Danger and Context: Unsafe Anal Sexual Practice among Homosexual and Bisexual Men in the AIDS Crisis (original) (raw)
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Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2005
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.
Increase in unprotected anal intercourse with casual partners among Sydney gay men in 1996–98
Australian and New Zealand Journal of Public Health, 1998
We examined differences over time in Sydney gay men's unprotected anal intercourse, particularly with a view to investigating any behavioural changes after the recent improvements in anti-retroviral therapies. Trends in unprotected anal intercourse were monitored through the Sydney Gay Community Periodic (cross-sectional) Surveys which were conducted at six-monthly intervals between February 1996 and February 1998. Gay men (n=2,863) were recruited and self-completed a short questionnaire at three gay venues and a sexual health clinic. There was a significant increase in unprotected anal intercourse with casual partners (but not with regular partners), applicable to both HIV positive and HIV negative men. Sexual practice was generally unrelated to ideas about recent advances in viral load testing and combination therapies.
Knowledge and practice of sexual safety in Melbourne gay men in the nineties
Australian Journal of Public Health, 1994
Despite the impact of education programs, the ability of gay men to sustain sexual safety still comes under public scrutiny. A self-administered questionnaire was distributed in 1990 to a convenience sample of 284 gay-identified Melbourne men recruited from gay groups, health clinics, gay pubs and nightclubs, sex-on-premises venues, and the social networks of these men. The questionnaire measured the perceived safety of various sexual practices and the practice of unprotected anal intercourse over the previous three months. These results were compared with results from other Australian studies. Whereas nearly all the men were sexually active, only a small proportion considered activities such as oral sex without ejaculation and anal sex with condoms to be 'totally safe'. The majority considered these activities to be 'more safe than unsafe', suggesting a risk-reduction rather than a 'no-risk' approach to sex. C:omparisons with other Australian studies suggest that gay men are becoming more confident in the safety of sexual activities labelled as 'safe' by the AIDS Council. There was no elevated practice of unprotected anal sex at 'sex-on-premises' venues. Most men who had anal sex used condoms all of the time, whether sexual partnerships were 'once only' or were 'ongoing', suggesting that 'condoms always' is still a viable option in various partnerships. There was some evidence that a minority of men abandoned condoms in ongoing partnerships. If specific education campaigns are developed to promote 'negotiated safety' in partnerships, then such campaigns should not contradict the 'condoms always' strategy.
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2006
In recent years, increases in both risk behavior and in seroconversion among homosexually active men have been noted in a number of parts of the world. Data were available from 903 HIV negative homosexual men regarding number of acts of unprotected anal intercourse (UAI), separated into receptive and insertive UAI, with and without ejaculation, with steady and with casual partners. Partners were classified according to serostatus as reported by respondents. Men (N = 325) reported 13,692 UAI acts, most of which were with steady partners, of whom most were reported to be HIV-negative. With HIV-positive partners, both steady and casual, and with casual partners of unknown serostatus, receptive UAI with ejaculation was relatively rare. Insertive UAI without ejaculation was relatively common with casual partners of unknown serostatus. Patterns of UAI suggest that risk of transmission may be greater with steady partners. Men appear to modify practice according to both the nature of the relationship (steady or casual) and (assumed) serostatus of partner. KEY WORDS: HIV; risk behavior; behavioral surveillance; homosexually active men.
Sexual practices in a broad cross–sectional sample of Sydney gay men
Australian and New Zealand Journal of Public Health, 1977
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 nonconcordant 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. (Aust N Z
Journal of Applied Social Psychology, 2000
This longitudinal study of gay men examined safer sex within steady relationships and assessed whether relationship quality influenced safer sex with casual partners. The theoretical frameworks of Rusbult's (1980) investment model of romantic relationships and of Ajzen's (1988, 1991) model of planned behavior were used. Unprotected intercourse with a steady partner was practiced significantly more often when both partners in a steady relationship were seronegative and had an explicit agreement to keep it safe with casual partners. However, there was no indication that explicit agreements reduced the occurrence of unsafe extrarelational sex. Both the investment model of romantic relationships and the model of planned behavior were successful in accounting for sexual risk behavior outside the relationship.
Aids and Behavior, 2006
In recent years, increases in both risk behavior and in seroconversion among homosexually active men have been noted in a number of parts of the world. Data were available from 903 HIV negative homosexual men regarding number of acts of unprotected anal intercourse (UAI), separated into receptive and insertive UAI, with and without ejaculation, with steady and with casual partners. Partners were classified according to serostatus as reported by respondents. Men (N = 325) reported 13,692 UAI acts, most of which were with steady partners, of whom most were reported to be HIV-negative. With HIV-positive partners, both steady and casual, and with casual partners of unknown serostatus, receptive UAI with ejaculation was relatively rare. Insertive UAI without ejaculation was relatively common with casual partners of unknown serostatus. Patterns of UAI suggest that risk of transmission may be greater with steady partners. Men appear to modify practice according to both the nature of the relationship (steady or casual) and (assumed) serostatus of partner.
Resistances to behavioural change to reduce HIV/ …, 1999
Understanding sexual behaviour change in response to HIV/AIDS has been an enduring puzzle for those working to stop the pandemic. Gay communities in the developed world have rapidly achieved a remarkable level of behaviour change in facing the epidemics they have weathered. What might we learn from the example of the Australian gay communities that might be useful for other communities and populations? It was gay men who invented the idea of 'safe sex'; and some of the 'heterosexual' epidemics may be less heterosexual than we think. An important lesson from the fact of significantly reduced HIV transmission in gay communities is that prevention education works. Second, the concept of 'community' seems to contribute to successful behaviour change by creating a collective sense of commitment to stopping HIV. Third, all communities are different and have different resources to contribute. It is important to work with each community's own capacities. Each community's 'sexual culture' is an important resource. Understanding 'sexual culture' provides rich resources for prevention education. Finally, we need three sources of research knowledge to help us produce effective prevention: epidemiology; social-behavioural monitoring; and cultural and educational research.