Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort 英文参考文献.docVIP

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Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort 英文参考文献.doc

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Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort 英文参考文献

SerosortingIsAssociatedwithaDecreasedRiskofHIV SeroconversionintheEXPLOREStudyCohort SusanS.Philip1,3*,XuesongYu2,DeborahDonnell2,EricVittinghoff3,SusanBuchbinder1,3 1San Francisco Department of Public Health, San Francisco, California, United States of America, 2Statistical Center for HIV/AIDS Research and Prevention, Seattle, Washington,UnitedStatesofAmerica,3UniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica Abstract Background:Seroadaptationstrategiessuchasserosortingandseropositioningoriginatedwithincommunitiesofmenwho havesexwithmen(MSM),buttherearelimiteddataabouttheireffectivenessinpreventingHIVtransmissionwhenutilized byHIV-negativemen. Methodology/PrincipalFindings:DatafromtheEXPLOREcohortofHIV-negativeMSMwhoreportedbothseroconcordant and serodiscordant partners were used to evaluate serosorting and seropositioning. The association of serosorting and seropositioningwithHIVseroconversionwasevaluatedinthiscohortofhighriskMSMfromsixU.S.cities.Serosortingwas independently associated with a small decrease in risk of HIV seroconversion (OR=0.88; 95%CI, 0.81–0.95), even among participants reporting $10 partners. Those who more consistently practiced serosorting were more likely to be white (p=0.01),havecompletedcollege(p=,0.0002)andtohavehad10ormorepartnersinthesixmonthsbeforethebaseline visit (p=0.01) but did not differ in age, reporting HIV-infected partners, or drug use. There was no evidence of a seroconversioneffectwithseropositioning(OR1.02,95%CI,0.92–1.14). Significance: In high risk HIV uninfected MSM who report unprotected anal intercourse with both seroconcordant and serodiscordant partners, serosorting was associated with a modest decreased risk of HIV infection. To maximize any potentialbenefit,itwillbeimportanttoincreaseaccurateknowledgeofHIVstatus,throughincreasedtestingfrequency, improvedtesttechnology,andcontinueddevelopmentofstrategiestoincreasedisclosure. Citation:PhilipSS,YuX,DonnellD,VittinghoffE,BuchbinderS(201