Gay men report high rates of unprotected anal sex with partners of unknownor discordant HIV status

Objective: To examine patterns and factors that correlate with unprotected anal intercourse (UAI) practices among San Francisco gay men, including UAI with partners of unknown or different HIV antibody status. Design: A longitudinal cohort recruited for the San Francisco Young Men's H ealth Study in 1992; re-assessed annually. Participants and methods: A sample of 510 unmarried gay men who were 18 to 29 years at baseline were originally recruited as part of a larger populati on and referral-based sample. Subjects participated in four consecutive wav es of data collection. Results: The prevalence of reported unprotected anal intercourse (UAI) incr eased from 37% to 50% between 1993-1994 and 1996-1997. Almost half of all m en who reported UAI in 1996-1997 indicated that it occurred with a partner of unknown or discordant HIV antibody status. This high-risk practice corre lated with greater numbers of male sex partners, use of nitrite inhalants, sex in commercial sex environments, perceived difficulty controlling sexual risk-taking, and negative emotional reactions following UAI. Conclusions: These data on increasing rates of sexual risk-taking further c onfirm trends in sexual behavior previously suggested by rising rates of re ctal gonorrhea in this population. Additional and sustained prevention effo rts are urgently needed in light of the very high background rates of HIV i nfection found among gay men in San Francisco. (C) 1999 Lippincott Williams & Wilkins.