Abstract
The aim of this analysis was to examine gay men's sexual risk practice to determine patterns of risk managemtent. Ten cross-sectional surveys of gay men were condtrcted six-monthly from February 1996 to August 2000 at Sydney gay community social, sex-on-prmises and sexual health sites (average n=827). Evely February during this period, five identical surveys were conducted at the annual Gay and Lesbian Mardi Gras Fair Day (average n=11 78). Among the minority of men who had umprotected and intercourse which involved ejaculation inside with a serodiscordant regular partner, there was a clear pattern of sexual positioning. Few regular couples mere both receptive and insertive. Most HIV-positive men were receptive and insertive. Most HIV-positive men were recptive and most HIV-negative men were insertive. Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with casual partners, there was also a patterns of sexual positioning. Whereas many casual couples were both receptive and insertive (especially those involviug HIV-positive respondents), among the remainder HIV-positive men tended to be receptive and HIV-negative men tended to be insertive. These pattenu of HIV-positive/receptive and HIV-negative/insertive suggest strategic risk reduction positionings rather tlran rrlere sexrial preferences among a minority of gay men. If so, they point they point to complacency but to an ever more cornplex domain of HIV prevention.