PREVALENCE OF HIGH-RISK SEX AMONG HIV-POSITIVE GAY AND BISEXUAL MEN -A LONGITUDINAL ANALYSIS

Introduction: This longitudinal study examined the prevalence and demo graphic correlates of unprotected insertive and receptive anal interco urse among HIV-positive gay and bisexual men who were aware of their s erostatus. Methods: Participants (n = 395), sampled randomly at two HI V outpatient clinics in Los Angeles, completed two waves of self-admin istered questionnaires (separated by approximately 7-9 months) that me asured sexual behaviors in the previous 60 days. Results: The cross-se ctional prevalence of unprotected insertive anal intercourse was 11.2% at time 1 and 7.1% at time 2. Longitudinal analyses indicated that ne arly 15% of the participants had engaged in that high-risk behavior ei ther at time 1 or time 2 and approximately 4% had engaged in the behav ior at each time period. Similar rates of unprotected receptive anal i ntercourse were observed. These high-risk activities were more prevale nt with seropositive and unknown serostatus partners than with seroneg ative partners. The rate of anal intercourse risk behaviors was higher among asymptomatic men and among those who were exclusively gay. Conc lusion: The findings demonstrate considerable differences in the preva lence of stable and occasional high-risk sexual behaviors among HIV-po sitive gay and bisexual men. Simple cross-sectional analyses cannot ca pture the stability or variation in behavior across time and, thus, ma y generate misleading conclusions about disease transmission, especial ly if the partner's HIV serostatus is not considered in the analysis. The findings indicate a need for focused safer-sex interventions for s eropositive men. The HIV outpatient clinic is an ideal setting for suc h interventions.