Risks and HIV Status
posted: 26/10/2010
Gay men using London gyms are revealing more about choosing their partners and taking risks with anal sex. The latest annual sex risk survey of gay men at London gyms has appeared. 36% of the 648 men taking part in 2008 had anal sex without condoms in the previous year. Condomless anal sex is becoming more common, but this headline “masks a more complex picture,” which varies with HIV status, the researchers say.
Same HIV status or different status: more risks
Men are now having more sex without condoms with partners who have the same HIV status, than with men whose HIV status is different or unknown to them. But there are also more men reporting sex without condoms with a main partner whose HIV status is unknown or different.
1 in 3 taking risks but more choose same HIV status partners
The first study, in 1998, found 24% of men had unprotected anal intercourse in the previous three months. By 2008 this was up to 36%. But in both the two latest surveys (2005 and 2008), more men report having unprotected sex with men of the same HIV status as themselves (“sero-sorting”) than with men of unknown, assumed or different HIV status. In 2008 21% reported condomless anal sex with men of the same status and 16% reported this with men of unknown, assumed or different status.
Some positive men choosing positive
Among HIV-positive men in 2008, 14% sero-sorted (chose a partner who is also HIV+) their casual partners. 10% of the HIV-positive men have a main partner who also has HIV.
Negative men rarely choose casual partners by HIV status
Among men who reported that their last HIV test was negative, less than 2% chose casual partners who are also HIV negative. However 21% had unprotected sex with a main partner whose last HIV test was also negative. The proportion of supposed HIV negative men reporting condomless sex with men who also last tested HIV negative has risen to 21% since 1998, when 12% reported it.
Test together or just talk?
The researchers are worried about how HIV-negative men decide their main partner is also HIV negative. While four in ten men took the HIV test together, the others only talked about their status. This is not good enough, because the longer the time since the last test and the risks taken since that test mean the test result may now be wrong.
Men’s relationship risks
Men’s main relationships seem to be where more risks are now being taken, although the numbers are low. There have been significant increases in the numbers of men reporting having unprotected sex with a main partner of unknown, assumed or different HIV status between 2005 and 2008.
Positive men risks
Among HIV positive men, 2.5% reported having unprotected sex with a main partner of unknown, assumed or different HIV status in 2005, and it was 8.1% in 2008. For about half the positive men, in fact their partner’s HIV status was known to be HIV-negative.
A significant proportion of HIV-positive men (19%) report unprotected sex with casual partners of an unknown or assumed HIV status, although this has fallen a lot compared with the earlier surveys.
Negative men risks down
Fewer than 6% of HIV-negative men report unprotected sex with casual partners of an unknown or assumed HIV status, the lowest level in these gym surveys. The researchers comment: “This is an encouraging trend and is likely to reflect consistent and sustained health promotion campaigns targeting gay men.”
Summing up, the researchers say that their data “suggest that main partners may have become an important source of HIV risk among London’s gay men.” They recommend that more health promotion campaigns should focus on HIV risk within relationships and on HIV testing among couples.
Source with reference details
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