Fifteen percent of young gay men in South Beach HIV-positive, but no link found with drug use

10 June 2003

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Fifteen percent of young gay men in South Beach Miami, an international gay holiday destination, are HIV-positive according to a small study published in the June 1^st edition of the Journal of Acquired Immune Deficiency Syndromes.

The study also found that 45% of gay men aged 18 -29 reported having unprotected anal sex. However, despite South Beach’s reputation for partying, investigators failed to find any link between recreational drug use and unprotected sex.

In the 1990s the newly gentrified South Beach area of Miami gained a reputation as a hedonist gay holiday resort, with anecdotal stories in the gay press that HIV-positive men were moving to Miami to “party” their remaining years of life away and engage in carefree unprotected sex.

Glossary

oral

Refers to the mouth, for example a medicine taken by mouth.

oral sex

Kissing, licking or sucking another person's genitals, i.e. fellatio, cunnilingus, a blow job, giving head.

risky behaviour

In HIV, refers to any behaviour or action that increases an individual’s probability of acquiring or transmitting HIV, such as having unprotected sex, having multiple partners or sharing drug injection equipment.

sample

Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).

At the same time evidence was emerging of an increase in HIV risk behaviour and HIV prevalence amongst younger gay men. Against this background, investigators at Florida International University and the University of California wished to establish the attitudes towards condom use, rates of unprotected sex, and HIV prevalence amongst younger gay men in Miami.

The study involved 100 gay men aged between 18 and 29 and was conducted in 1996. The men were recruited at a population level, with investigators targeting addresses in the South Beach area.

Participants completed both an interviewer-administered questionnaire and a self-completed questionnaire in their own home. The first half involved items on demographic background and less sensitive questions on attitudes towards condoms and the prevalence of unprotected anal sex amongst young gay men. The self-completed sections asked men to provide details about their social and sex lives. This included items on cruising behaviour, recreational drug use and partnership status. Participants were also asked to say if they had had unprotected oral sex or anal sex with casual or primary partners.

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Following the questionnaire, participants had an oral HIV test.

The overwhelming majority of men, 93%, had had a prior HIV test, and 15 tested HIV-positive, five of whom reported that they had previously tested HIV-negative.

Factors associated with testing HIV-positive were cruising for sex in a public place, and agreement with the statement that “having to stop sex to put on a condom takes the fun out of sex.”

Investigators found that 45% of men had had unprotected anal sex in the past twelve months. Having a primary partner (OR 2.4; 95% CI 11.01-5.88), cruising (OR 0.39; 95% CI 0.16 - 0.96) and oral sex with ejaculation (OR 2.82; 95% CI 1.00 - 7.95) were all associated with unprotected anal sex. However, the investigators did not find that HIV-positive men were any more likely to have had unprotected anal sex in the previous twelve months.

The investigators note that the 15% HIV infection rate amongst young gay men in their sample is comparable to the 17% found in San Francisco, and that South Beach and San Francisco had comparable rates of unprotected sex.

Despite South Beach’s reputation as a gay party destination, the investigators did not find a link between unprotected sex and drug use.