A Latent Class Analysis of Seroadaptation among Gay and Bisexual Men




Card, Kiffer G.
Lachowsky, Nathan J.
Cui, Zishan
Carter, Allison
Armstrong, Heather
Shurgold, Susan
Moore, David
Hogg, Robert S.
Roth, Eric A.

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Archives of Sexual Behavior


Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada were recruited. Stratified by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viralload sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72%) and a large proportion of HIV-positive men (42%) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM’s sexual health needs.


The authors would like to thank the Momentum Health Study participants, office staff, and community advisory board, Kirk J. Hepburn, who edited this manuscript, as well as our community partner agencies: Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC.


Seroadaptation, Latent Class Analysis, Gay and Bisexual Men, HIV, Sexual orientation


Card, K. G., Lachowsky, N. J., Cui, Z., Carter, A., Armstrong, H., Shurgold, S., Moore, D., Hogg, R. S., & Roth, E. A. (2018). “A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men.” Archives of Sexual Behavior, 47(1), 95-106. https://doi.org/10.1007/s10508-016-0879-z