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A MOSTLY INTERNET-BASED BEHAVIORAL SURVEY AMONG MSM IN THE CZECH REPUBLIC

A MOSTLY INTERNET-BASED BEHAVIORAL SURVEY AMONG MSM IN THE CZECH REPUBLIC. Procházka, I., Novotný, J., Kaňka, P., Janík, D. Czech AIDS Help Society, Charles University, Prague . Homosexuality and HIV/AIDS.

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A MOSTLY INTERNET-BASED BEHAVIORAL SURVEY AMONG MSM IN THE CZECH REPUBLIC

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  1. A MOSTLY INTERNET-BASED BEHAVIORAL SURVEY AMONG MSM IN THE CZECH REPUBLIC Procházka, I., Novotný, J., Kaňka, P., Janík, D. Czech AIDS Help Society, Charles University, Prague

  2. Homosexuality and HIV/AIDS • The Czech republic – low HIV prevalencecountry (similar epi pattern like SK, H, SLO) • Male homosexual behaviour – the dominant mode of HIV transmission in the Czech republic (about 500 cases (+12 IDUs+HS) from cca 950 of all HIV cases – 53 percent and the rate is increasing)

  3. Method • Aim of the study: To estimate knowledge, attitudes and behavior related to HIV among Czech MSM • Anonymous questionnaires (interactive) published in web gay pages (incl. chat pages) and in gay journal • 43 items (6-demographic, 9-knowledge, 7-attitudes, 21-behavioral) • Behavioral items mostly related to the previous 12 months period

  4. Sample • 774 respondents – 3 % (n-27) from journal • Age: 14-65 years (x-26) • Education: 56% high school, 29% university degree • Residency: 41% Prague, 32% bigger cities • Household: 46% alone, 35% with partner • Identity: 79% HS-gay, 17% Bi, 3% HT • HIV status: 62% neg., 37% ?, 4 men HIV+

  5. Results – sex with men • Any sex with other man in the previous year • 89 % (1: 23%, 2-5: 39%, 6-10: 12%, 11-20: 7%, over 20: 7%) Number of partners has increased with the age and HS identity. 81% of MSM with stable partner (longer than one year) had more than one partner

  6. Results - anal sex with man 71% (1: 33%, 2-5: 29%, 6-10: 5%, 11-20: 2%, over 20: 2%) • Less frequent among younger and older men, from smaller towns and villages, more common among men living in partnerships

  7. Results – UAI with man • 54% (1: 36%, 2-5: 16%, over 5: 3%) • UAI more frequent among less educated, living in partnerships and from bigger cities

  8. Results - heterosexual partners • Any heterosexual partner • 17% (1:11%, 2-5:6%, over 6: 1%) • More frequent among older men, Bi, from smaller towns

  9. Results – oral sex with man • Oral sex = safer sex, if without ejaculation (half of our sample estimated it as high risk behavior) • Oral sex with ejaculation • 59% (1: 37%, 2-5: 17%, over 5: 5%) • More frequent among younger, less educated men, living in partnership and with HS identity

  10. Results – casual sex • Casual partner • 60% (1: 18%, 2-5: 27%, 6-10: 8%, 11-20: 4%, over 20: 4%) More frequent among older men, from bigger cities, and living in partnerships !?

  11. Results - Casualpartner with riskiersex • 32% (1: 15%, 2-5: 12%, over 5: 5%) • More frequent among older and younger men, less educated, living in partnerships !?, higher perception of condom´s rejection by partner

  12. Results – HIV tests • Ever have been tested for HIV • 52% (from them 33% in the last year) • The proportion has increased with the age (the exception is the oldest group over 40), university education, HS identity, among men living in partnerships, from bigger cities and with higher No. of partners and riskier behavior (but not with casual partner). • Knowledge of partner´s HIV test • 45% of MSM having partner • More common among more educated, living in partnerships, from Prague, with HS identity.

  13. Estimation of behavioral risks • Very high risk – UAI with more than one partner – 18% • High risk – UAI with one partner (but not stable and/or did not know his HIV test´s result) • - Ejaculation into mouth with more than one partner - 27% • Moderate risk – UAI with one partner and knowledge his HIV test or no UAI but ejaculation into mouth with one partner – 24% • Very low risk – No UAI, no ejaculation into mouth – 29% • Estimation reflects the externality/internality of control locus.

  14. Conclusions • The proportion of promiscuous behaviour (the number of partners) is lower. It is not so high among Czech MSM (in comparison with WE countries and USA) but the frequency of UAI is higher (similar to H, PL- Csépe, Izdebski). • Nevertheless one fifths of MSM have high risk behavior (UAI with more partners). • Partnerships are insufficient barriers of HIV transmission. They are related to risky behavior and relatively common unfaithfulness (even with risky behavior) within them (especially in the bigger cities) and unknown HIV status of partner.

  15. Conclusions 2 • Education did not influence the number of partners but the accepted level of risk. • The riskier behavior among younger MSM is related to oral sex with ejaculation, not to higher level of UAI. • The HIV testing has increased in the last years but has not reached the level from WE countries. • The homosexual HIV transmission has increased by 20-30 percent in the each of the last two years.The preventive strategies fail in higher HIV prevalence in the community.

  16. Recommendations • To continue in the preventive efforts within the gay community, especially to increase the level of individual perception of risk and social norms of healthy lifestyles • To improve the offer for gay-friendly HIV VCT sites especially in the rural areas • To doubt the safety of UAI within stable and „faithful“ partnerships

  17. Thank you for your attention

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