Heterosexual behaviour and HIV risk in New Zealand: data from a national survey

Abstract: The pattern of any future major heterosexual epidemic of acquired immunodeficiency syndrome (AIDS) will depend partly on sexual behaviour and condom use among heterosexuals. This survey was designed to provide information on patterns of sexual behaviour in New Zealand. A national sample aged 18 to 54 was selected using a random method and telephone interviews were administered to 2361 people, using a questionnaire based on the protocol developed by the Global Program on AIDS of the World Health Organization. The reported mean lifetime number of partners increased with age up to 25 to 29 years for women and 30 to 34 years for men, and declined at older ages. Fifteen or more lifetime partners were reported by 17 per cent of men and 4 per cent of women. Multiple partnerships in the previous 12 months were commonest in those aged 20 to 24. In this age group, 32 per cent of men and 20 per cent of women reported two or more partners. Recent condom use for contraception was reported by 23 per cent of men and 19 per cent of women. Use was highest amongst those aged 18 to 24, and decreased sharply with age. The true proportion of the population with many sexual partners may be higher than reported. These data will be useful in modelling approaches to estimate the likelihood of future heterosexual spread of AIDS. The data on lifetime numbers of partners suggest that sexual decisions depend not just on age and sex but also on the era, and thus on changing social values about sexual behaviour.     

Sexual behavior changes and HIV antibody in a cohort of New York City gay men.

A sample of 357 gay/bisexual men, ages 20 to 65, were interviewed in 1985 regarding their sexual patterns over the course of the AIDS (acquired immunodeficiency syndrome) epidemic. Within four months after the interview, men were tested for antibody to HIV (human immunodeficiency virus) and 36 per cent were found positive. Cessation of receptive anal intercourse was associated with HIV negative antibody status, (OR greater than 3.0). Reducing the number of sexual partners, becoming monogamous, or eliminating other forms of sexual contact were not related to risk of HIV.     

The San Francisco Men''s Health Study: continued decline in HIV seroconversion rates among homosexual/bisexual men.

The incidence of infection by the human immunodeficiency virus (HIV) has been monitored since 1984 in an area probability sample of homosexual/bisexual men drawn from a six-kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Annualized HIV seroconversion rates in previously uninfected cohort members have declined by 88 per cent from 5.9 per cent during the first six months of 1985 to 0.7 per cent during the last six months of 1987. Concurrent declines of approximately 80 per cent in the prevalence of sexual behaviors associated with HIV transmission were also observed in the sample.     

Sexual practices in a broad cross–sectional sample of Sydney gay men

Abstract: The aim of this study was to provide current data on the sexual practices in a broad cross–sectional sample of gay and homosexually active men in Sydney. Anonymous, short questionnaires were completed by 1611 gay men recruited at the 1996 Gay and Lesbian Mardi Gras Fair Day or at one of six venues (including two sexual health centres) across the metropolitan area during the following week. The sample was diverse, but the men tended to be of Anglo–Australian background, well educated, professionally employed, attached to gay community and gay identified. They mainly had sex with other men rather than with men and women. Most (86.0 per cent) had been tested for human immunodeficiency virus. Excluding 241 men recruited in sexual health centres, 11.2 per cent were HIV–positive and 73.4 per cent were negative. Where it occurred in regular relationships, unprotected anal intercourse was usually between seroconcordant partners (78.5 per cent). Unprotected anal intercourse between discordant or noncon–cordant regular partners was much less common, and in about half the cases involved withdrawal prior to ejaculation exclusively rather than ejaculation inside. Almost 12 per cent of the men had at least 'occasionally' engaged in unprotected anal intercourse with a casual partner in the previous six months, with approximately half of these men having adopted a withdrawal strategy on every occasion. We conclude that short surveys can provide valuable and timely data on sexual practices in a broad cross–sectional sample of gay and homosexually active men. Key messages for those involved in gay men's education are the high rates of unprotected anal intercourse between casual partners and the extensive practice of withdrawal.     

The gay report on sexually transmitted diseases.

Most studies of sexually transmitted diseases in homosexual men have examined prevalence in clinic populations; for comparative purposes, we analyzed data from a survey of 4,329 gay men conducted in 1977. Among 4,212 respondents to the self-administered questionnaire, 66.8 per cent reported previous infection with pediculosis; 38.4 per cent, gonorrhea; 24.1 per cent, nonspecific urethritis; 18.1 per cent, venereal warts; 13.5 per cent, syphilis; 9.7 per cent, hepatitis; and 9.4 per cent, herpes. Number of different lifetime sexual partners best predicted histories of symphilis (r = .249), gonorrhea (r = .402), and the other diseases; frequency of checkups, years as a practicing homosexual, and furtive sexual activities were among the many other significant correlates of venereal infections. Respondents most often sought examinations from private physicians (39.4 per cent); those who visited gay clinics were examined most often and felt most positive about their medical care. Gay men who participated in the survey reported frequent infections with many of the same sexually transmitted diseases often seen in private medical practices, public VD clinics, and gay health centers. Since high rates of disease are related to large numbers of different partners, frequent exposures with anonymous contacts, and anal intercourse, we recommend frequent examinations for those whose life-styles include these characteristics.     

