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Risk Reduction Practices in Men Who Have Sex with Men in Switzerland: Serosorting, Strategic Positioning, and Withdrawal Before Ejaculation

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Abstract

The aim of this study was to identify predictors of intentional use of the HIV risk reduction practices of serosorting, strategic positioning, and withdrawal before ejaculation during unprotected anal intercourse (UAI) with casual partners. A cross-sectional survey pertaining to the Swiss HIV behavioral surveillance system, using an anonymous self-administered questionnaire, was conducted in 2007 in a self-selected sample of men having sex with other men (MSM). Analysis was restricted to participants with UAI with casual partner(s) (N = 410). Logistic regression was used to estimate factors associated with intentional use of serosorting, strategic positioning, and withdrawal before ejaculation. In the previous 12 months, 71% of participants reported having UAI with a casual partner of different or unknown HIV-status. Of these, 47% reported practicing withdrawal, 38% serosorting, and 25% strategic positioning. In the 319 participants with known HIV-status, serosorting was associated with frequent Internet use to find partners (OR = 2.32), STI (OR = 2.07), and HIV testing in the past 12 months (OR = 1.81). Strategic positioning was associated with HIV-status (OR = 0.13) and having UAI with a partner of different or unknown HIV-status (OR = 3.57). Withdrawal was more frequently practiced by HIV-negative participants or participants reporting high numbers of sexual partners (OR = 2.48) and having UAI with a partner of unknown or different serostatus (OR = 2.08). Risk reduction practices are widely used by MSM, each practice having its own specificities. Further research is needed to determine the contextual factors surrounding harm reduction practices, particularly the strategic or opportunistic nature of their use.

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Acknowledgments

Warm thanks to the participants, who responded to the survey as well as the associations, establishments, websites, and magazines that distributed the questionnaire. The authors have no conflicts of interest to report. This study was financed by the Swiss Federal Office of Public Health, Bern, Switzerland.

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Authors and Affiliations

  1. Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Bugnon 17, 1005, Lausanne, Switzerland

    Françoise Dubois-Arber, André Jeannin & Stéphanie Lociciro

  2. Commission externe d’évaluation des politiques publiques, Etat de Genève, Genève, Switzerland

    Hugues Balthasar

Authors
  1. Françoise Dubois-Arber
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  2. André Jeannin
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  3. Stéphanie Lociciro
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  4. Hugues Balthasar
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Correspondence to Françoise Dubois-Arber.

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Dubois-Arber, F., Jeannin, A., Lociciro, S. et al. Risk Reduction Practices in Men Who Have Sex with Men in Switzerland: Serosorting, Strategic Positioning, and Withdrawal Before Ejaculation. Arch Sex Behav 41, 1263–1272 (2012). https://doi.org/10.1007/s10508-011-9868-4

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  • DOI: https://doi.org/10.1007/s10508-011-9868-4

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