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RESEARCH ARTICLE

Differing trends in sexual risk behaviours in three Australian states: New South Wales, Victoria and Queensland, 1998–2006

Iryna B. Zablotska A C , Garrett Prestage B , Andrew E. Grulich B and John Imrie A
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Social Research, University of New South Wales, Sydney, NSW 2052, Australia.

B National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.

C Corresponding author. Email: i.zablotska@unsw.edu.au

Sexual Health 5(2) 125-130 https://doi.org/10.1071/SH07076
Submitted: 4 October 2007  Accepted: 24 January 2008   Published: 2 June 2008

Abstract

Background: In Australia, the HIV epidemic is concentrated among gay men. In recent years, the number of new diagnoses stabilised in New South Wales (NSW), but increased in other states. We reviewed the trends in sexual behaviours to explain this difference. Methods: We used the Gay Community Periodic Surveys in NSW, Victoria and Queensland during 1998–2006 and restricted analyses to the 30–49 year olds who contribute most of the HIV cases. We used the χ2-test for trends in unprotected anal intercourse with casual partners (UAIC) and regular partners, number of partners, type of relationships, knowledge of HIV serostatus and its disclosure. We compared behaviours of HIV-positive and -negative men and men across states using logistic regression adjusted for the year of report. Results: Trends in behaviours differed across the states: following a period of increase, UAIC prevalence declined in NSW since 2001, but continued to increase in Victoria and Queensland. There were other changes in NSW that were not observed in Victoria and Queensland: a decline in factors increasing HIV risk (the proportions of men with multiple sex partners and men engaging in UAIC and not knowing or not disclosing HIV serostatus) and an increase in behaviours reducing it (the proportions of men in monogamous relationships and men disclosing HIV serostatus while having UAIC). Conclusion: There were patterns of declining HIV risk behaviours in NSW, and increasing risk behaviours elsewhere, that mirrored recent changes in HIV case notifications in Australia. These data suggest that behavioural surveillance can predict changes in HIV epidemiology.

Additional keywords: HIV, HIV serostatus disclosure, knowledge of HIV serostatus, regular relationships, unprotected sex with casual partners.


Acknowledgements

The authors would like to acknowledge the key community partners – the Australian Federation of AIDS Organisations, the National Association of People Living with HIV/AIDS, the AIDS Council of New South Wales and People Living with HIV/AIDS for being instrumental in the establishment of the behavioural surveillance in Australia and being a part of the partnership in HIV response. Many thanks go to all study participants for sharing their life experiences with the research team. We are also grateful to the New South Wales State Health Department, for their financial support to the studies and committed efforts in HIV prevention; and our thanks also go to the Victoria Department of Human Services and Victorian AIDS Council, the Queensland Health and Queensland Association for Healthy Communities for the ongoing work in HIV prevention and their support of the behavioural surveillance in Australia.


References


[1] Volk JE,  Prestage G,  Jin F,  Kaldor J,  Ellard J,  Kippax S, et al. Risk factors for HIV seroconversion in homosexual men in Australia. Sex Health 2006; 3 45–51.
CrossRef | PubMed |

[2] McDonald A (ed.). HIV/AIDS. Viral load and sexually transmissible infections in Australia: Annual Surveillance Report, 2006. Sydney: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales; 2007.

[3] Guy RJ,  McDonald A,  Bartlett M,  Murray J,  Giele CM,  Davey TM, et al. HIV diagnoses in Australia: diverging epidemics within a low-prevalence country. Med J Aust 2007; 187 1–4.


[4] Gebhardt M. Recent trends in new diagnoses of HIV infections in Switzerland: probable increase in MSM despite an overall decrease. Report no. E051208.2. Bern: Swiss Federal Office of Public Health; 2005.

[5] Dukers NH,  Fennema HS,  van der Snoek EM,  Krol A,  Geskus RB,  Pospiech M, et al. HIV incidence and HIV testing behavior in men who have sex with men: using three incidence sources, The Netherlands, 1984–2005. AIDS 2007; 21 491–9.
CrossRef | PubMed |

[6] MacDonald N,  Dougan S,  McGarrigle CA,  Baster K,  Rice BD,  Evans BG, et al. Recent trends in diagnoses of HIV and other sexually transmitted infections in England and Wales among men who have sex with men. Sex Transm Infect 2004; 80 492–7.
CrossRef | PubMed |

[7] Marcus U,  Voss L,  Kollan C,  Hamouda O. HIV incidence increasing in MSM in Germany: factors influencing infection dynamics. Euro Surveill 2006; 11 157–60.
PubMed |

[8] Wolitski RJ,  Valdiserri RO,  Denning PH,  Levine WC. Are we headed for a resurgence of the HIV epidemic among men who have sex with men? Am J Public Health 2001; 91 883–8.
PubMed |

