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Factors associated with serosorting among HIV-positive MSM in France - results from the French VESPA ANRS study
M. Suzan-Monti1, M. Preau1,2, J. Blanche1, S. Cabut1, P. Carrieri1, F. Lert3, Y. Obadia1,4, B. Spire1, the ANRS VESPA EN-12 Study Group
1INSERM, U912 (SE4S), Marseille, France, 2Université de Nantes, Nantes, France, 3INSERM U687, Villejuif, France, 4ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
Background: Despite its limited effectiveness on HIV prevention, serosorting among MSM has been shown to be relatively frequent among those who do not consistently use condoms. The aim of the study was to identify HIV+ MSM characteristics associated with serosorting in choosing their steady partner.
Methods: From a population of 1117 HIV+ MSM enrolled in the VESPA ANRS EN12 study, we selected those who were engaged in a stable relationship for more than 12 months. Individuals who seroconverted anytime during that relationship and those whose HIV diagnosis was established during the previous 12 months were excluded. These criteria enabled us to interpret seroconcordance as a proxy of patient's serosorting. Viral load was obtained from medical records. A face-to-face interview collected information about psychosocial characteristics such as anxiety (HAD) disclosure to family, and sexual behaviour. Logistic regression was used to identify factors associated with serosorting in choosing their steady partner.
Results: The study group consisted of 360 individuals, 275 having a serodiscordant steady partner and 85 having a seroconcordant one. Median[IQR] age was 42[37-58], and 71% of patients had an undetectable viral load, while median[IQR] years since HIV diagnosis were 10.2[5.9-17.1]. The multivariate analysis showed that after adjustment for time since HIV diagnosis, serosorting was associated with detectable viral load (OR[95%CI]:1.7[1.0-3.3]). Other factors associated with serosorting were seropositivity disclosure to family (OR[95%CI]:2.2[1.1-4.4]), and lower levels of anxiety (OR[95%CI]:0.93[0.9-1.0] per unit). Additionally, serosorting was associated with non systematic condom use with the steady partner (OR[95%CI]:3.4[1.7-6.8]), and having used classified advertisements during the previous 12 months to seek casual partners (OR[95%CI]:2.3[1.0-5.3]).
Conclusions: Among HIV+ MSM serosorting in choosing their steady partner is more frequent in viremic patients and might express the need for a better mental and sexual quality of life with steady and casual partners.
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