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Association Between Serosorting and Bacterial Sexually Transmitted Infection Among HIV-Negative Men Who Have Sex With Men at an Urban Lesbian, Gay, Bisexual, and Transgender Health Center

Hotton, Anna L. MPH, PhD*†; Gratzer, Beau MPP*‡; Mehta, Supriya D. MHS, PhD

doi: 10.1097/OLQ.0b013e31826e870d
Original Study

Background Serosorting, selecting sex partners of the same HIV status, may be associated with increased risk of sexually transmitted infection (STI). We examined the association between unprotected anal intercourse (UAI) with a seroconcordant partner and STIs among HIV-negative men who have sex with men (MSM) at an urban lesbian, gay, bisexual, and transgender STI clinic.

Methods Subjects reported how they assessed their most recent sex partner’s HIV status. Those who reported getting tested together or asking were classified as known concordant; those who determined their partner’s serostatus based on appearance, age, or social aspects were classified as assumed concordant. Generalized estimating equations generated prevalence ratios for associations between seroconcordance and STIs.

Results From May 2010 through October 2011, 961 HIV-negative MSM were screened for gonorrhea, chlamydia, and syphilis at 1110 visits. Sexually transmitted infection prevalence was 20.1%: 20.2% at visits with known seroconcordant UAI, 35.3% at visits with assumed seroconcordant UAI, 29.5% at visits where UAI with an unknown status partner was reported, 34.8% at visits with serodiscordant UAI, and 16.1% at visits with no reported UAI. Assumed serodiscordant UAI (adjusted prevalence ratio [aPR], 2.51; 95% confidence interval [CI], 1.79–3.51), unknown status partner (aPR, 1.76; 95% CI, 1.31–2.38), and serodiscordant UAI (aPR, 2.57; 95% CI, 1.76–3.75) were significant predictors of STI after controlling for age and race/ethnicity, STI history, alcohol use, substance use, and multiple sex partners. Known seroconcordant UAI was not associated with STI.

Conclusions Assumed seroconcordant UAI was associated with increased STI prevalence, although known seroconcordant UAI was not. The risk associated with UAI with a partner of assumed seroconcordance should be emphasized for HIV-negative MSM.

Among HIV-negative men who have sex with men seeking sexually transmitted infection testing, assumed seroconcordant unprotected anal intercourse (UAI) was associated with increased sexually transmitted infection prevalence relative to no UAI, although seroconcordant UAI with direct assessment of partner serostatus was not.

From the *Department of Research, Howard Brown Health Center, Chicago, IL, and Divisions of †Epidemiology, and Biostatistics and ‡Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL.

Financial support: No financial support was received for this study.

Conflicts of interest: None.

Correspondence: Anna L. Hotton, MPH, PhD, Howard Brown Health Center, 4025 N Sheridan Rd, Chicago, IL 60613. E-mail:

Received for publication May 3, 2012, and accepted August 9, 2012.

© Copyright 2012 American Sexually Transmitted Diseases Association