Contexts for last occasions of unprotected anal intercourse among HIV-negative gay men in Sydney: The health in men cohort

Abstract

The objective of the paper was to compare encounters involving unprotected anal intercourse (UAI) and protected anal intercourse (PAI) among HIV-negative gay men in Sydney. Data were from those completing baseline face-to-face interviews to end June 2003 for the Health in Men open cohort of HIV-negative gay men in Sydney. The 1,148 participants ranged in age from 18 to 75 years (median=36). Three hundred and fifty-two (30.7%) reported an occasion of UAI with a casual partner in the previous 6 months and 531 (46.3%) reported an occasion of UAI with a regular partner in that same time. The men's most recent sexual contact with a casual partner involving UAI was distinguished from those involving PAI by a greater likelihood for both partners to disclose HIV serostatus (p=0.006) and by respondents being more inclined to restrict themselves to the insertive position or to practise withdrawal during occasions involving any UAI than when a condom was used (p=0.003 and p=0.001 respectively). Neither location nor recreational drug use differentiated men's most recent sexual contacts involving UAI from those involving PAI. The decision by HIV-negative gay men to use condoms during sexual encounters with either regular or casual partners is guided more by HIV serostatus and risk reduction strategies than by other factors.

Acknowledgments

The authors thank the Australian Federation of AIDS Organisations and the AIDS Council of New South Wales for collaboration with the project, and the men who have participated in the HIM study. Support was received from the Commonwealth Department of Health and Ageing (Canberra), the New South Wales Health Department (Sydney), and the US National Institutes of Health (National Institutes of Health/National Institute of Allergy and Infectious Diseases/Division of Acquired Immune Deficiency Syndrome: HIV Vaccine Design and Development Team award N01-AI-05395).

Notes

Of these 163 men, 135 were currently in a relationship with a regular partner at the time of interview. While it cannot be clearly determined whether this partner was the same partner as that referred to in the questions about the most recent occasions, 52 of these 135 men (38.5%) reported that they were living with their regular partner.