Objectives:
To estimate changes in sexual behaviour over time.
To examine the proportion of undiagnosed HIV infection in a community sample
of homosexual men. To explore the relation between HIV status, diagnosis,
and sexual behaviour.
Methods:
Five cross sectional surveys of men attending
selected gay community venues in London between
1996 and 2000 (n=8052). Men were recruited in 45 to 58 social venues (including
bars,clubs, and saunas) across London. Participants self completed an anonymous
behavioural questionnaire. In 2000, participants in community venues provided
anonymous saliva samples for testingfor anti-HIV
antibody.
Results:
The proportion of men having unprotected anal
intercourse (UAI) increased significantly each year from 30% in 1996 to
42% in 2000 (p<<0.001). In 2000, 132 of 1206 (10.9%) saliva samples
were HIV antibody positive. Of the HIV saliva antibody
positive samples, 43/132 (32.5%) were undiagnosed. Around half of
both diagnosed and undiagnosed HIV saliva positive men reported UAI in
the past year. Of the 83% of men who reported their current perceived HIV
status, 4.1% reported an incorrect status. HIV antibody positivity was
associated with increasing numbers of UAI partners, and having a sexually
transmitted infection (STI) in the past year (OR 2.15).
Conclusions:
Homosexual men continue to report increasing levels
of UAI. HIV prevalence is high in this group, with many infections remaining
undiagnosed. The high level of risky behaviour in HIV positive men, regardless
of whether they are diagnosed, is of public health concern, in an era when
HIV prevalence, antiretroviral resistance, and STI incidence are increasing.
© 2004 BMJ Publishing Group Ltd |