biostudies-literatureGoodreau SMNational Institute of Allergy and Infectious DiseasesNICHD NIH HHSNIAID NIH HHSNIMH NIH HHSNational Institute of Mental HealthNational Institute of Child Health and Human Development3933-3943https://www.ebi.ac.uk/biostudies/studies/S-EPMC8528882biostudies-literatureUnknown25(12)Seroadaptive behaviors help reduce HIV risk for some men who have sex with men (MSM), and have been well documented across MSM populations. Advancements in biomedical prevention have changed the contexts in which seroadaptive behaviors occur. We thus sought to estimate and compare the prevalence of four stages of the "seroadaptive cascade" by PrEP use in the recent era: knowledge of own serostatus, knowledge of partner serostatus; serosorting (matching by status), and condomless anal intercourse. Serosorting overall appeared to remain common, especially with casual and one-time partners. Although PrEP use did not impact status discussion, it did impact serosorting and the likelihood of having condomless anal intercourse. For respondents not diagnosed with HIV and not on PrEP, condomless anAIDS and behaviorA Behavioral Cascade of HIV Seroadaptation Among US Men Who Have Sex with Men in the Era of PrEP and U = U.PMC8528882R21 MH112449P30 AI027757P2C HD042828AI138783R01 AI138783Maloney KMGoodreau SMMorris MJanulis PJenness SMSanchez THfalseA Behavioral Cascade of HIV Seroadaptation Among US Men Who Have Sex with Men in the Era of PrEP and U = U.Seroadaptive behaviors help reduce HIV risk for some men who have sex with men (MSM), and have been well documented across MSM populations. Advancements in biomedical prevention have changed the contexts in which seroadaptive behaviors occur. We thus sought to estimate and compare the prevalence of four stages of the "seroadaptive cascade" by PrEP use in the recent era: knowledge of own serostatus, knowledge of partner serostatus; serosorting (matching by status), and condomless anal intercourse. Serosorting overall appeared to remain common, especially with casual and one-time partners. Although PrEP use did not impact status discussion, it did impact serosorting and the likelihood of having condomless anal intercourse. For respondents not diagnosed with HIV and not on PrEP, condomless an2021-01-01T00:00:00Z2021 Dec2025-04-04T19:37:50.849Z2025-04-04T19:37:50.849ZS-EPMC85288823388451010.1007/s10461-021-03266-0