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(Vancouver) Young gay and bisexual men were far more likely to use condoms in the mid-1990s than they were in the mid-1980s, Vancouver researchers have found. Condom usage in the gay community, which began in the early 1980s in response to the AIDS crisis, has been successful in dramatically reducing HIV infection rates among gay and bisexual men in Vancouver.
These findings were published in the latest issue of the journal AIDS, in a paper entitled "Comparison of sexual behaviours, unprotected sex and substance use between two independent cohorts of gay and bisexual men," by Kevin Craib and colleagues of the BC Centre for Excellence in HIV/AIDS.
"As an epidemiologist, any infections occurring in a population is cause for concern," says Kevin Craib, "but the comparative analysis we've done shows that there's been a vast reduction in rates of HIV infection within the Vancouver gay community from one decade to the next, which can largely be attributed to increased condom usage."
Craib compared data from two longitudinal cohorts of gay and bisexual men: the Vancouver Lymphadenopathy-AIDS Study (VLAS), which ran from 1982 to 1998, and the Vanguard Project, an ongoing study which began in 1995.
In this particular analysis, which was restricted to men 18 to 30 years of age at the time each study was conducted, the sexual practices and HIV results of 263 VLAS participants from 1985 to 1988 were compared with those of 235 Vanguard participants from 1995 to 1998.
The comparison between the two studies showed that young gay and bisexual men in the mid-1990s reported a higher average number of sexual partners than men in the same age group a decade prior, and were more likely to engage in anal sex than their earlier counterparts.
Nonetheless, the men in the later cohort were much less likely to become infected with HIV, which can be attributed to markedly higher condom usage in the '90s. Men in the mid-1980s were 10 to 20 times more likely to report never using condoms during anal sex with casual partners, and those in the '90s were more likely to report always using condoms.
After adjusting for differences between the two cohorts, members of the earlier cohort were nine times more likely to report high-risk sexual behaviour, and four times more likely than the later cohort members to become infected with HIV.
Despite the decline in infection rates in this population, further prevention efforts are needed, the researchers say. Young gay and bisexual men continue to report high-risk behaviours and new cases of HIV infection are still being seen in this population.
This research would not have been possible without the enormous contribution of hundreds of volunteers in the VLAS and Vanguard Project.
Research is ongoing with participants in the Vanguard Project, in which over 900 young gay and bisexual men have been recruited to participate. Participants have annual HIV tests, submit blood samples and complete self-administered questionnaires on sexual behaviours, substance use, demographic information and life experiences. Eligible participants are gay and bisexual men between the ages of 15 and 30 who live in the Lower Mainland.
From 1982 to 1998, the Vancouver Lymphadenopathy-AIDS Study followed a cohort of over 700 gay men aged 18 to 75, who were recruited through the offices of six Vancouver physicians. Originally biannually and subsequently on an annual basis, VLAS participants completed questionnaires, had medical exams and submitted blood samples for HIV testing and storage.
The objective of both studies was to monitor the rate of HIV infection in this population and to examine the social determinants of risk behaviour. Funded by Health Canada's National Health Research and Development Programme, the studies are projects of the BC Centre for Excellence in HIV/AIDS at St. Paul's Hospital, in cooperation with the University of British Columbia.
For more information, contact:
Vanguard Project Coordinator
608 - 1081 Burrard Street
Vancouver, BC, Canada, V6Z 1Y6