If governmentfunding of HIV prevention doesn’t increase, infections from unprotected anal sex is likely to continue rising.
That’s one of the nuggets of wisdom deduced from the results of last summer’s Sex Now survey of BC gay men.
The survey found that the number of gay men having unprotected casual anal sex rose from 14 percent of those surveyed in the year 2000 to 19 percent of those surveyed two years later. The Community-Based Research Centre (CBRC) surveyed 1,854 men in Vancouver, Victoria and Prince George, including participants at Pride parades.
After a five-year downturn in HIV infection rates to 2000, infection rates are on the rise again-up 33 percent between 1999 and 2001. They remained static between 2000 and 2001, according to The BC Centre for Disease Control (BCCDC) .
Dr Terry Trussler says BC’s HIV incidence rate is about 4.6 percent-or five times the national average. Trussler, who works for the CRBC, says government targets to reduce HIV infection in BC by 50 percent and in Vancouver by 25 percent in five years are unrealistic.
“Gay men need to speak out for a fair share of resources to keep our community informed about sexual safety concerns and the changing dynamics of the unique health risks we face in our everyday lives,” Trussler says.
He says gay men, who account for 65 percent of new infections, need to know that funding for their health concerns has all but vanished.
“Health authorities at all levels have either assumed gay men’s needs have been addressed or have neglected emerging conditions,” Trussler says. “The net result is the same: there are virtually no funds with which to respond.”
A critical finding of the Sex Now survey was that at least 70 percent of gay men expect sex partners to disclose their HIV status. Sixty percent of men using parks, baths and the Internet expect partners to disclose their status.
However, one-third of respondents express difficulty in talking about sexual safety with partners. Trussler says that puts the onus for safety on positive men.
Other survey findings include:
Knowledge about HIV and syphilis is high among gay men but less so among younger men coming out. Access to gay health information is critical for youth, especially outside Vancouver;
Half of men surveyed are in a relationship. More than a third reported unprotected sex which should be safe if HIV status is confirmed, communication is clear and promises kept, the survey notes. But researchers are concerned that about 16 percent of partnered men say they are having unprotected sex with other men;
Half of HIV-positive men are in a relationship with a negative partner;
Some 34 percent of those surveyed have experienced some form of explicit abuse, of which four percent was physical.
Trussler says HIV-positive men are largely ignored by education efforts. With more positive men remaining healthier longer, they remain in the sex pool and need prevention programs aimed at them.
A 2001 report prepared by Rick Marchand for the BCCDC report notes the provincial Ministry of Health paid out $7.5 million for HIV/AIDS community services but only $104,000 went directly to community prevention efforts. It suggests creating a dedicated organization for gay men’s prevention work.
Marchand says the ‘de-gaying’ of HIV/AIDS programs could be catastrophic.
“The signs of trouble show we need to take action before this situation gets worse,” he says.
Trussler says health authorities in gay centres such as Toronto, Amsterdam, London and San Francisco have responded to infection rate increases with renewed support.
The report released jointly last year in Barcelona by the World Health Organization and United Nations Program on HIV/AIDS says more than 40 million people worldwide are infected. Of that, 950,000 cases were in North America, 55,000 of them in Canada.
Vancouver was singled out at the Spanish conference for its striking rise in infection rates in recent years, Trussler says.
The BCCDC reports there were 38 reported diagnoses of AIDS in BC in 2001 for a total of 3,145 since 1983. That figure is down from 109 in 2000 and from the high of 307 in 1993.
The survey was done with support from AIDS and gay men’s health programs throughout the province as well as from the BCCDC. Community associations such as the AIDS Vancouver, AIDS Vancouver Island, Gay Men’s Health, the Asian Society for the Intervention of AIDS, the AIDS Prevention Street Nurse Program, AIDS Prince George and others will be able to use the data to develop programs.
The survey was based on one done of 18,000 men in the United Kingdom. The local survey was triggered by the recent rise in HIV infection rates as well as increases in the transmission of syphilis, gonorrhea and hepatitis. Media reports of barebacking also spurred the study.
Demographic information on age, income and education levels were collected but the focus was on unprotected anal sex and health access issues. Opinions on men’s social and community involvement, locations for sex, drug and alcohol use, relationship status and personal support networks were also collected.
The final report on the survey is due in June.
COMMUNITY BASED RESEARCH CENTRE
604.683.1757
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