Important note: Information in this article was accurate in March 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, March 6, 2000
Prepared by AIDS Weekly editors from staff and other reports
"The incidence of HIV infection is unacceptably high among this cohort of young gay and bisexual men," S.A. Martindale and colleagues wrote ("HIV infection and risk behaviors among young gay and bisexual men in Vancouver," Canadian Medical Association Journal, 2000 Jan 11;162(1):21-5. "Preliminary results suggest a disturbing trend toward increasing levels of unprotected anal intercourse."
Young gay and bisexual men may perceive that the consequences of HIV infection have dramatically improved with the availability of highly active antiretroviral therapy. Martindale and colleagues therefore sought to identify trends in HIV infection rates and associated risk behaviors among young gay and bisexual men in Vancouver by conducting prospective cohort study involving gay and bisexual men aged 18-30 years who had not previously tested HIV positive.
Subjects were recruited through physicians, clinics, and community outreach in Vancouver. Participants were tested annually for HIV antibodies and asked to complete a self-administered questionnaire pertaining to sociodemographic characteristics, sexual behaviors, and substance use. Prevalence of HIV infection and risk behaviors were determined for eligible participants who completed a baseline questionnaire and HIV testing as of May 1998.
The primary outcome was the proportion of men who reported having protected sex during the year before enrollment and who reported any episode of unprotected sex by the time of the first follow-up visit.
A total of 681 men completed a baseline questionnaire and HIV testing as of May 1998. The median duration between baseline and the first follow-up visit was 14 months. The median age was 25 years.
Most of the subjects were white and of high socioeconomic status. The majority (549 [80.6%]) reported having sex only with men; 81 (11.9%) reported bisexual activity. Of the 503 men who had one or more regular male partners, 245 (48.7%) reported at least one episode of unprotected anal sex in the year before enrollment; the corresponding number among the 537 who had one or more casual male partners was 140 (26.1%).
The prevalence and incidence of HIV seropositivity were 1.8% (95% confidence interval [CI] 0.8%-2.8%) and 1.7 per 100 person-years [95% CI, 0.7-2.7], respectively. Fifty-two (26.5%) of the 196 and 55 (29.7%) of the 185 men with regular partners who reported having practiced protected insertive and receptive anal sex in the year before the baseline visit reported engaging in these activities without a condom at the follow-up visit; the corresponding numbers among the 232 and 242 men with casual partners who had practiced protected insertive and receptive anal sex before the baseline visit were 43 (15.5%) and 26 (9.4%) respectively at follow-up.
The corresponding author for this study is R.S. Hogg, British Columbia Center for Excellence HIV AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada.
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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