The number of gay men in London reporting high risk sex for HIV transmission has stabilised, according to data presented to the Eleventh Annual Conference of the British HIV Association in Dublin last week. However, although the proportion of gay men engaging in unprotected anal sex with a casual partner remained steady between 2001 – 2004, the number of men engaging in risky sex during this period is still significantly higher than in the mid-late 1990s.
Every year between 1998 and 2004 gay men attending gyms in central London were asked to complete an anonymous questionnaire enquiring about HIV status, unprotected anal sex in the previous three months with both casual and regular partners, steroid use, partnership status, and the HIV status of regular and casual sexual partners.
A total of 5000 men have completed questionnaires since 1998, with between 500 – 840 men per year participating in the survey.
High risk sexual behaviour was defined by the investigators as unprotected anal sex with a casual partner of discordant or unknown HIV status. The majority of the men (79%) completing questionnaires were aware of their HIV status, with a total of 16% saying they were HIV-positive, 63% HIV-negative, and 21% reporting never testing for HIV.
The mean age of men contributing data was 35 years, with the majority being white, employed and with a higher education.
In 1998, 7% of all men reported unprotected anal sex with a man who was of a different HIV status or whose HIV status they did not know. This proportion rose by approximately 33% per year until 2001 (adjusted odds ratio, 1.33, p
A statistically significant increase in the number of HIV-positive men reporting high risk sex with HIV-negative men or men of unknown HIV status was also observed between 1998 – 2001 (15% - 39%, adjusted odds ratio 1.52, p
Similar trends were observed amongst HIV-negative men, the percentage reporting unprotected anal sex with HIV-positive men or men whose status they did not know increasing from 7% in 1998 to 12% in 2001 (adjusted odds ratio 1.21, p
Amongst men who had never tested for HIV the percentage reporting unprotected sex with an HIV-positive man or a man whose HIV-status they were unaware of increased from 2% in 1998 to 9% in 2001 (adjusted odds ratio, 1.54, p
The investigators note that similar trends have been observed internationally in studies looking at the HIV risk behaviours of gay men. Nevertheless, they still note that the number of gay men reporting sex involving a high risk of HIV transmission remain significantly higher now than in 1998 when their survey began.
Elford J et al. High-risk sexual behaviour among London gay men: no longer increasing?. Eleventh Annual Conference of the British HIV Association, Dublin, oral presentation abstract 014, April 20 – 23, 2005.