Behavioural trends among Australian gay men pose increasing challenges for HIV prevention: findings from the Gay Community Periodic Surveys, 2003-1
Gay men remain the primary population affected by HIV in Australia. While recent attention has been focused on increasing HIV testing and the use of antiretroviral-based prevention to reduce infections, it is equally important to sustain safe sex and other risk reduction practices. Increases in unprotected anal intercourse (UAI), for example, may counteract any beneficial changes in testing and treatment.
Methods: The Gay Community Periodic Surveys (GCPS) are repeated, cross-sectional surveys of men at gay events, venues and clinics in six Australian states and territories. National trends in key indicators for the period 2013-12 were analysed using logistic regression. The data were age standardized and weighted for recruitment venue prior to analysis. Results: Results from 70,214 participants were included. The majority were recruited from Sydney (34.5%), Melbourne (29.1%) and Queensland (20.6%) and from gay events (53.5%) and social venues (28.4%). Mean age in 2012 was 36.5 years (SD=12.4). Among the whole sample, the majority (>50%) continue to avoid UAI with any partner (this trend is stable over time) and the proportion of men reporting >10 partners in the last six months has declined significantly (from 29.5% in 2003 to 24.0% in 2012). Among men with regular partners, UAI has become significantly more common over time (45.9% to 49.9%). UAI has also become significantly more commonly reported by men with casual partners (31.6% to 38.3%). Among non-HIV-positive men, the proportion tested for HIV in the last year has remained stable (60.5% in 2012). The proportion of HIV-positive men on treatment has increased from 63.5% in 2003 to 77.9% in 2012.
Conclusion: While some behavioural trends among Australian gay men may be beneficial, significant rises in UAI by men with regular and casual partners (in the context of stable rates of HIV testing) pose a significant challenge to HIV prevention efforts.