[9] Grulich AE,  Kaldor JM. Trends in HIV incidence in homosexual men in developed countries. Sex Health 2008; 5 113–18.
CrossRef |

[10] Volk JE,  Prestage G,  Jin F,  Kaldor J,  Ellard J,  Kippax S, et al. Risk factors for HIV seroconversion in homosexual men in Australia. Sex Health 2006; 3 45–51.
CrossRef | PubMed |

[11] Elford J. Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy. Curr Opin Infect Dis 2006; 19 26–32.
CrossRef | PubMed |

[12] Read TR,  Hocking J,  Sinnott V,  Hellard M. Risk factors for incident HIV infection in men having sex with men: a case-control study. Sex Health 2007; 4 35–9.
CrossRef | PubMed |

[13] Crawford JM,  Kippax SC,  Mao L,  Van D,  Prestage GP,  Grulich AE, et al. Number of risk acts by relationship status and partner serostatus: findings from the HIM cohort of homosexually active men in Sydney, Australia. AIDS Behav 2006; 10 325–31.
CrossRef | PubMed |

[14] Crawford JM,  Rodden P,  Kippax S,  Van D. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS 2001; 12 164–70.
CrossRef | PubMed |

[15] Kippax S,  Noble J,  Prestage G,  Crawford JM,  Campbell D,  Baxter D, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS 1997; 11 191–7.
CrossRef | PubMed |

[16] Guzman R,  Colfax GN,  Wheeler S,  Mansergh G,  Marks G,  Rader M, et al. Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men. J Acquir Immune Defic Syndr 2005; 38 82–6.
CrossRef | PubMed |

[17] Mao L,  Crawford JM,  Hospers HJ,  Prestage GP,  Grulich AE,  Kaldor JM, et al. “Serosorting” in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. AIDS 2006; 20 1204–6.
CrossRef | PubMed |

[18] Poppen PJ,  Reisen CA,  Zea MC,  Bianchi FT,  Echeverry JJ. Serostatus disclosure, seroconcordance, partner relationship, and unprotected anal intercourse among HIV-positive Latino men who have sex with men. AIDS Educ Prev 2005; 17 227–37.
CrossRef | PubMed |

[19] Xia Q,  Molitor F,  Osmond DH,  Tholandi M,  Pollack LM,  Ruiz JD, et al. Knowledge of sexual partner’s HIV serostatus and serosorting practices in a California population-based sample of men who have sex with men. AIDS 2006; 20 2081–9.
CrossRef | PubMed |

[20] Parsons JT,  Schrimshaw EW,  Wolitski RJ,  Halkitis PN,  Purcell DW,  Hoff CC, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS 2005; 19 S13–25.
PubMed |

[21] Van D,  Prestage G,  French J,  Knox S,  Kippax S. Increase in unprotected anal intercourse with casual partners among Sydney gay men in 1996–98. Aust N Z J Public Health 1998; 22 814–18.
CrossRef | PubMed |

[22] McFarland W,  Caceres CF. HIV surveillance among men who have sex with men. AIDS 2001; 15 S23–32.
CrossRef | PubMed |

[23] Van D,  Rawstorne P,  Nakamura T,  Crawford J,  Kippax S. HIV treatments optimism is associated with unprotected anal intercourse with regular and with casual partners among Australian gay and homosexually active men. Int J STD AIDS 2002; 13 181–3.
CrossRef | PubMed |

[24] Van D,  Mao L,  Fogarty A,  Rawstorne P,  Crawford J,  Prestage G, et al. Undetectable viral load is associated with sexual risk taking in HIV serodiscordant gay couples in Sydney. AIDS 2005; 19 179–84.
PubMed |

[25] Clements MS,  Prestage G,  Grulich A,  Van D,  Kippax S,  Law MG. Modeling trends in HIV incidence among homosexual men in Australia 1995–2006. J Acquir Immune Defic Syndr 2004; 35 401–6.
CrossRef | PubMed |

[26] Manhart LE,  Aral SO,  Holmes KK,  Foxman B. Sex partner concurrency: measurement, prevalence, and correlates among urban 18–39-year-olds. Sex Transm Dis 2002; 29 133–43.
CrossRef | PubMed |

[27] Schwarcz S,  Scheer S,  McFarland W,  Katz M,  Valleroy L,  Chen S, et al. Prevalence of HIV infection and predictors of high-transmission sexual risk behaviors among men who have sex with men. Am J Public Health 2007; 97 1067–75.
CrossRef | PubMed |

[28] Prestage G,  Van D,  Grulich A,  Kippax S,  McInnes D,  Hendry O. Gay men’s casual sex encounters: discussing HIV and using condoms. AIDS Care 2001; 13 277–84.
CrossRef | PubMed |

[29] Van D,  Kippax S,  Crawford J,  Rawstorne P,  Prestage G,  Grulich A, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care 2002; 14 471–80.
CrossRef | PubMed |



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