adaptive behaviors (i.e., deliberate safer-sex practices to reduce transmission risk) to better understand the magnitude of their association with HIV diagnosis. We searched four databases (1996-2017) and reviewed references from other systematic reviews. We included studies conducted in the United States that compared sexual behavior among HIV-infected "aware" versus "unaware" MSM. We meta-analytically pooled RRs and associated 95% confidence intervals (CI) using random-effects models, and assessed risk of bias and evidence quality. Twenty studies reported k = 131 effect sizes on sexual practices outcomes, most of which reported changes in unprotected sex (k = 85), and on sex with at-risk partners (k = 76); 11 reported sero-adaptive behaviors. Unprotected anal intercourse with an HIV-uninfected/unknown-status partner was less likely among aware MSM (insertive position: k = 2, RR 0.26, 95% CI 0.17, 0.41; receptive position: k = 2, RR 0.53, 95% CI 0.37, 0.77). Risk of not always serosorting among aware MSM (k = 3) was RR = 0.92 (0.83, 1.02). Existing evidence, although low-quality, suggests that HIV-infected MSM tend to adopt safer sexual practices once aware of their diagnosis. Variation in reporting of outcomes limits their comparability. Sero-adaptive behavior data are sparse.
• Keywords:
  HIV Diagnosis HIV Infections HIV Serosorting Homosexuality, Male Humans Male Men Who Have Sex With Men Risk-Taking Sero-adaptive Behaviors Sexual And Gender Minorities Sexual Behavior Sexual Partners Systematic Review United States

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• Source:
  AIDS Behav. 27(1):257-278
• Pubmed ID:
  35829969
• Pubmed Central ID:
  PMC9834435
• Document Type:
  Journal Article
• Funding:
  R37 DA015612/DA/NIDA NIH HHSUnited States/ ; U38 PS004649/PS/NCHHSTP CDC HHSUnited States/ ; 5U38PS004649/national center for hiv/aids, viral hepatitis, std, and tb prevention/
• Volume:
  27
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c88bb9d10c2e9ff8a6f2b94640e05abcc769053f12b52a1c46370746e3fe2402
• Download URL:
  https://stacks.cdc.gov/view/cdc/123813/cdc_123813_DS1.pdf
• File Type:
  [PDF - 1.20 MB ]