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RESEARCH ARTICLE

Elevated reporting of unprotected anal intercourse and injecting drug use but no difference in HIV prevalence among Indigenous Australian men who have sex with men compared with their Anglo-Australian peers

Toby Lea A E , Michael Costello B , Limin Mao A , Garrett Prestage C , Iryna Zablotska C , James Ward D , John Kaldor C , John de Wit A and Martin Holt A

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

B Anwernekenhe National Aboriginal and Torres Strait Islander HIV/AIDS Alliance, Newtown, NSW 2042, Australia.

C The Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia.

D Baker IDI Heart & Diabetes Institute, Central Australia, Alice Springs Hospital, Alice Springs, NT, 0871 Australia.

E Corresponding author. Email: toby.lea@unsw.edu.au

Sexual Health 10(2) 146-155 http://dx.doi.org/10.1071/SH12097
Submitted: 28 June 2012  Accepted: 19 October 2012   Published: 1 February 2013

Abstract

Background: Although half of the HIV notifications among Aboriginal and Torres Strait Islander people (‘Indigenous Australians’) are attributed to homosexual transmission, there has been little research examining sexual and drug use risk practices among Indigenous Australian men who have sex with men (MSM). Methods: Respondents were Indigenous Australian (n = 1278) and Anglo-Australian men (n = 24 002) participating in the routine cross-sectional Gay Community Periodic Surveys conducted in Australia from 2007 to 2011. Sociodemographic characteristics, sexual risk practices, drug use, HIV testing and HIV status of Indigenous and Anglo-Australian men were compared and evaluated to discover whether Indigenous status was independently associated with HIV risk practices. Results: Although an equivalent proportion of Indigenous and Anglo-Australian men reported being HIV-positive (9.6%), Indigenous MSM were more likely to report unprotected anal intercourse with casual partners in the previous 6 months (27.9% v. 21.5%; Adjusted odds ratio (AOR) = 1.29, 95% confidence interval (CI): 1.11–1.49). Indigenous men were more likely than Anglo-Australian men to report use of several specific drugs and twice as likely to report injecting drug use in the previous 6 months (8.8% v. 4.5%; AOR = 1.43, 95% CI: 1.11–1.86). Conclusions: Despite a higher proportion of Indigenous men reporting sexual and drug use practices that increase the risk of HIV transmission, there were no differences in the HIV status of Indigenous and Anglo-Australian men. However, the elevated rates of risk practices suggest that Indigenous MSM should remain a focus for HIV prevention, care and support.

Additional keywords: Aboriginal, Gay Community Periodic Survey, men who have sex with men, sexual risk.


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