Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
The Bay Area Reporter - September 3, 1999
Liz Highleyman
The study included 510 gay men between the ages of 18 and 29; the men were participants in the San Francisco Young Men's Health Study. Participants completed a self-administered questionnaire and were tested for HIV antibodies.
The results show that the rate of unprotected anal intercourse increased by approximately 30 percent between 1993 and 1997. Over one-third of the participants reported unprotected anal sex at the beginning of the study, compared to one-half in its final year. Sixty-eight percent said they had had unprotected anal intercourse during at least one of the four years of the study. Additionally, approximately half the men practicing unprotected anal sex had partners whose HIV serostatus was unknown or different from their own. According to Ekstrand, men in the "high-risk" group -- those who practiced unprotected sex and who had partners of unknown or dissimilar serostatus -- had a greater number of sex partners, had sex more often, and were more likely to be HIV-positive. Thirty-two percent of the men reported that they had disclosed their serostatus to all the partners with whom they engaged in anal sex.
Ekstrand said, "People who are sexually adventurous are pushing the envelope. ... They're engaging in high-risk behavior and aren't talking about their HIV status with their partners." Among the reasons cited for unprotected sex by the men in the high-risk group were unavailability of condoms, sexual arousal, and alcohol or drug use.
Despite the reported increases in unprotected sex, rates of new HIV infections have not increased among young gay men in San Francisco, remaining stable at about 2 percent per year. According to UCSF, several U.S. cities, including San Francisco, have recently reported increased rates of rectal gonorrhea, which is believed to be transmitted by the same sexual activities as HIV. However, this assertion is questioned by Michael Petrelis, who said that the July 1999 monthly report from the San Francisco Department of Public Health's STD control branch shows similar rates of rectal gonorrhea in 1998 and 1999 (14 cases this past July and 93 cases so far this year, compared to 15 cases in July 1998 and 93 cases for the equivalent portion of last year). Petrelis has asked UCSF to release more information to the public to explain the apparent discrepancy, and has called on UCSF and the DPH to hold meetings with the gay community.
In related news, on August 30 the Centers for Disease Control and Prevention reported rates of unprotected sex and HIV infection among young gay men in several U.S. cities. The results were from a survey of gay men between the ages of 15 and 22 conducted in Baltimore, Dallas, Los Angeles, Miami, New York City, and San Francisco. According to the study, 7 percent of the young men were HIV-positive overall, and 3 percent contracted HIV per year, a rate slightly higher than that for San Francisco alone. Forty-one percent in the national survey reported unprotected sex in the past six months, a rate somewhat lower than that reported for the final year of Ekstrand's study. The researchers said that HIV prevalence rates were highest nationwide among young African American and mixed race gay men.
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