Extramarital relations and perceptions of HIV/AIDS in Nigeria

Data from a 1991 survey of five Nigerian towns are used to examine currently married men's and women's perceptions of AIDS which, together with other socioeconomic factors, are then related to extramarital sexual behaviour. An overwhelming majority of the respondents have accurate information about AIDS. In particular, most associate HIV/AIDS transmission with multiple sexual partners, though only one-third of them think that the fear of AIDS has limited casual sex in their communities. About 54 per cent of men and 39 per cent of women have had extramarital relations, with 18 per cent of men and 11 per cent of women having done so in the previous week. The incidence of extramarital relations varies considerably by respondents' level of education, type of marriage, religion, and spousal closeness. More importantly, knowledge of multiple sexual partners as a risk factor for HIV/AIDS is inversely related to extramarital affairs. The study underscores the link between knowledge and behaviour, and calls for a well-articulated campaign designed to educate the populace about the threat of AIDS, with the aim of modifying both premarital and extramarital sexual behaviour, thereby reducing the risk factor for HIV through heterosexual relations which is the main mode of transmission in Nigeria.     

Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities

Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters.     

男男同性交友平台大学男生艾滋病相关知识行为分析

了解男男同性交友平台大学生艾滋病相关知识和行为现状,为高校开展针对艾滋病预防教育提供依据.方法 采用滚雪球抽样方法抽取442名大学男生,在男男同性交友平台上使用自填式网络问卷调查其艾滋病相关知识和行为情况,比较不同特征大学生的艾滋病知识知晓水平和性行为差异.结果 男男同性交友平台上本科低、中、高年级和研究生组中有性行为者分别占63.8%,72.1%,86.3%和83.7%,差异有统计学意义(x2=14.197,P=0.003).有性行为组男大学生“新八条”知晓率(81.0%)高于无性行为组(66.4%),差异有统计学意义(x2=10.144,P=0.001).有性行为者中最近6个月同性多性伴(性伴数≥2人)的发生率为41.3%(137/332),57.0% (159/279)的人表示近6个月发生同性性行为时,每次都会使用安全套.同性恋多性伴比例(44.0%)和HIV检测率(66.4%)均高于异性恋或性取向不确定者(29.0%,39.1%),差异有统计学意义(x2值分别为19.753,21.791,P值均<0.01).结论 男男同性交友平台上大学生艾滋病相关知识掌握不全面,高危行为发生率较高,未发生过性行为的学生主要集中在大学低年级,应及时进行全面的艾滋病预防教育.     

The indeterminate macro-social: new traps for old players in HIV / AIDS social research

The author discusses the first-ever study of male-to-male HIV-related sexual behavior in Fiji, Samoa, and Vanuatu, and the importance of sexual culture to HIV/AIDS education and research. The survey, based loosely upon Australian instruments, is attempting to document the HIV/AIDS knowledge, attitudes, social behaviors, and sex practices of homosexually active men to better target educational interventions for that population in the South Pacific. The research is being conducted by the AIDS Task Force of Fiji, a small nongovernmental organization, with help from the Australian government and UNAIDS. The researcher is informed by the knowledge of local gay, male educators. However, these educators understand that most men who have sex with men in the South Pacific do not self-identify as gay, but rather as men without any specific sexual identity who have sex with both men and women as they see fit. The sexual cultures of Papua New Guinea, India, Thailand, Australia, and Africa are considered.     

中国部分城市2004年1389例男男性接触者艾滋病高危行为及相关因素调查

目的了解中国大陆男男性接触者(MSM)的艾滋病病毒/艾滋病(HIV/AIDS)高危行为及有关影响因素。方法对6大城市1389例MSM采用定向抽样法进行匿名问卷调查和尿液HIV—1抗体检测。应用SPSS 11.0软件对数据资料进行整理分析。结果MSM平均年龄为27.62岁。首次性交年龄平均19.18岁。寻找同性性伴的最主要途径是互联网(43.07%),同性爱者活动场所(35.29%)。近6个月平均同性性伴数为5.69人,平均陌生性伴为4.37人,平均肛交同性性伴为4.33人。曾参与群交者占11.61%。尿液HIV-1抗体初筛检测13例阳性。有肛交史者近6个月内坚持使用安全套者占32.46%,最近一次肛交用过安全套者占76.37%。近6个月曾与女性性交从不用安全套者占47.18%。结论MSM普遍存在易感染HIV的多种高危行为,需加大对该人群的AIDS干预力度,并创造有助于MSM的AIDS控制的支持性环境。     

The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86.

