New data on gay and bisexual men in the UK show that many men have significant information needs around the law on HIV transmission, and that testing for hepatitis C is relatively common. Moreover, there is new information on sexual practice in relation to poppers and oral sex.
The annual Gay Men’s Sex Survey uses a self-completion questionnaire that is available in a booklet form (distributed by health promotion organisations) and in an online version (promoted by a number of commercial gay, health promotion and gay community websites). For the 2006 edition 12,155 valid responses were received from gay or bisexual men living in the UK.
Knowledge around prosecutions for HIV transmission
The questionnaire presented a number of facts about HIV transmission and the law that health promoters believe are important to know, and asked whether respondents already knew this information.
The survey found varying levels of knowledge:
- “People with HIV have been imprisoned in the UK for passing their infection without intending to do so” – 21% knew this.
- “No one has been imprisoned in the UK simply for exposing someone else to HIV during sex (where infection did not occur)” – only 22% of men knew this.
- “Some people with HIV have been imprisoned in the UK for passing their infection to a sexual partner” - 77% of respondents knew this.
Although HIV-positive men had the highest level of knowledge on these topics, it is of concern that only 36% and 33% of them were already aware of the facts in the first and second statements.
Groups showing particularly low levels of knowledge on this topic were those who had never tested for HIV, younger men, men with less formal education, and men with fewer sexual partners.
Use of poppers during sex
The survey asked a number of questions about the use of the recreational drug poppers during sex. These questions were asked because previous research has identified using poppers during receptive unprotected anal intercourse (UAI) with an HIV-positive partner to be a significant factor that facilitates HIV transmission.
More than half of respondents had used poppers at any time, 18% had used them during receptive UAI, and 8% had used them during receptive UAI with a man they did not know to be HIV-negative.
Oral sex
The survey confirmed that having oral sex is near-universal in gay and bisexual men who have had a sexual partner in the last year – 98.9% had done so. Moreover 62% had taken ejaculate in their mouth, which is thought to increase the risk of HIV transmission during oral sex.
Hepatitis C testing history
Just over half the respondents believed that they had been tested for hepatitis C. Moreover, 4.4% of those tested, and 2.1% of the total sample said that they had been diagnosed positive for hepatitis C.
These figures may be over-estimates, as there may be confusion between the different types of viral hepatitis, and it is not standard practice to screen gay and bisexual men for hepatitis C in sexual health clinics. However the researchers believe that responses to the question on positive diagnoses are likely to be more accurate.
As may be expected, having hepatitis C was significantly more common among men with diagnosed HIV than other men. A total of 65% of men with current hepatitis C infection also had diagnosed HIV, and 35% were either HIV-negative or untested.
Although there have been a number of hepatitis C diagnoses among HIV-negative men in Brighton, other studies from a central London clinic and from the Health Protection Agency (Giraudon 2008) have found little evidence of widespread sexual transmission of hepatitis C in HIV-negative gay men. This finding is therefore surprising.
Giraudon I, Ruf M et al. Increase in diagnosed newly acquired hepatitis C in HIV-positive men who have sex with men across London and Brighton, 2002-2006: is this an outbreak? Sexually Transmitted Infections 2008; 84: 111-115.