The US government agency responsible for preventing and tracking HIV infection, has for the first time recommended that sexually active gay and bisexual men test regularly and routinely for HIV.
On 9 May the Center for Disease Control (CDC) held a press conference where they announced that they were recommending annual HIV tests for gay men who have been sexually active in the past 12 months. More frequent screening is recommended for individuals “who have multiple anonymous sexual partners or having sex in conjunction with illicit drug use.” Previously the CDC had recommended that doctors only offer HIV tests to gay men whose behaviour might have exposed then to the risk of HIV.
The move was prompted by increased rates of sexually transmitted infections, most notably gonorrhoea and syphilis, amongst gay men, which are being interpreted by CDC officials as evidence of an increase in unprotected anal sex amongst gay men. The CDC has expressed concern that a new wave of HIV infections amongst gay men is on the horizon.
Gay men are also recommended to be tested annually for chlamydia, gonorrhoea and syphilis and to get vaccinated against the sexually transmittable liver infections, hepatitis A and B.
Since the late 1990s concern has been expressed by many people working in HIV prevention that the advent of HAART has made gay men less concerned about HIV and therefore more likely to have anal sex without condoms. A recent survey conducted amongst gay men in Washington DC revealed that just over 20% admitted to having anal sex without a condom in 2000, while the most recent UK gay men’s sex survey indicated that approximately 40% of gay men had had unprotected anal sex at least once in the past year.
There have been increases in new HIV diagnoses amongst gay men, particularly those of African American or Latino origin, in many US cities in the past few years. In the UK, new HIV infections amongst gay and bisexual men have remained steady at approximately 1,500 a year for the past decade, although there was a slight increase in 2000-01.
Since the late 1990s health promotion campaigns targeted at UK gay men have set out the potential benefits of HIV testing, and regular sexual health screenings are recommended for all sexually active gay men.
Updated guidance on the treatment of gonorrhoea and the use of the spermicide nonoxynol-9 was also issued by the CDC. The spread of drug resistant strains of gonorrhoea had prompted the CDC to recommend that doctors in California should not use the normal drug of choice, Cipro, or similar drugs from the fluoroquinolone class of antibiotics to treat the infection. Nor should nonoxynol-9 spermicide be used to prevent STIs, as research has shown that it can cause anal and vaginal irritation, making it more likely that a person could be infected with HIV or another STI.