Substance use and unsafe sex amongst homosexual men in Edinburgh

A self-reported behaviour survey using an anonymous critical incident based questionnaire was administered by trained interviewers in 1998. Five hundr ed and thirty-one homosexual and bisexual men were recruited from gay bars, clubs, cafes, a sauna and 'cruising ground' in central Edinburgh. The use of alcohol and recreational drugs and details of sexual activity over the p receding three months and at the last sexual encounter were recorded. Unsaf e sex was defined as anal sex without the use of a condom with a partner of unknown or different HIV status. Safer sex was defined as all other types of sex, including anal sex with a condom and anal sex without a condom with a partner whose HIV status was known to be the same. Of the questionnaires completed, 506 were suitable for analysis; 29 men (6.1%) reported anal sex with a partner of unknown or different HIV status without a condom ('unsaf e sex') during their last sexual encounter. A total of 53 men (10.5%) could recall an episode of unsafe sex within the last three months. Men who had used marijuana or inhaled nitrites ('poppers') less than two hours before s ex, or whose sexual partners had done so, were more likely to have unsafe s ex than those who had not. Although alcohol use was more likely before sex with casual partners, the use of alcohol less than 2 hours before sex was n ot associated with sex being unsafe.