This article appeared in The National Post, Tuesday, January 11, 2000.
By Brad Evenson
Scientists fear that gay and bisexual men have been lulled into a false sense of security by anti-HIV drugs and are engaging in more unprotected sex and risky behaviour than any time since the early 1980s.
The results of a Vancouver study, published today in the Canadian Medical Association Journal, suggest a "disturbing trend toward increasing levels of unprotected anal intercourse."
Of the 681 young men in the study, 11 became HIV positive in the 14 months between their enrollment and follow-up by researchers last fall.
That equates to about 1.7 per 100 people over a one-year period. By far the greatest risk-9.5 per 100 people-was among men who exchanged sex money, goods or drugs.
The infection rate may have been even higher, as more than 40 men quit the study, and those who did so appeared to be the ones at higher risk of infection.
Nearly 10% of the remaining group reported having unprotected anal sex during this period.
While the overall rate of HIV incidence is declining in gay and bisexual men in North America, this does not carry through to those under 25. Paradoxically, the people most likely to become infected with HIV today were in Kindergarten when it was first observed in the early 1980s and heard about its dangers all their lives.
While an annual 1% to 2% incidence rate of HIV does not seem high, this can add up to a prevalence rate of 25% over 20 years, the study points out.
The Vancouver numbers reflect what doctors have observed in Ontario, where a reported 3.2 gay or bisexual men per 100 is infected each year.
In Montreal, the most recent figures are 1.3 per 100 people.
The chief reason, researchers say, is the optimistic notion that anti-retroviral drugs turn AIDS into a manageable chronic disease. "There was much more optimism about what the anti-retroviral therapy could do for people," said Robert Hogg, of the BC Centre for Excellence in HIV/AIDS in Vancouver.
As the so-called "cocktails" of drugs begin to fail some patients, they are forced to go on to highly active drug regimes, some swallowing as many as 150 pills per day.
New reports show that some of these drugs are toxic to liver cells and side-effects to include wasting, severe sores, and a disorder characterized by fat pooling on the back, known as the "buffalo hump."
"People have a false sense that if they get HIV, the drugs will save them," says Dr. Hogg
The study says sexual risk-taking may arise from feelings of fatalism and inevitability, a lack of direct experience with the AIDS epidemic or a desire to escape the rigorous standards of a lifetime of safer sex.
"A surprising proportion of the participants reported having anal sex with a man they knew at the time was HIV positive," the study says.
"This was especially true among those who became HIV positive
during follow-up, who more commonly reported unprotected sex with
both regular and casual partners."
For more information, contact:
Vanguard Project Coordinator
608 - 1081 Burrard Street
Vancouver, BC, Canada, V6Z 1Y6