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Gay Men & Sexual Health in Scotland Lisa Williamson MRC Social and Public Health Sciences Unit

Gay Men & Sexual Health in Scotland Lisa Williamson MRC Social and Public Health Sciences Unit 11 June 2008. Gay men & sexual health. Men who have sex with men (MSM) are most at risk of acquiring HIV in the UK Increases in HIV and other sexually transmitted infections (STIs) in recent years

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Gay Men & Sexual Health in Scotland Lisa Williamson MRC Social and Public Health Sciences Unit

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  1. Gay Men & Sexual Health in Scotland Lisa Williamson MRC Social and Public Health Sciences Unit 11 June 2008

  2. Gay men & sexual health • Men who have sex with men (MSM) are most at risk of acquiring HIV in the UK • Increases in HIV and other sexually transmitted infections (STIs) in recent years • Increases in sexual risk behaviour • unprotected anal intercourse (UAI) with two or more partners • UAI with casual partners • UAI with partners of unknown/discordant HIV status

  3. Sexual risk behaviour

  4. Infectious syphilis, rectal gonorrhoea & HIV in MSM, Scotland, 1996-2007 & % MSM reporting UAI with casual partners in MRC bar surveys 19.7 19.7 19.7 18.6 18.6 18.6 10.7 11.2 10.7 11.2 10.7 11.2 11.2 10.7 Data source: STISS, NESISS & HIV Bar survey data : Hart GJ & Williamson LM, STI 2005

  5. HIV testing • HIV testing in GUM clinics increased by 101% between 2001 and 2005 • In 2005, 77% of MSM were offered and accepted an HIV test • Reported HIV testing increased from 51% in 1996 to 60% in 2005 in MRC bar-based surveys (recent testing increased from 26% to 39%) • Estimated 32% of HIV positive MSM in the UK are unaware of their infection

  6. Undiagnosed HIV infection • Anonymous, unlinked HIV prevalence study shows there are higher rates of HIV among men who decline testing • Stigma remains a significant barrier to HIV testing • In the 2005 MRC survey, 42% of HIV positive men were undiagnosed – over half had previously tested negative • Need to increase regularity of HIV testing • Estimated that one half of new HIV infections originate from people unaware of their positive status

  7. Sexual risk & HIV status among gay men in UK (5 cities) Source: Williamson et al, AIDS 2008; 22:1063-1070

  8. Gay men living with diagnosed HIV Among men diagnosed HIV positive over one year ago • 18% reported only having UAI with casual partners of the same HIV status • 32% reported UAI with partners of unknown or discordant HIV status • 48% reported having another STI in the 12 months leading up to the survey • Higher likelihood of UAI with two or more partners than among men diagnosed more recently • Maintenance of safer sex may be problematic Source: Williamson et al, AIDS 2008; 22:1063-1070

  9. Implications for HIV/STI prevention • Increases in HIV / other STIs among MSM in Scotland • Significant minority of gay men in community surveys continue to report high risk sexual behaviours • Encourage regular, repeat HIV testing / STI screening among men reporting high risk sexual behaviours • Need for behavioural interventions to reduce sexual risk among men living with diagnosed HIV, as well as among HIV negative men at high risk of seroconversion

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