Gay Men's Sexual Health Survey

The Gay Men's Sexual Health Survey is led by Lisa McDaid and was designed with Paul Flowers (Glasgow Caledonian University) and Graham Hart (SPHSU and now University College London). The survey has been conducted every three years since 1996. Since 2005, we have collected oral fluid samples to be tested anonymously for HIV to improve the estimate of HIV prevalence and undiagnosed infection in this population.

Current Research

A 6th wave of data collection was carried out in May 2011. We surveyed 1513 men in gay bars and saunas in Glasgow and Edinburgh; 1216 provided oral fluid samples to be tested for HIV. The aim of the 2011 survey is to assess prevalence of HIV, undiagnosed infection and sexual risk behaviour, and specifically examine associations between alcohol and drug use and HIV risk. We will also explore the frequency of HIV testing and the extent to which going for an HIV test is becoming a routine health-seeking behaviour for gay men. Data are currently being analysed and the results will be available in late 2012.

Previous Findings

Findings from the 2008 survey have now been published. Almost half of the men surveyed reported a recent HIV test; a substantial increase from the previous survey in 2005. HIV prevalence was comparable in 2005 and 2008 (4.4% and 4.6%, respectively). Although there was also a decrease in undiagnosed HIV infection (from 42% in 2005 to 26% in 2008), there was no difference in this between men who had and had not tested in the year prior to the survey. Lower levels of undiagnosed infection among HIV-positive men tested in the past 6 months suggest the challenge now is to further increase the frequency of HIV testing.

The men surveyed in 2008 reported relatively high levels of contact with HIV prevention activities. 73% obtained free condoms from a gay venue or the Internet, 51% reported accessing sexual health information, 14% reported talking to an outreach worker and 8% reported participating in sexual health/HIV prevention counseling. Contact with HIV prevention activities was associated with frequency of gay scene use and either HIV or other STI testing in the past 12 months, but not with sexual risk behaviours. Offering combination prevention, including outreach by peer health workers, increased uptake of sexual health services delivering behavioural and biomedical interventions, and supported by social marketing to ensure continued community engagement and support, could be the way forward.

We also asked men about their willingness to participate in future HIV prevention research. Over three quarters were willing to participate in some form of research, 65% for an HIV vaccine, 57% for a behaviour change study, and 53% for a rectal microbicides (an antiretroviral gel applied before sex). Willingness to participate in circumcision research was particularly low (14%). There were no associations between sexual risk behaviour and willingness, suggesting recruitment of high-risk men, who have the potential to benefit most from such research, is likely to be more challenging.

Publications