The prevalence and incidence of infection by the human immunodeficiency virus (HIV) has been under study in a cohort of 1,034 single men recruited by area probability sampling from a six kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Prevalence of infection among homosexual/bisexual study subjects increased from an estimated 22.8 per cent during the last half of 1982 to 48.6 per cent during the period July through December 1984. During three subsequent six-month periods, prevalence remained stable at approximately 50 per cent. Annual infection rates, measured by seroconversion among seronegative study subjects, decreased from an estimated 18.4 per cent per year from 1982 to 1984, to 5.4 and 3.1 per cent during the first and second halves of 1985, and to 4.2 per cent during the first six months of 1986. These declines were associated with reductions of 60 per cent or more in the prevalence of high-risk sexual practices associated with both acquiring and disseminating infection by the human immunodeficiency virus.     

AIDS and sexual behavior reported by gay men in San Francisco.

In November 1983, we surveyed 655 gay men in San Francisco regarding their sexual practices during the previous month and the same month one year ago. The sample was selected to include men in situations that would lead to high risk of sexual activities related to AIDS (acquired immune deficiency syndrome) transmission (i.e., men frequenting bathhouses and gay bars) as well as men in low-risk situations (those going to neither place and men in primary relationships). The Bath group showed little change in frequency of bathhouse use and in number of sexual partners from that location. The other groups showed substantial reductions in frequency of sexual contacts from bars, baths, T-rooms, or parks. Men in monogamous relationships showed little change in sexual behavior within their relationship. Men in non-monogamous relationships and men not in relationships reported substantial reductions in high-risk sexual activity, but not a corresponding increase in low-risk sexual behavior. Knowledge of health guidelines was quite high, but this knowledge had no relation to sexual behavior. Using sex to release tension, use of sex to express gay identity, and knowledge of persons with AIDS in the advanced stages of disease were related to frequency and type of sexual behavior.     

萍乡市男男同性恋性病艾滋病哨点监测结果分析

目的了解男同人群的性相关危险因素特点,找出有效的途径或策略,进一步有效控制艾滋病的流行。方法问卷调查与实验室检测。结果总共监测310名男同,其中酒吧会所监测占30.97%,网络监测占69.03%;90%被监测男同是高中以上文化程度;最近一年患性病的占14.19%;310人当中HIV感染者8例,感染率为2.58%;网络招募人中HIV感染为3.27%。艾滋病知识知晓率为98.71%;有将近15%的感染者有过商业性行为(包括3名感染者);有商业性行为的男男同性恋艾滋病感染率与没有商业性行为的男男同性恋的艾滋病感染率两者比较有明显差异;与女性发生性关系的时候有三分之一不使用安全套,每次都会使用的不到一半,最近一次与女性发生性关系有三分之一没有使用安全套。结论男同容易将艾滋病性病进行婚内、外传播;男同存在掌握相关HIV防治知识与实际防范结果背离现象;网络加大了男同交往的频率和范围,也加大了艾滋病传播风险;同性商业性行为风险性更高;男同的双性性关系及无保护性性交在艾滋病传播中起到一个非常重要的桥梁作用;今后要把宣传干预重点放在双性恋、男性性商业服务人群、男同配偶或性伴、甚至青年妇女、青年学生身上。     

Sexual Risk Behavior of Men Who have Sex with Men: Comparison of Behavior at Home and at a Gay Resort

This study compared sexual behavior of gay and bisexual men (N = 551) while at their primary residence to their behavior while vacationing at a gay resort community. Participants reported behavior for the days they spent in the resort and for their last 60 days in their home residences. Overall, 11 times more non-main partners were reported for unprotected anal intercourse (UAI) per day while in the resort as for the “at home” period. Regression analysis identified negative attitudes toward condoms, less concern about AIDS, and daily number of non-main, male partners at home with whom UAI occurred as significant predictors of the daily number of non-main male partners with whom holidaymakers engaged in UAI while in the resort area. The results suggest that sexual risk taking by men who have sex with men (MSM) while on holiday may be elevated over that at home and that prevention efforts need to be promoted in gay resorts. Behavioral surveillance research would be helpful in better characterizing the current social contexts of sexual risk taking by MSM. Theory-based studies of the nature of risk-taking and sexual decision-making on “gay holiday” could inform the development of empirically proven and conceptually grounded interventions.     

