Population-Level Sexual Mixing According to HIV Status and Preexposure Prophylaxis Use Among Men Who Have Sex With Men in Montreal, Canada: Implications for HIV Prevention. Issue 1 (15th October 2019)

• Record Type: Journal Article
• Authors: Wang, Linwei; Moqueet, Nasheed; Lambert, Gilles; Grace, Daniel; Rodrigues, Ricky; Cox, Joseph; Lachowsky, Nathan J; Noor, Syed W; Armstrong, Heather L; Tan, Darrell H S; Burchell, Ann N; Ma, Huiting; Apelian, Herak; Knight, Jesse; Messier-Peet, Marc; Jollimore, Jody; Baral, Stefan; Hart, Trevor A; Moore, David M; Mishra, Sharmistha
• Is Part Of: American journal of epidemiology. Volume 189:Issue 1(2020)
• Page Start: 44
• Page End: 54
• Publication Date: 2019-10-15
• Subjects: HIV -- MSM -- PrEP -- PrEP-matching -- serosorting -- sexual mixing patterns; Epidemiology -- Periodicals; Public health -- Periodicals; 614.4
• DOI: 10.1093/aje/kwz231
• Languages: English
• ISSNs: 0002-9262

Abstract

Abstract: Using cross-sectional survey data (Engage, 2017–2018) from 1, 137 men who have sex with men, ≥16 years old, in Montreal, we compared observed human immunodeficiency virus (HIV) seroconcordance in previous-6-months' sexual partnerships with what would have been observed by chance if zero individuals serosorted. Of 5 recent partnerships where both individuals were HIV-negative, we compared observed concordance in preexposure prophylaxis (PrEP) use with the counterfactual if zero individuals selected partners based on PrEP use. We estimated the concordance by chance using a balancing-partnerships approach assuming proportionate mixing. HIV-positive respondents had a higher proportion of HIV-positive partners (66.4%, 95% confidence interval (CI): 64.0, 68.6) than by chance (23.9%, 95% CI: 23.1, 24.7). HIV-negative respondents (both on and not on PrEP) had higher proportions of HIV-negative partners (82.9% (95% CI: 81.1, 84.7) and 90.7% (95% CI: 89.6, 91.7), respectively) compared with by chance (76.1%, 95% CI: 75.3, 76.9); however, those on PrEP had a higher proportion of HIV-positive partners than those not on PrEP (17.1% (95% CI: 15.3, 18.9) vs. 9.3% (95% CI: 8.3, 10.4). Those on PrEP also had a higher proportion of partners on PrEP among their HIV-negative partners (50.6%, 95% CI: 42.5, 58.8) than by chance (28.5%, 95% CI: 27.5, 29.4). The relationship between PrEP and sexual-mixing patterns demonstrated by less population-level serosorting among those on PrEP and PrEP-matching warrants consideration during PrEP roll-out.