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Trends in sexual behaviour among London homosexual men 1998–2003: implications for HIV prevention and sexual health promotion
  1. J Elford1,
  2. G Bolding1,
  3. M Davis1,
  4. L Sherr2,
  5. G Hart3
  1. 1City University London, Institute of Health Sciences, St Bartholomew School of Nursing and Midwifery, London, UK
  2. 2Royal Free and University College Medical School, London, UK
  3. 3MRC Social and Public Health Sciences Research Unit, Glasgow, UK
  1. Correspondence to:
 Jonathan Elford
 City University, Institute of Health Sciences, St Bartholomew School of Nursing and Midwifery, 24 Chiswell Street, London EC1Y 4TY, UK; j.elfordcity.ac.uk

Abstract

Objectives: To examine changes in sexual behaviour among London homosexual men between 1998 and 2003 by type and HIV status of partner.

Methods: Homosexual men (n = 4264) using London gyms were surveyed annually between 1998 and 2003 (range 498–834 per year). Information was collected on HIV status, unprotected anal intercourse (UAI) in the previous 3 months, and type of partner for UAI. High risk sexual behaviour was defined as UAI with a partner of unknown or discordant HIV status.

Results: Between 1998 and 2003, the percentage of men reporting high risk sexual behaviour with a casual partner increased from 6.7% to 16.1% (adjusted odds ratio (AOR) 1.36 per year, 95% confidence interval (CI) 1.26 to 1.46, p <0.001). There was no significant change in the percentage of men reporting high risk sexual behaviour with a main partner alone (7.8%, 5.6%, p = 0.7). These patterns were seen for HIV positive, negative and never tested men alike regardless of age. The percentage of HIV positive men reporting UAI with a casual partner who was also HIV positive increased from 6.8% to 10.3% (AOR 1.27, 95% CI 1.01 to 1.58, p <0.05).

Conclusion: The increase in high risk sexual behaviour among London homosexual men between 1998 and 2003 was seen only with casual and not with main partners. STI/HIV prevention campaigns among London homosexual men should target high risk practices with casual partners since these appear to account entirely for the recent increase in high risk behaviour.

  • HAART, highly active antiretroviral therapy
  • STI, sexually transmitted infections
  • UAI, unprotected anal intercourse
  • homosexual/bisexual men
  • sexual behaviour
  • time trends

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