San Francisco Chronicle; Wednesday, July 1, 1998
David Perlman, Chronicle Science Editor

In a report to the 12th World AIDS Conference in Geneva, research scientist Maria Ekstrand noted that in 1996, 51 percent of the men said they had engaged in unprotected insertive or receptive anal intercourse -- up from 37 percent in 1992.

"We found these increases very alarming," Ekstrand said, "and we didn't start out looking for it."

Because the act of answering questionnaires about behavior often causes people to change their behavior, Ekstrand said she would have assumed that the young men in the UCSF survey would have modified their sexual activities as they realized the activities were indeed unsafe.

About half the men who said they were having unprotected sex also said they were doing it with partners whose HIV infection status they did not know, or whose status, if known, was different than their own, Ekstrand said. Among gay men, sex with a partner whose HIV status -- infected or uninfected -- is the same as their own is known as "negotiated safety."

"But it's not negotiated safety," Ekstrand said. "If there is any negotiation going on, it's negotiated danger."

Dennis Osmond, an epidemiologist on the UCSF team, reported that for reasons not yet understood, the HIV infection rates among the young men did not increase significantly during the survey period. Only 1.5 percent of the men became infected with HIV, the virus that causes AIDS, Osmond found. That may seem low, he noted, "but it's still high enough to maintain an epidemic. By the time these men reach their 40s and 50s, we're talking about 20 to 30 percent of them being infected with HIV."

Craig Waldo, another prevention specialist at the UCSF institute, has examined some of the reasons young gay men engage in risky sex behavior. He studied more than 300 of them living in Santa Cruz, Santa Barbara and Eugene, Ore., and found that the men who were most comfortable with their homosexuality and most willing to accept participation in a supportive gay community were also most likely to practice safe sex consistently and to avoid risky sex with casual partners. Those young men, Waldo found from his in-depth study, also score high on psychological measures of self-esteem and score lowest on measures of depression or suicidal feelings. Living in an environment where homophobia is overt and supportive gay communities do not exist has the opposite effect on young gay men, Osmond said.

They may be much less likely to accept their homosexuality and more prone to report feelings of worthlessness and alienation. Ultimately, they tend to be the most likely to engage in such high-risk sexual activities as unprotected anal intercourse or receptive oral sex with ejaculation.

The International AIDS Society announced yesterday that Waldo's unique social science study has been chosen to receive one of the organization's four Young Investigator Awards, given to reports presented at the AIDS conference by scientists under age 35. The other awards went to two researchers from Kenya and one from Tanzania.

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