Time from infection with HIV to onset of AIDS in patients with haemophilia in the UK

The two-stage parametric regression model of Brookmeyer and Goedert has been adapted and fitted to data on the development of AIDS in haemophiliacs in the UK who are seropositive for HIV. The risk of developing AIDS by a given time following seroconversion increases with increasing age at seroconversion. It is likely that the risk increases smoothly with age, although the data have been analysed in three age categories, and it is estimated that by seven years after seroconversion 6 per cent of patients aged under 25 at seroconversion, 20 per cent of those aged 25-44 and 34 per cent of those aged 45 or more have developed AIDS. For a given age at seroconversion the annual risk of developing AIDS increases with increasing time after seroconversion, and at seven years the annual risks of developing AIDS during the next year in the three age groups are estimated to be 2 per cent for those aged less than 25 at seroconversion, and 10 and 11 per cent respectively for those aged 25-44 and 45 or more.     

Consultations concerning venereal diseases and AIDS at the weekend outpatient clinic for homosexual men: developments 1983-1987

In the Amsterdam gay weekend clinic the trends in numbers and sorts of sexually transmitted diseases (STD) and reasons for consultation about AIDS from 1983 till 1988 were assessed. A strong decrease in STD consultations and diagnoses was seen, especially concerning urethral and anorectal gonorrhoea. At the same time, consultations about AIDS strongly increased. These data support the hypothesis that gay men have changed their sexual behaviour.     

Abjection. Objection. Subjection: rethinking the history of AIDS in Australian gay men’s futures

Abstract

In coining the term ‘post-AIDS’ some 20 years ago, I was noting the dissolution of a singular and unified experience of HIV and AIDS for gay communities that had been the case until that time. Not only were HIV-positive and HIV-negative gay men having increasingly different experiences, but divergent trajectories were opening up. Since then, many other factors have come into play, for example age and generation; the ascendancy of the biomedical and the technosexual; and the supremacy of neoliberal politics (including sexual politics). Now, if gay men are to survive as such – and there is a question about this – are there larger issues than HIV and AIDS that ought to command our attention? Or do we need to rethink how we situate HIV and AIDS within the larger framework of gay men’s health and wellbeing. This might be just a question of politics, or it could be a question of theory. Are we finally returning to the original gay liberation agenda of the eradication of difference, or simply being traduced (seduced?) by our success at intimate citizenship?     

Focusing on the negative

A San Francisco HIV prevention group has started a series of programs focusing on keeping HIV-negative gay men uninfected. The group, Invention, began the programs in September in response to city-funded studies showing gay men returning to unsafe sexual practices. The San Francisco AIDS Office estimates that 650 gay or bisexual men seroconvert each year, up from 250 in 1987. Infection is sometimes regarded as a rite of passage into the gay community, where half of all gay men are already HIV-positive, and those with HIV are perceived as having a superior social service network for health and counseling needs. The HIV-negative men regard infection as inevitable, and are not as fearful of HIV since those who are positive are living longer. Programs will discuss how to build a meaningful life, help the HIV-negative develop a sense of the gay community apart from AIDS, and encourage dialogue between negative and positive men.     

Original Research: AIDS Educational Videos for Gay and Bisexual Men: A Content Analysis

Objective: To systematically describe the content of AIDS educational videos targeting gay and bisexual men, and to compare it to the content of videos for heterosexual African American and Latino audiences. Design: AIDS videos targeting gay/bisexual men (n = 35), heterosexual African Americans (n = 14), and heterosexual Latinos (n = 25) were coded for the presence or absence of messages identified by various theoretical models as relevant to HIV education and risk reduction. Results and Conclusions: Videos targeting gay and bisexual men typically emphasized sexual risk reduction techniques, whereas videos for heterosexual minority viewers were more likely to provide information about HIV transmission and audience members' vulnerability to AIDS. Despite their focus on reducing personal risk, most gay/bisexual videos did not depict partner negotiation for safer sex, reinforce the perception that social norms favor sexual risk reduction, or eroticize safer sex practices. Suggestions are offered for future research and for production of AIDS educational videos.     

Prevalence of antibody to LAV/HTLV-III among homosexual men in Seattle.

The prevalence of antibody to LAV/HTLV-III among homosexual men attending a community clinic and a sexually transmitted disease clinic in Seattle, Washington in early 1985 was 42 per cent and 32 per cent, respectively. Seropositivity was apparently not related to age or number of sexual partners. The high prevalence of LAV/HTLV-III seropositivity in an area where overt AIDS (acquired immune deficiency syndrome) is still relatively uncommon suggests that public health measures to prevent acquisition and transmission of LAV/HTLV-III should be a high priority even in areas with low incidences of AIDS.