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Risk factors for HIV seroconversion in homosexual men in Australia

Jonathan E. Volk A C , Garrett Prestage A , Fengyi Jin A , John Kaldor A , Jeanne Ellard B , Susan Kippax B and Andrew E. Grulich A
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Epidemiology and Clinical Research, Level 2, 376 Victoria Street, Darlinghurst, NSW 2010, Australia.

B National Centre in HIV Social Research, Level 2, Webster Building, University of New South Wales, Sydney, NSW 2052, Australia.

C Corresponding author. Email:

Sexual Health 3(1) 45-51
Submitted: 11 April 2005  Accepted: 4 November 2005   Published: 20 February 2006


Background: Rates of newly acquired HIV infection are increasing in Australia, and sexual contact between men accounts for 85% of cases. Objective: To investigate behavioural risk factors for HIV seroconversion among gay and bisexual men from Sydney and Melbourne, Australia. Methods: 103 men with newly acquired HIV infection were recruited from clinics in Sydney and Melbourne and behavioural risk factor questionnaires were administered between January 2003 and October 2004. Results were compared with a cross sectional and a cohort study performed by our group that enrolled similar populations of men. Results: The majority of seroconverters (73%) reported more than five sexual partners in the last six months. Ninety-five men (92%) were able to identify a high-risk event (HRE) that they thought had led to their HIV seroconversion. Most (70%) reported receptive unprotected anal intercourse (UAI), insertive UAI, or both at their HRE. Sixteen men (16%) reported no UAI in the preceding six months including the HRE. Men were more likely to report receptive UAI at their HRE when they perceived a partner to be HIV-negative as compared with when they perceived a partner to be HIV-positive (P = 0.05). Injection drug use was reported by 22% of the men in the previous six months, and 62% reported intoxication with alcohol (≥5 drinks) or mood altering recreational drug use at the HRE. Conclusions: Gay and bisexual men who have recently seroconverted are highly sexually active and report high rates of unprotected anal intercourse and recreational drug use at the HRE.

Additional keywords: drugs, gay men, seroconverter, strategic positioning.


Financial support: The National Centre in HIV Epidemiology and Clinical Research and the National Centre in HIV Social Research are funded by the Australian Government Department of Health and Aging. The National Institute of Allergy and Infectious Diseases (grant AI52403) funds the PHAEDRA study, which provided the recruitment source for this study and funded the nurse interviews. Jonathan Volk was funded with a Fulbright Research Fellowship through the United States Department of State. The authors would like to thank the participating clinics: Taylor Square Private Clinic, 407 Doctors, AIDS Research Initiative, Holdsworth House, St. Vincent’s Hospital, Sydney Sexual Health Clinic, The Burwood Street Practice, The Centre Clinic, Prahran Market Clinic, Carlton Clinic, The Alfred Hospital, and the Melbourne Sexual Health Centre. The authors thank the PHAEDRA study staff, Jan Guerin, Pat Grey, Tim Ramacciotti, Ansari Shaik, and the study research nurses, Sophie Dinning, Robyn Richardson, Robyn Vale, Vanessa Rees, Cari Egan, Sam Miller, Rosie Newman, Mark Lacey, Richard Norris, Therese Toohey, Helen Wood, Kaye Lowe, Sally Algar, Claire McCormack, Jeff Hudson, Helen Kent, and Julie Silvers. They also express their gratitude to the men who participated in this research.


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