Article Text

Download PDFPDF
Original article
Prevalence, correlates and trends in seroadaptive behaviours among men who have sex with men from serial cross-sectional surveillance in San Francisco, 2004–2011
  1. Jonathan M Snowden1,
  2. Chongyi Wei2,
  3. Willi McFarland2,3,
  4. H Fisher Raymond2,3
  1. 1Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA
  2. 2Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
  3. 3San Francisco Department of Public Health, San Francisco, California, USA
  1. Correspondence to Dr Jonathan M Snowden, Department of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code L466, Portland, Oregon 97239, USA; snowden{at}


Objectives We sought to assess the prevalence and correlates of seroadaptive behaviours (ie, sexual history incorporating some unprotected anal intercourse (UAI)) and conventional risk reduction behaviours (ie, consistent condom use or no anal intercourse) among men who have sex with men (MSM) in San Francisco in 2011. We compared the prevalence of seroadaptive behaviours between serial cross-sectional surveys from 2004, 2008 and 2011.

Methods We analysed data from the 2011 wave of the National HIV Behavioral Surveillance system in San Francisco. We categorised men's self-reported sexual behaviour history in the past 6 months into a schema of seroadaptive behaviours and conventional risk reduction behaviours. We compared the prevalence of behaviour categories by self-reported HIV serostatus, HIV testing history, awareness of pre-exposure HIV prophylaxis (PrEP) and diagnosis of a sexually transmitted infection (STI).

Results Seroadaptive behaviours remained common in San Francisco MSM, with a 2011 prevalence of 46.6%, up from 35.9% in 2004. Consistent condom use or no anal intercourse was more common than seroadaptive behaviours in HIV-negative MSM, men who had not heard of PrEP and men without an STI diagnosis. Seroadaptive behaviours increased from 2004 to 2011.

Conclusions HIV seroadaptive behaviours remain common in San Francisco MSM, have increased in the last decade and are practiced differently by MSM with different sexual health knowledge and outcomes. Public health researchers and officials should continue to document the prevalence, intentionality, efficacy and safety of seroadaptive behaviours among diverse communities of MSM.

  • HIV

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.