Heterosexual behaviour in a large cohort of homosexually active men in England and Wales

Women and the heterosexual transmission of HIV: risks and prevention strategies

Heterosexual intercourse has become a significant means of HIV transmission, even in countries where this was previously not the case. Consequently the promotion of safer sexual practices for heterosexual women and men is of major public health importance. We examine the risks to women of contracting HIV through heterosexual sex, and critically discuss the most commonly recommended strategies for safer sex for heterosexuals. We conclude that all safer sex strategies have limitations, and therefore a wide range of options should be promoted.

Anthropology, HIV and contingent identities

The paper explores the relationship between social identity and HIV/AIDS, with special reference to gay men in Britain. This relationship was first seen as significant since it might have a bearing on the spread of HIV in the population. Three major forms of commentary have emerged on the issue: (i) basic research into the relationship between sexual identities and behaviours; (ii) applied research on how to convert the findings from (i) into health promotional materials, and (iii) discourse from within the politically gay community on what HIV/AIDS means for gay people. These different forms of commentary arise from a diverse range of voices, within and outside academia. The paper draws comparison between different disciplinary approaches to questions of identity and HIV/AIDS, in terms of their relative strengths and weaknesses (for example, contrasting psychology with anthropology). An ethnography of a day centre for people living with HIV/AIDS is used to illustrate the need to understand identity from a processual perspective, so that both individual and collective identities are seen as emerging from specific historical circumstances and struggles. A dialogic approach to understanding identity, tied to qualitative empirical research, is suggested as necessary to understanding how different forms of identity engage with HIV/AIDS (gender, ethnicity, age, sexual orientation), and how the identities of individuals and groups are always complex, shifting mosaics.

Are bisexually identified men in San Francisco a common vector for spreading HIV infection to women?

OBJECTIVES

This article examines sexual risk taking among self-identified bisexual men in San Francisco and whether risk reduction has occurred, with respect to both homosexual and heterosexual behaviors, among human immunodeficiency virus (HIV) antibody-positive and HIV antibody-negative men. It also examines psychosocial correlates of unprotected anal and vaginal intercourse.

METHODS

The participants were members of a population-based longitudinal cohort of 1034 single men aged 25 through 54 years recruited from the 19 census tracts in San Francisco that had the greatest prevalence of the acquired immunodeficiency syndrome in 1984. Of the total sample, 140 subjects initially identified themselves as bisexual; 85% of these men remained in the study.

RESULTS

The participants reported dramatic reductions in sexual risk taking. Prevalences of unprotected anal sex with men were similar among HIV-positive bisexual men (89% in 1984-1985 and 18% in 1988-1989) and those who were HIV negative (65% and 20%). The prevalence of unprotected vaginal sex was much lower for HIV-positive men (16% in 1984-1985 and 2% in 1988-1989) than for HIV-negative men (35% and 20%). Unprotected intercourse was associated primarily with situational and interpersonal factors.

CONCLUSIONS

Striking reductions in risk behaviors were reported. This subgroup of single, bisexually identified men appears unlikely to be a common vector for spreading HIV infection to women.

Investigation of motivational and behavioural factors influencing men who have sex with other men in public toilets (cottaging)

One-hundred-and-thirty-four individuals engaging in cottaging returned postal questionnaires. The sample was mainly urban and gay identified. Cottagers reported that cottaging was one way of meeting partners amongst a range of others they used. Most enjoyed it and felt in control of their cottaging. The majority of cottagers engaged in safer sexual activity, but there were a significant number who engaged in unsafe sexual activity last time they cottaged. Of those who had been voluntarily tested in the past and reported their serostatus, 23% were seropositive. Unsafe sexual activity was unrelated to whether tested or not, known serostatus or knowledge of the risks of transmission.

The sexual behaviour of young gay men in England and Wales

Much research has concluded that young gay men are at disproportionately higher risk of HIV infection through unsafe sexual behaviour. This paper is the first report on this particular group in the UK. As part of a larger cohort study, 111 young (less than 21) gay and bisexual men were interviewed about their sexual behaviour, knowledge of AIDS and HIV, particularly safer sexual practices and other factors. Three per cent had not had sex and 13% had not had anal intercourse with a man at the time of interview. Forty-five per cent had sexual experience with a woman and 34% had engaged in vaginal intercourse. The average age at first homosexual experience was just under 15 years and this is higher than other age groups in the cohort. Median number of male partners in the year before interview was 5, with 1 of whom anal intercourse occurred. Sexual repertoire was relatively restricted compared to older men. Condom use was slightly more consistent and levels of knowledge not significantly different. From these findings, the contention that young gay men are at higher risk of HIV infection through risky sexual behaviour is not supported.

Changes in sexual behaviour in a large cohort of homosexual men in England and Wales, 1988-9

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