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There has been much debate and discussion about the potential public health impact of the emergence of criminal prosecutions for the sexual transmission of HIV in the United Kingdom. This paper offers a unique opportunity to examine data that connects views on criminal prosecutions with evidence of HIV prevention need among an opportunistic sample of men in the UK who are homosexually active. Quantitative and qualitative data on criminal prosecutions were collected as a part of the Gay Men's Sex Survey 2006, and this paper represents an initial analysis of those responses. The data demonstrate how dominant views on criminal prosecutions come into direct conflict with health promotion aims, thereby exacerbating pre-existing HIV prevention need in a population at increased risk of participating in HIV transmission. This conflict is most clearly apparent in the close relationship between men's support of criminal prosecutions, and their expectation that a partner with diagnosed HIV will disclose his status before engaging in sex. Changing such unrealistic and universalised expectations has long been an aim of HIV prevention planning that targets Gay and Bisexual men, yet it would appear that the popularity of criminal prosecutions helps to resist attitudinal change, thereby exacerbating HIV prevention need. [ABSTRACT FROM AUTHOR]

This study tested the hypothesis that stigmatization toward people living with HIV/AIDS (PLWHA) was associated with stigmatization toward different vulnerable groups, including men who have sex with men (MSM), injecting drug users (IDUs), female sex workers (FSW) and their clients (CFSW). A number of scales and indicators were constructed for the purpose: the four Overall Stigmatization Scale for a Vulnerable Group (OSSVG) and the five Dimensional Stigmatization Scale (DSS) each measuring different dimensions of stigmatization toward the four vulnerable groups, together with four indicators measuring stigmatization toward PLWHA. A random sample of 2,008 Hong Kong Chinese adults aged 18-50 years in the general population were interviewed by telephone. Of these respondents, 22.8- 76.8% perceived that FSW, CFSW, MSM and IDU were pathological and 42-82.2% perceived them as immoral; 74.7% believed that PLWHA are promiscuous. Furthermore, the four OSSVG and the five DSS scales were inter-correlated with one another (Spearman coefficient = 0.11-0.67) and most of them were significantly associated with the four PLWHA stigmatization indicators (Odds Ratio = 1.25-4.27). Other factors were associated with the OSSVG and DSS scores (e.g. age, marital status, religion affiliation, education level, income and perceived severity of the HIV problem in Hong Kong). Campaigns for removing stigmatization toward these vulnerable groups are required in order to reduce stigmatization toward PLWHA. Stigmatization toward FSW and their clients might have been over-looked. The removal of the public's blame on these groups for spreading HIV may be useful. The impact of HIV prevalence of a vulnerable group onto the associations between stigmatization toward that particular group and PLWHA warrants investigation. [ABSTRACT FROM AUTHOR]

The present study was set up to investigate social-cognitive determinants of HIV-risk precautionary intentions among men who have sex with men (MSM), who meet sex partners on the Internet. Participants were enrolled through the major gay chat room in The Netherlands, www.chatboy.nl, and were asked to complete an online questionnaire. Theory of Planned Behaviour variables attitude, subjective norm, and perceived control explained 55% of the variance in intention to use condoms for anal sex with future e-dates. Adding descriptive norm, personal norm and anticipated regret explained 70%. Sexual fantasies and HIV-status had unique effects on intentions. Differences between high and lower intenders are presented. Limitations of the study are discussed and objectives for an intervention to promote condom use are given. [ABSTRACT FROM AUTHOR]

Controlled trials conducted in the USA provide clear evidence that peer education can bring about a reduction in high risk sexual behaviour among gay men. HIV prevention interventions that systematically identified, recruited, trained and engaged popular opinion leaders (POLs) made a significant impact on sexual behaviour at a community level in small US towns. However, recent trials conducted in the UK have failed to replicate these findings. A POL intervention in London made no significant impact at a community level on the risk behaviours of gay men. Jeffrey Kelly, one of the authors of the US studies, has identified nine core elements central to the popular opinion leader model. In Kelly's view 'the UK projects were not tests of the popular opinion leader model because they did not employ most of these POL core elements'. The absence of any significant impact of the UK programmes on sexual risk behaviour at a community level was not, therefore, surprising. In fact, the London POL project incorporated all the core elements into its design and succeeded in employing seven out of nine in its delivery. Attempts to employ all the core elements, however, were hampered by problems in recruiting popular opinion leaders as well as barriers to communication. Process evaluation revealed that it was these obstacles which limited diffusion. This in turn explained the absence of any impact of the London POL project on sexual risk behaviour at a community level. The obstacles to successful diffusion in London have provided a valuable opportunity for examining the processes that underlie the POL model. Our study raises the question as to whether social interventions shown to be effective in one setting, place or moment in time can be replicated in another. [ABSTRACT FROM AUTHOR]

The aim of this analysis was to examine gay men's sexual risk practice to determine patterns of risk management. Ten cross-sectional surveys of gay men were conducted six-monthly from February 1996 to August 2000 at Sydney gay community social, sex-on-premises and sexual health sites (average n = 827). Every February during this period, five identical surveys were conducted at the annual Gay and Lesbian Mardi Gras Fair Day (average n = 1178). Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with a serodiscordant regular partner, there was a clear pattern of sexual positioning. Few regular couples were both receptive and insertive. Most HIV-positive men were receptive and most HIV-negative men were insertive. Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with casual partners, there was also a pattern of sexual positioning. Whereas many casual couples were both receptive and insertive (especially those involving HIV-positive respondents), among the remainder HIV-positive men tended to be receptive and HIV-negative men tended to be insertive. These patterns of HIV-positive/receptive and HIV-negative/insertive suggest strategic risk reduction positionings rather than mere sexual preferences among a minority of gay men. If so, they point not to complacency but to an ever more complex domain of HIV prevention. [ABSTRACT FROM AUTHOR]

This paper was presented in a session at the AIDS Impact conference devoted to a debate on the methods that should be used to evaluate educational interventions. The paper highlights two desiderata for evaluation of interventions directed at gay men. First, the view is presented that there is no acceptable substitute for assessing the effect of an intervention on gay men's sexual behaviour (rather than, for example, their AIDS-related attitudes or beliefs). This view is justified in terms of (a) the differences that exist between AIDS-related thinking in the cold light of day and during actual sexual encounters; and (b) the often faulty nature of intuitions about the factors that contribute to sexual risk-taking and the ways in which it might be reduced. Second, it is argued that the randomized control study design represents the best means for ensuring that interventions will be as effective as possible. Criticisms which have been made of this design are discussed and the conclusion drawn that they do not amount to a strong case against it. [ABSTRACT FROM AUTHOR]

We examined trends in sexual practice among gay and homosexually active men in Australia. Self-complete questionnaires were distributed with mail-order sex video catalogues in 2000 and returned anonymously through a reply-paid facility. The data were compared with those from men who responded to promotional material sent out with the same catalogues and who participated in national telephone surveys of men who have sex with men conducted in 1992 and 1996. A key independent variable was gay community attached (GCA) versus non-GCA (NGCA) derived from two items about number of gay friends and amount of free time spent with gay men. Responses came from 1,832 men ranging in age from 16 to 80 (median = 39) years. HIV status was 73% negative, 5% positive, 22% untested; 1,181 men were GCA and 651 men were NGCA. Overall, from 1992 to 2000 there was a significant upward trend in the proportion of men reporting any unprotected anal intercourse (UAI) in the previous six months with regular partners: 21.5%, 24.7%, 46.4% of the total sample (p < 0.001). And similarly for UAI with casual partners: 12.4%, 16.2%, 25.5% (p < 0.001). The upward trends in UAI-regular and UAI-casual were similar and significant (p < 0.001) for both GCA and NGCA men. These nationwide Australian data provide evidence of continuing increases in unprotected anal intercourse with regular and with casual partners. Whereas the majority of men do not engage in any unprotected anal intercourse during a defined interval, ever increasing proportions of them do. [ABSTRACT FROM AUTHOR]

Some gay men disclose their HIV serostatus to enable them to decide to discard condoms in at least some casual encounters. In this paper we consider under what circumstances this occurs. We draw on data from the Sydney Men and Sexual Health cohort study, including both structured and semi-structured interviews. We find that casual sexual encounters among gay men are complex events, involving a broad range of types of partner and circumstance. A significant minority of men disclose their HIV serostatus; 36.3% of those who discussed their serostatus with casual partners engaged in unprotected anal intercourse (UAI) with those partners, while only 9.9% of those who did not discuss their serostatus engaged in UAI with those partners. We also find that disclosure of HIV serostatus, discussion and use of condoms during casual encounters are affected by the particular circumstances of those encounters, including the degree of familiarity between casual partners. [ABSTRACT FROM AUTHOR]

This study compares the cognitive structure of sexual techniques of safe versus unsafe gay men older than 30 years. Subjects rated 25 sexual techniques by six bipolar adjective scales making up a short version of the semantic differential. Scales measured subjects' perception of the safety and gratification potential of the sexual techniques. We used cluster analysis, multidimensional scaling and factor analysis. Subjects reporting no unprotected anal sex with non-steady partners (N = 312) differ from men reporting unsafe behaviour (N = 19). Safe and unsafe men used different main categories to structure the domain of sexual behaviour. Within the group of safe men, the domain of sexual behaviour structured by perceptions of gratification and safety seem to mirror the epidemiological structuring of sexual techniques using the non-penetration versus penetration, and transmission of body fluids versus no transmission of fluids dimension. Among risky men, this structuring is not that clearly present. We found different estimations of the level of risk associated with unprotected insertive versus receptive anal sex in combination with a higher perception of the gratification potential of the former. Unsafe men seem to make a noticeable difference between their own and their partner's risk and gratification. [ABSTRACT FROM AUTHOR]

Findings are presented from a questionnaire survey of 562 gay men resident in southern England on their sexual behaviour in the context of holidays. Data were gathered during summer 1996 by means of a self-completion questionnaire; 395 men reported at least one holiday undertaken in 1996 and the analysis focuses on the first or only holiday described. Of 391 men giving details of sexual activity, 187 reported sex with a new partner, 113 men reported penetrative sex and 17 reported penetration without consistent use of condoms. Sexual activity on holiday was predicted by: being on holiday alone or with friends, taking condoms, being motivated by 'gay social life and sex' in planning a holiday, higher expectations of sexual activity/risk and a higher number of new partners at home. Penetrative sex was predicted by: more sexual partners on holiday, taking condoms and higher expectations of sexual activity/risk. Unprotected sex was predicted by: not taking condoms, higher expectations of sexual activity/risk and positive HIV status. Survey findings are discussed in relation to previous research, and implications for travel-related HIV prevention initiatives targeting gay men are explored. [ABSTRACT FROM AUTHOR]

A case control analysis within an ongoing cohort study was used to examine differences between seroconverters and men who remained HIV-negative. The cases were interviewed within one to 13 months prior to their seroconversion. Their responses to a structured questionnaire were compared with those of HIV-negative controls drawn from the same time period and from the same longitudinal study, Sydney Men and Sexual Health. Data collected from both cases and controls included: demographic and contextual variables, knowledge of HIV transmission, sexual practices, drug and alcohol use and attitudinal factors. The aim was to compare the sexual behaviours, and the social and cultural contexts of such behaviours, of men prior to their HIV seroconversion with men who did not seroconvert. Twenty-three men had seroconverted within the cohort. Cases were identified by a positive HIV antibody test or self-report of positive HIV status following a previous negative HIV test. Three-hundred-and-sixty-nine controls were selected on the basis of being HIV negative at interview in 1994, and having at least one subsequent medically-confirmed negative HIV antibody test. Univariate predictors of seroconversion were: being in a regular relationship with a known HIV-positive partner, drug use, and engaging in a range of anal and esoteric sexual practices. Practices commonly used to enhance sexual pleasure, such as group sex, watching and being watched having sex, the use of sex toys and dressing up/fantasy, were engaged in more frequently by seroconverters. Engaging in these esoteric sexual practices was highly correlated with drug use, involvement in the gay community and engagement in a wide range of anal practices. In the multivariate analysis independent predictors of seroconversion were: younger age; being in a regular relationship with a known HIV-positive partner; believing withdrawal to be safe with regard to HIV transmission; and range of esoteric practices. These results indicate the importance of the social and cultural contexts of particular sexual practices and consequent HIV transmission. Sexually adventurous men may be at increased risk for HIV because they seek sex within particular sexual sub-cultures. [ABSTRACT FROM AUTHOR]

Presents a study which examined the relation between socio-demographic factors and the safer sexual behavior of gay and bisexual men in the West Midlands Region of the United Kingdom. Indepth look at condom usage; Details on the risk of the HIV infection; Methodology used to conduct the study; Findings of the study.

Abstract We assessed the factors associated with unprotected anal intercourse in gay men's casual partnerships, using data from a longitudinal cohort study ongoing since October 1992. Participants were recruited through gay community and a variety of other sources and interviewed for the Sydney Men and Sexual Health study. Of 1,037 interviewees at outset, 834 men had casual partners during the six months prior to interview; 609 had any anal intercourse with a casual partner. Of 172 HIVpositive men, 58 (33.7%) engaged in unprotected anal intercourse with casual partners. Of 662 non-positive men, 111 (16.8%) engaged in unprotected anal intercourse with casual partners. Logistic regression analysis revealed that gay men's engagement in unprotected anal intercourse with casual partners (compared with engagement in safe sex-either no anal intercourse or protected anal intercourse) was predicted by positive HIV status, occupational differences (being out of the workforce or in white collar positions rather than in professional or managerial positions), engagement in a wider range of anal practices, believing withdrawal to be safe and less favourable attitudes towards condoms. Additional logistic regressions which, initially, excluded positive men who only engaged in unprotected anal intercourse with positive casual partners ( n= 26) and then excluded men who did not engage in anal intercourse ( n= 225) yielded quite similar sets of predictors of unprotected anal intercourse with casual partners. However, in both the additional analyses HIV status was not a significant predictor. It is concluded that gay men who engage in unprotected anal intercourse with casual partners do not comprise a singular group, although they commonly engage in a diversity of anal practices and they dislike condoms. [ABSTRACT FROM AUTHOR]

Investigates the possibility of adapting techniques in cognitive psychology to study gay men's thinking about AIDS/HIV. Contributing factors to gay men's decision on unprotected anal intercourse (UAI); Contact with the gay community; Effectivity of AIDS education.

Compares the risk of having AIDS due to unsafe sexual behavior between young and old gay men. Sexual safety as a social process rather than a function of age and youthfulness; Need to define HIV risk within specific historical and cultural cohorts; Need to question the prioritizing of universal definitions of youth in HIV research.

Studies in both the UK and the USA continue to show that gay and bisexual men put themselves at risk of exposure to HIV through unprotected intercourse, most often with regular partners. As part of a larger study of homosexually active men, 310 men who had had unprotected anal intercourse with a man in the previous year were asked to describe the last occasion on which this had happened. The majority of men had had unprotected intercourse with a regular partner and did not perceived it as risky, although most did not know the HIV status of their partner. Regular and non-regular partners were perceived differently. Men were more likely to be emotionally involved in regular partners and to perceive unprotected penetrative sex with a regular partner as not risky. Future health education initiatives must take into account men's emotional involvement in regular partners and their perception of unprotected intercourse with such partners as not risky. [ABSTRACT FROM AUTHOR]

Presents information on cases of AIDS and HIV infection in Thailand men, and results from a survey done in the northeast of Thailand among men who have sex with other men (MHSWM). Sexual networks and condom use with partners; Details of indepth interviews; Information on gays and katoey; Statistics on sexual habits.

Discusses the role of sexual exclusivity in relation to HIV, and the use of rule making in gay relationships. Data collected from interviews with homosexually active men; Methods; Results; Excerpts from some interviews; Reference material.

Discusses the progress of behavioral research among homosexual and bisexual men in the United States between 1981 and 1991. Future directions for second decade of human immunodeficiency virus (HIV) and acquired immune deficiency virus (AIDS) epidemic. Goals for behavioral research agenda in coming decade.

Studies condom use in a large cohort of homosexually active men in England and Wales. Widespread use of condom; Factors correlating with condom use.

Describes the findings from an investigation of sexual dysfunction in a large group of homosexual men with severe HIV disease. Survey of 149 subjects enrolled in a clinical trial of didanosine; Frequently cited dysfunctions; View on sexual functioning as important aspect of quality of life.