| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
LETTER |
At the time of the study, Sanny Y. Chen was with the Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, and the San Francisco Department of Public Health, San Francisco, Calif. Willi McFarland, Mitchell H. Katz, Sandra K. Schwarcz, Timothy A. Kellogg, and Jeffrey D. Klausner were with the San Francisco Department of Public Health. Steven Gibson was with the Stop AIDS Project, San Francisco, Calif. James W. Dilley is with the AIDS Health Project, University of California, San Francisco.
Correspondence: Requests for reprints should be sent to Willi McFarland, MD, PhD, 25 Van Ness Ave, Suite 500, San Francisco, CA 94102 (e-mail: willi.mcfarland{at}sfdph.org).
We recently reported on worrisome increases in sexual risk behavior, sexually transmitted diseases (STDs), and HIV incidence among men who have sex with men (MSM) during a period of increasing use of highly active antiretroviral therapy (HAART), from 1994 to 1999.1 We have since obtained data on sexual risk behavior for 2000 and 2001. In addition, we have added to our surveys questions on whether unsafe sex was occurring with partners of unknown HIV serostatus, updated trends in male rectal gonorrhea, and provided data on primary and secondary syphilis cases among MSM.
As previously reported, the Stop AIDS Project conducts serial cross-sectional surveys of MSM in a variety of community settings in the course of outreach health education. The street-based intercept survey asks questions about sexual behavior in the preceding 6 months, including anal sex, condom use, number of sexual partners, and knowledge of partners’ HIV serostatus.
Overall, 10 568 MSM completed the survey between 1999 and 2001. The proportion of MSM reporting any anal sex in the last 6 months increased from 67% in 1999 to 74% in 2001 (Figure 1a
). The proportion of respondents reporting any unprotected anal sex increased from 32% to 38%, with a parallel increase from 18% to 23% in the proportion reporting unprotected anal sex with 2 or more partners (Figure 1b). Between 1999 and 2001, the proportion reporting unprotected anal sex with 2 or more partners of unknown HIV serostatus increased from 10% to 15% for respondents who reported being HIV-negative and from 19% to 25% for those who said they were HIV-positive (Figure 1c). Although a decline in the number of respondents was noted from 1999 to 2001, there were no substantial shifts in respondents’ age or race over time and no differences in trends in sexual risk behavior within demographic groups.
|
). The number of primary and secondary syphilis cases among MSM increased from only 6 cases in 1998 to 115 cases in 2001. We conclude that the increases in unsafe sex seen from 1994 to 1999, in association with the availability of HAART, were not isolated but rather reflect an ongoing trend. Moreover, data on HIV serostatus of partners suggest that much of this unsafe sex is occurring among partners who are serodiscordant.
Reference
1. Katz MH, Schwarcz SK, Kellogg TA, Klausner J, Dilley JW, Gibson S, McFarland W. Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men in San Francisco. Am J Public Health 2002;92:388–394.
This article has been cited by other articles:
|
|
 |
|
  W. T. Steward, E. D. Charlebois, M. O. Johnson, R. H. Remien, R. B. Goldstein, F. L. Wong, and S. F. Morin Receipt of Prevention Services Among HIV-Infected Men Who Have Sex with Men Am J Public Health, June 1, 2008; 98(6): 1011 - 1014. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Sarna, S M F Luchters, S Geibel, S Kaai, P Munyao, K S Shikely, K Mandaliya, J van Dam, and M Temmerman Sexual risk behaviour and HAART: a comparative study of HIV-infected persons on HAART and on preventive therapy in Kenya Int J STD AIDS, February 1, 2008; 19(2): 85 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. O Aral, K. A Fenton, and K. K Holmes Sexually transmitted diseases in the USA: temporal trends Sex. Transm. Inf., July 1, 2007; 83(4): 257 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Holtgrave, J. F. McGuire, and J. Milan Jr The Magnitude of Key HIV Prevention Challenges in the United States: Implications for a New National HIV Prevention Plan Am J Public Health, July 1, 2007; 97(7): 1163 - 1167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Schwarcz, S. Scheer, W. McFarland, M. Katz, L. Valleroy, S. Chen, and J. Catania Prevalence of HIV Infection and Predictors of High-Transmission Sexual Risk Behaviors Among Men Who Have Sex With Men Am J Public Health, June 1, 2007; 97(6): 1067 - 1075. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. I. Hall, R. H. Byers, Q. Ling, and L. Espinoza Racial/Ethnic and Age Disparities in HIV Prevalence and Disease Progression Among Men Who Have Sex With Men in the United States Am J Public Health, June 1, 2007; 97(6): 1060 - 1066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H-H M Truong, T Kellogg, J D Klausner, M H Katz, J Dilley, K Knapper, S Chen, R Prabhu, R M Grant, B Louie, et al. Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex. Transm. Inf., December 1, 2006; 82(6): 461 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Aynalem, L Smith, C Bemis, M Taylor, K Hawkins, and P Kerndt Commercial sex venues: a closer look at their impact on the syphilis and HIV epidemics among men who have sex with men Sex. Transm. Inf., December 1, 2006; 82(6): 439 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Sethi, B M Holden, J Gaffney, L Greene, A C Ghani, and H Ward HIV, sexually transmitted infections, and risk behaviours in male sex workers in London over a 10 year period Sex. Transm. Inf., October 1, 2006; 82(5): 359 - 363. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. LaFond and S. A. Lukehart Biological Basis for Syphilis Clin. Microbiol. Rev., January 1, 2006; 19(1): 29 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. V. Chin-Hong, E. Vittinghoff, R. D. Cranston, L. Browne, S. Buchbinder, G. Colfax, M. Da Costa, T. Darragh, D. J. Benet, F. Judson, et al. Age-Related Prevalence of Anal Cancer Precursors in Homosexual Men: The EXPLORE Study J Natl Cancer Inst, June 15, 2005; 97(12): 896 - 905. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Trends in Primary and Secondary Syphilis and HIV Infections in Men Who Have Sex With Men--San Francisco and Los Angeles, California, 1998-2002 JAMA, August 25, 2004; 292(8): 917 - 918. [Full Text] [PDF]
|
|
|
|
|
|
N. Crepaz, T. A. Hart, and G. Marks Highly Active Antiretroviral Therapy and Sexual Risk Behavior: A Meta-analytic Review JAMA, July 14, 2004; 292(2): 224 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Increases in HIV Diagnoses--29 States, 1999-2002 JAMA, January 28, 2004; 291(4): 417 - 419. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Potts and J. Walsh Tackling India's HIV epidemic: lessons from Africa BMJ, June 19, 2003; 326(7403): 1389 - 1392. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
