27 per cent of HIV positive gay and bisexual men may not know they are infected

Up to 27 per cent of gay and bisexual men in Ontario who are HIV positive may not know they are infected, says a University of Toronto study.

The newly-released Ontario Men's Survey is a socio-behavioural and HIV prevalence study of self-identified gay and bisexual men, conducted by a team of researchers from U of T’s HIV Social, Behavioural and Epidemiological Studies Unit

The survey found discrepancies between self-reported HIV status and the results of voluntary saliva tests which indicate that up to 27 per cent of HIV-positive men may not know their true HIV status. However, HIV testing has become more common. About 80 per cent of gay/bisexual men in Toronto have been tested for HIV, compared to 65 per cent 10 years ago; in the rest of the province, it ranges from 73 to 82 per cent, compared to 60 per cent in the past.

“This survey offers an unprecedented snapshot of the Ontario gay/bisexual community and an updated baseline on the HIV status, the social lives and the sexual and health behaviours of its members,” said Myers, director of the HIV Social, Behavioural and Epidemiological Studies Unit, which is affiliated with the Departments of Public Health Sciences and Health, Policy, Management and Evaluation at U of T.

Researchers surveyed men across the province who identified themselves as gay or bisexual; data were collected during 2002 in 13 regions of Ontario. With a sample size of more than 5,000, the Ontario Men’s Survey is the largest study of gay and bisexual men ever undertaken in Canada. The study is also the first in-depth look at the gay/bisexual community in Ontario since a national survey in 1991.

The picture that emerges is one of a community that is racially and culturally diverse, more visible than it was a decade ago and more developed in terms of the social and community services it offers.

“The gay community has changed considerably since 1991,” said Myers. “Current data will help Ontario communities to be more targeted with HIV prevention and care programs.”

The survey data suggest a need for continuing education around safer sex issues. Twenty-five per cent of gay and bisexual men surveyed have participated in unprotected intercourse with a casual male partner at least once in the past three months, says Myers. At the same time, men appear to be aware of some of the risks. The research showed:

• The majority of respondents only reported participating in safer sexual activities.
• Men were less likely to have unprotected sex with casual partners than with regular partners.
• Both HIV-positive and HIV-negative men are more likely to have safer sex with partners they know to be or assume to be HIV positive. However, the men still base their decisions on assumptions, which may not be correct.

Awareness of safe sex practices also remains a concern, because condoms are not foolproof. About 14 per cent of men surveyed reported problems with condom slippage during the previous year; approximately the same number reported problems with condom breakage. More than half the men who had anal intercourse reported delaying application of a condom at least once during a sexual encounter.

Other key survey findings include:

• 60 per cent said gay bars are the preferred venue for seeking sexual encounters; 35 per cent look to the Internet, while 31 per cent visit bathhouses.
• There are regional differences among the Ontario gay/bisexual populations. For instance, men from urban areas, where gay bars are more plentiful, were more likely to visit these bars a few times a week (in Toronto, about 20 per cent and in Ottawa, about 18 per cent, compared to 13 per cent in Southern Ontario and seven per cent in Northern Ontario.
• More than 40 per cent of men surveyed had never known someone who died of AIDS.
• About 45 per cent of men surveyed never disclose their HIV status, either positive or negative, to a casual partner.

The survey was funded by the Ontario Ministry of Health and Long-term Care and by GlaxoSmithKline’s positive action fund and builds upon a longstanding university-community partnership.