Bay Area Reporter - July 26, 2001
Ed Walsh

The survey of 343 gay men in London found that 31 percent of men who attended a daylong safer sex workshop contracted a sexually transmitted disease over a 12-month period, compared with 21 percent of men who were given just a 20-minute counseling session. The men were recruited from STD clinics in London and were considered "high risk" because at the start of the study, about a third reported that they had unprotected anal intercourse in the previous month.

"The potential for behavioural interventions to do more harm than good needs to be taken seriously," the researchers wrote.

The scientists said they were surprised by their results and theorized that the men who attended the workshop may have developed "a misplaced sense of confidence in their ability to negotiate high risk sexual situations."

The researchers called for more study and challenged the conventional wisdom of the effectiveness of safer sex workshops.

"This behavioural intervention was acceptable and feasible to deliver," they wrote, "but it did not reduce the risk of acquiring a new sexually transmitted infection among these gay men at high risk. Even carefully designed interventions should not be assumed to bring benefit."

The study's lead author, John Imrie, of the Royal Free and University College Medical School in London, told the Bay Area Reporter that his study was unique because it was the first to judge the effectiveness of safer sex counseling for gay men using STD transmission rates.

Imrie cited a 1998 study on the general population that found that brief counseling sessions were just as effective in curtailing STD transmission rates as longer counseling sessions. That report, published in the October 7, 1998 edition of the Journal of the American Medical Association, found that there was some benefit to counseling overall. The STD rate was reduced by 20 percent for those who received either the brief or longer-term counseling.

Kevin Robert Frost, vice president for clinical research and prevention programs at the American Foundation for AIDS Research, told the B.A.R. that he applauded the study's authors for challenging conventional wisdom.

"The biggest lesson in that paper is that we have to continue to figure out how to target our prevention efforts using effective validated tools," Frost said. "What the survey really highlighted for me is that we can't just assume that just because we're providing some intervention, that the intervention is going to be effective. Rather, we ought to be validating the prevention tools we have at our disposal to make sure that, in fact, they are going to be the most effective tools out there."

Frost cautioned against jumping toward any conclusions to explain the study's results.

"There's a lot of that shoot-from-the-hip analysis going on," he said.

"Frankly, we're talking about sex, and sex is a very complicated thing." Frost also praised the British Medical Journal for publishing the study despite its negative results.
010726
BR010717

Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2001. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .