This article appeared in The Globe and Mail, Tuesday January 11, 2000.
By Andre Picard
New drugs have considerably improved the prospects of those with HIV-AIDS, but that rosier health picture seems to have sparked a paradoxical response, a disturbing trend toward unprotected sex among young gay men.
Researchers at the British Columbia Centre for Excellence in HIV/AIDS found that almost half of homosexual and bisexual men between the ages of 18 and 30 had unprotected anal intercourse in the past year.
While having a regular partner explained some of that behaviour, more than one in four of men who engaged in casual sex didn't use a condom, and many men have unprotected sex with HIV positive partners even when they know their status.
Those levels of unsafe sex are translating into an "unacceptably high" human immunodeficiency virus incidence rate of 1.7 per 100 person-years (meaning that, out of those studied over a year, an average of 1.7 out of 100 contracted HIV), according to Dr. Stephanie Strathdee of Johns Hopkins University school of hygiene and public health in Baltimore and her colleagues at the BC Centre for Excellence.
Results of their study appear today in the Canadian Medical Association Journal. The incidence rate among those who engage sex for money or drugs was a worrisome 9.5 per 100 person-years.
"Despite declines in HIV risk behaviours among gay men in the mid-1980s, there is growing concern about the risk of HIV infection among young gay and bisexual men in the second decade of the HIV/AIDS epidemic," the researchers write.
They also warned that the seemingly low incidence rate is deceiving because it will translate into a prevalence rate of about 25 per cent within 20 years.
The study of an ongoing research project included 681 young men, most of whom are white and of above average status.
In previous research, the BC Centre for Excellence in HIV-AIDS has identified a number of factors that contribute to unprotected anal sex and other risky behaviour. These include a history of sexual abuse, drug and alcohol abuse, use of poppers (amyl and butyl nitrites) and low education level.
But the new study suggests that "complacency toward HIV infection may have arisen because of optimism surrounding recent advances in antiretroviral therapies."
Antiretroviral therapies are drugs that slow the progression of the disease by preventing the AIDS virus from replicating. There are now more than 250 combinations of HIV drugs. Despite initial criticism, it appears the effect of the drugs is not permanent.
Dr. Strathdee and her team report that many young gay men seem to be practicing "negotiated safety"- unprotected sex within a relationship if both of them tested negative.
But, at the same time, a "surprising proportion of the participants reported having anal sex with a man they knew at the time was HIV positive." In fact, it is not uncommon for gay and bisexual men to have one HIV-negative partner and another HIV-positive one.
The Vancouver study confirms a recent San Francisco study that shows significant increases in unsafe sex practices among gay and bisexual men in the United States coinciding with the availability of antiretroviral treatments. As of Dec. 31, 1998, a total of 43,347 positive HIV tests an 16,236 acquired immune deficiency syndrome cases had been reported to the Laboratory Centre for Disease Control at Health Canada.
Men having sex with men continues to be the most frequently
reported risk factor among those who contract HIV-AIDS in Canada
and the United States.
For more information, contact:
Bonnie Devlin
Vanguard Project Coordinator
608 - 1081 Burrard Street
Vancouver, BC, Canada, V6Z 1Y6
Tel: (604)806-8306
Fax: (604)806-9044